 Abdominoplasty
Better known as "tummy-tuck", the procedure removes unwanted skin and fat, tightens the muscles around the lower abdominal wall, and, by changing for the better the shape and size of the abdomen, does away with "pot belly". Why is it necessary?
Losing excess weight often leaves the dieter happier - but with stretched flabby skin around the abdomen which can easily be removed. Another person may be forever battling with an excess of weight. Whilst not wanting to slim, they nonetheless may be bothered by the low abdominal apron-like skin and fat overload. This often causes an unhygienic fold, which may become mildly infected and, particularly in summer, lead to a bad odour. Another candidate for abdominoplasty is often a woman after childbirth being left with a pot-belly. Caused by distension of the skin and abdominal muscle during the pregnancy, this can be accentuated by excessive fat. On the surface of the skin, one can often see striae. This is on the longitudinal areas where the most superficial layer of the skin seems to have broken apart following distension and hormonal influences during pregnancy. Genetics too, are a factor in striae occurring. This however, cannot be removed by an abdominoplasty procedure. Following corrective abdominoplasty, one's shape is slimmer and smoother and the waistline smaller. After surgery, a permanent horizontal scar of between 15 to 30 cms just above the pubic area will remain. In cases of extended surgery, a second vertical scar may be necessary. See also under liposuction The Surgery
When major aesthetic surgery is required, this is carried out under a general anaesthetic with the need for at least one night in hospital. Drains are inserted to evacuate any blood or fluid collection under the wound during that first night. Small, below-the-navel abdominoplasties can however be carried out using local anaesthetic and sedatives, without the need for an over night stay. Apart from the scarring mentioned above, in extensive abdominoplasty surgery the umbilicus is freed from its skin tissue and re-fixed in its re-aligned location where a scar will be seen. Deep under the abdominal skin, the surgeon may opt to narrow the musculature via stitches. This, together with the removal of excess skin, is another way of eliminating the pot belly. Healing
Although usually uneventful, odd setbacks do occur particularly amongst smokers and the overweight. Pain varies from patient to patient but the immediate post-operative pain lessens into tenderness. After surgery the abdominal wall may well feel tight, which also eases off. Scar tissue can cause irritation. Stitches are removed after 2-3 weeks. Convalescence
Office work can be resumed soon after surgery. After the stitches are removed, the patient can move around more or less normally. Manual labour however needs a longer rest period. After six weeks, the abdominal wall is once more strong and all activities can be cautiously resumed. It may take some 3 months before all the sensations of the surgery disappear. Complications
In this surgery, many small blood vessels are divided, reducing circulation to the suture line. This can lead to necrosis whereby part of the stretched and thinned skin and fat layer is lost, leaving an open wound which may take several weeks to heal and may require further corrective surgery. The suture line may also cause minor irritation. Surgery is therefore carefully carried out so that no undue strain is placed on the tissue or the circulation. The greatest risk of complication following surgery is, as ever, run by smokers, diabetics and the overweight! Minimal liposuction procedure can compliment abdominoplasty, but extensive liposuction should never be used other than well in advance of the surgery, or at a much later time. Fluid and blood can collect within the wound - even if drainage is used. A small deposit of fluid is of no consequence but larger amounts have to be removed. The result
Abdominoplasty results are varied. The most rewarding case is when a huge fold of skin and fat is removed and with it the skin irritation and foul smell. The pot belly removal is rewarding but not always so evident. Scars are unavoidable. The more skin removed, the longer the scar. Although the surgeon does all possible to hide the scar under a bikini or beneath a bathing suit, with modern fashions this is not always possible. Scars can initially be very red, they may be raised, and may be itchy but soon become acceptable - often very acceptable. |
