Abdominoplasty (tummy tuck in English) is plastic surgery of the abdomen. It is an extensive surgical procedure, the aim of which is to remove excess fat from the core, sagging skin, strengthen the abdominal wall muscles and remove stretch marks and thereby reduce them. Such abdominal surgery significantly improves a person’s appearance and is also aesthetically beneficial – it ends with an excessively large or overhanging abdomen over pants or a skirt, difficulty bending over when standing up, unsightly folds, etc. Therefore, this procedure is prevalent, and hundreds of thousands worldwide undergo it yearly.
The procedure is suitable in the following cases:
- Sagging skin after weight loss or pregnancy
- Diagnosis: spacing of rectus abdominis muscles
- Abdominal wall permitted
- Abdominal shape change after pregnancy – the so-called dropped belly
- C-section scar
- Stretch marks
- Excessive fat in the abdomen and lower abdomen
The procedure is suitable for patients in good health, not those suffering from obesity. If the patient plans to lose weight, the operation should be postponed. Successes can be achieved even in elderly patients despite losing skin elasticity in old age.
Despite the loss of skin elasticity, abdominoplasty can significantly improve the abdomen’s appearance, even in older clients. Abdominal overhang is sometimes associated with diastasis, a functional disorder of the abdominal wall. With diastasis, the rectus abdominis muscle is spread apart, and the abdominal wall is relaxed. As a result, there is a gap (diastasis) between the muscles, which is the cause of a “protruding” or “hanging” abdomen. This problem can often be solved with physiotherapy. The proper exercise method can achieve great results even without surgery.
Therefore, with diastasis, it is always recommended to try exercise first and proceed to abdominoplasty only when there is no other option.
Suitable candidate
- has a stable weight for several months
- is at least one year postpartum and has not breastfed for a year
- does not smoke (at least six weeks before the operation)
- is physically healthy
- if he has scars on his abdomen from another operation, they are already healed
- has realistic expectations from the procedure and a positive attitude
Types of abdominoplasty
There are several approaches to solving the problem in the abdominal area; it depends on the patient’s specific situation, concerns, and expectations. In addition, scars, post-operative period, and results may vary with the type of approach.
Endoscopic abdominoplasty
It is intended for patients with diastasis recti and is minimally invasive.
Mini abdominoplasty
Here, the area of the lower or upper abdomen is corrected, where the border of the procedure is the navel. The process is shorter and is more likely to be recommended for younger patients whose abdominal muscles have spread.
Classic abdominoplasty
or abdominal lipectomy is a surgical procedure that removes fat and skin accumulated over time in the abdominal area; other procedures cannot remove that. This procedure strengthens the abdominal wall muscles, which relax after childbirth or long-term obesity. The result will be the desired effect of a flat stomach.
Lipoabdominoplasty
is a combination of abdominoplasty and liposuction; it is used especially when it is necessary to tighten the skin and at the same time to remove subcutaneous fat tissue or excess skin wall. The procedure may also include correction of the abdominal muscles.
Umbilicoplasty
is a plastic treatment of the umbilical scar. The operation is not complex, performed under local anesthesia, and the spot is inside the navel. In this operation, the surgeon does not move the navel but changes its shape. Most patients want the bulging navel to be retracted during the procedure.
Liposuction or abdominoplasty?
In the past, doctors did not recommend combining liposuction and abdominoplasty but carrying out the procedures separately – the Abdominoplasty procedure represents a more significant intervention in the body than liposuction. Both interventions are associated with inadequate blood supply to the abdominal wall, so plastic surgeons were concerned that, for example, necrosis could occur.
Nowadays, however, combining both procedures is used more often. Therefore, the approach combining abdominoplasty and liposuction is called lipo abdominoplasty in one word.
Modern ultrasound or laser liposuction devices make it possible to perform liposuction and abdominoplasty at the same time. This type of procedure produces excellent results.
Laser lipolysis reduces excess fat and stimulates the skin to begin the process of regeneration and production of collagen and elastic fibers. It is critical in the regeneration process to ensure that the skin remains as firm as possible after the double procedure. For this purpose, modern laser liposuction SlimLipo or ultrasonic liposuction VaserLipo is used.
When is liposuction enough?
Liposuction is a less invasive method than abdominoplasty and, unlike abdominoplasty, does not leave scars. It is especially recommended in cases where the excess skin is not very visible, and the skin itself is free of scars and stretch marks. Therefore, liposuction is often better for younger patients whose skin regenerates faster.
Discuss your expectations openly with the surgeon. He must be able to describe all the options and risks, including the limitations of each procedure. A tummy tuck is a significant operation, so take your time and don’t rush your decision. The process is performed under general anesthesia.
Before the procedure
For a positive procedure result and proper healing, it is essential to be in the best possible condition before the operation. For this reason, it is necessary to follow the surgeon’s recommendations so that your body and skin are ready for surgery and recovery. It is generally recommended to:
- Do not smoke
- Follow the recommended diet
- Use disinfectant soap on the body due to infection.
- Do not use aspirin or other medicines containing salicylates.
- Keep the skin hydrated
Some women may be advised to stop using birth control a month before abdominoplasty. This is because some patients must lose weight first to reach their ideal weight.
The course of the procedure
The operation lasts up to 4 hours, depending on the specific case. General anesthesia is used, and the patient usually spends the night in the clinic. In the case of mini abdominoplasty or liposuction of the abdomen, the procedure can be performed under local anesthesia and sedation. Mini abdominoplasty takes approximately 2 hours.
It is necessary to make a pre-operative examination and photographs of the area before the procedure will be taken, allowing for assessing the condition before and after.
In this procedure, an incision is made from one side of the pelvis to the other above the pubic hairline. The incision size depends on the amount of skin and fat that needs to be removed. The surgeon strengthens the muscles by pulling them together and sewing them into a new position during the procedure. The abdominal wall is maintained, and the waistline narrows. Excess skin is removed.
The surgeon closes the surgical wound in several layers, mostly with absorbable sutures. Then, suction drains are placed under the skin, and the abdominal wall is relieved with a compression bandage. It is possible to perform liposuction and liposculpture procedures simultaneously to make the resulting situation as good as possible. This procedure also removes stretch marks in the lower abdomen.
The scar that remains after this procedure is minor because it is placed in a suitable place. Over time, it can be smoothed out with a laser.
After two weeks, the patient can return to everyday life and, after six weeks, to sports and more physically demanding activities. The body is still recovering; the load must be added gradually. Specific appropriate exercises even help the wound to heal, increasing blood flow to the area and speeding up the process.
During this process, a compression garment is worn, exerting pressure and keeping the abdominal muscles and overall mass tight. Underwear is worn for 4 to 6 weeks. After the procedure, a diet regimen is suitable so that peristalsis is not burdened.
It is also recommended to care for the scar by massaging it, applying pressure with creams intended for it, and not exposing it to the sun.
The result of abdominoplasty
Actual results can be seen after several months, but the initial effect appears immediately after the procedure. The length and ability of healing are individual for each person. The scar develops for up to two years. The healing and recovery time is unique for each individual. However, the final results will be visible after one year, and the scar will develop over the next two years. The abdominoplasty results are permanent, even more so if the recommended diet and exercise are followed; however, fat may re-accumulate. Pregnancy and the aging process are also influencing factors.
Complications after abdominoplasty
Abdominoplasty is an extensive procedure, and a particular risk is always present.
Possible complications are:
- Abdominal asymmetry – asymmetrical location of the navel
- accumulation of tissue fluid in the subcutaneous tissue (seroma) – it is necessary to insert a drain and inject suction
- bruises
- keloid scars
- infection in the surgical wound
- bleeding
- loss of feeling in the operated area – this is often a temporary complication that arises from the interruption of superficial nerves
- opening of the wound – due to mechanical violence
- pseudocysts – a frequent, minor complication, the formation of small pockets filled with liquid
- alergic reaction
- necrosis
- vein thrombosis – possibility to prevent it by regular movement and to walk after surgery
- dissatisfaction with the result
