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Women and men who have loose abdominal skin and fat that
is concentrated in the abdomen can benefit from abdominoplasty.
Sometimes these conditions are inherited. In other instances,
substantial weight loss may cause abdominal skin to become
flaccid. Abdominoplasty also can tighten muscles that have
been separated and weakened by pregnancy. The procedure may
somewhat improve the appearance of stretch marks, especially
those located below the navel.
Am
I a good candidate for skin resurfacing?
Your Personal Consultation
During the consultation, you will be asked about the results you would
like to achieve from abdominoplasty. This will help your surgeon to understand
your expectations and determine whether they realistically can be achieved.
| You may be a good candidate for abdominoplasty if you
have one or more of the following conditions: |
| • |
excess or sagging abdominal skin |
| • |
an abdomen that protrudes and is out of proportion
to the rest of your body |
| • |
abdominal muscles that have been separated and weakened |
| • |
excess fatty tissue that is concentrated in your abdomen |
If you plan to become pregnant or lose weight in the future, you should
discuss this with your plastic surgeon. Scarring from previous abdominal
surgery may limit the results of your abdominoplasty.
How will my
plastic surgeon evaluate me for abdominoplasty?
Your plastic surgeon may examine your abdomen while you are standing as
well as lying down. Your skin tone and the degree of loose skin in the
abdominal region will be assessed. Your surgeon also will evaluate the
amount of excess fat in your abdomen and the condition of your abdominal
muscles.
You should come to the consultation prepared to discuss your medical history.
This will include information about any medical conditions, drug allergies,
medical treatments you have received, pregnancies, previous surgeries and
medications that you currently take. It is important for you to provide
complete information.
Will my insurance
help cover the cost of surgery?
Abdominoplasty, as an aesthetic (cosmetic) procedure, generally is not
covered by insurance. In some instances, however, a patient may have a
hernia and not just a spreading of the abdominal muscles. Insurance reimbursement
may be available for that portion of the procedure that is not cosmetic.
Many factors determine your eligibility for coverage, including the specific
terms of your insurance policy. A letter of predetermination may be required
by your insurance company prior to surgery. Your plastic surgeon or a staff
member in your surgeon's office will discuss these matters with you.
How Abdominoplasty Is Performed
Individual factors and personal preferences will determine the specific
technique selected to smooth and flatten your abdomen.
Where
are the incisions placed?
Generally, a horizontal incision is placed just within or above the pubic
area. The length of the incision, which extends laterally toward the pelvic
bones, depends largely on the amount of skin to be removed. The contour
of this incision will vary somewhat according to the structure of your
abdomen and the style of bathing suit or undergarments that you prefer.
Your plastic surgeon will try to keep the incision within your bathing
suit lines, but this may not always be possible.
Some patients have loose skin above the navel. In such cases, the surgeon
may make a second incision around the navel so that the redundant skin
above it can be pulled down. The excess abdominal skin is then removed.
The position of the navel remains unchanged.
Skin of the lower abdomen that contains stretch marks may be removed as
well. Any remaining stretch marks may be somewhat flattened and improved,
but you should not expect a dramatic change in their appearance. The procedure
may include tightening of the underlying abdominal muscles using sutures.
What
are some variations to the common abdominoplasty technique?
There are many variations both to the design of the incisions and the technique
itself. In some instances, it may be possible to avoid an incision around
the navel. When the amount of loose skin is minimal and the excess fat
deposits are located below the navel, a short horizontal incision is all
that is necessary. This procedure is called a partial, or "mini," abdominoplasty.
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| Generally, a horizontal incision is placed just
within or above the pubic area. If there is loose skin above the
navel, the surgeon may make a second incision around the navel. Skin
in the shaded area is separated from the abdominal wall. |
To tighten the abdominal wall, the surgeon brings
loose underlying tissue and muscle together with sutures. |
Sometimes liposuction may be used alone, or in conjunction with abdominoplasty,
to remove abdominal fat. Endoscopic abdominoplasty is another technique
for minimizing scars and may be useful when patients have only a mild degree
of excess fat and muscle laxity.
 |
Abdominal skin is pulled downward,
and the excess is removed. A small opening is made
to bring the navel through. |
Your plastic surgeon will discuss with you the particular method that he
or she recommends for achieving the best result in your particular case.
Understanding Risks
Fortunately, significant complications from abdominoplasty are infrequent.
Every year, many thousands of people undergo successful aesthetic surgery
of the abdomen, experience no major problems and are pleased with the results.
Anyone considering surgery, however, should be aware of both the benefits
and risks.
I understand
that every surgical procedure has risks, but how will I learn more so that
I can make an informed decision?
The subject of risks and potential complications of surgery is best discussed
on a personal basis between you and your plastic surgeon, or with a staff
member in your surgeon's office.
Some of the potential complications that may be discussed with you include
bleeding, infection and reactions to anesthesia. Tissue loss along portions
of the horizontal incision is a possibility when the abdominoplasty is
very extensive. This complication, which delays healing and prolongs recovery,
is more common in patients who smoke or have medical conditions such as
diabetes. Revisionary surgery is sometimes helpful in certain instances
where incisions may have healed poorly.
Following surgery, occasionally, fluid may accumulate under the skin. Removal
of this serum is a painless process but may require several visits to the
plastic surgeon's office.
You can help to lessen certain risks by following the advice and instructions
of your plastic surgeon, both before and after surgery.
Your Surgical Experience
The goal of your plastic surgeon and the entire staff is to make your surgical
experience as easy and comfortable for you as possible.
How should I
prepare for surgery?
If you are a smoker, you will be asked to stop smoking well in advance
of surgery. Aspirin and certain anti-inflammatory drugs can cause increased
bleeding, so you should avoid taking these medications for a period of
time before surgery. Your surgeon will provide you with additional preoperative
instructions.
Abdominoplasty may be performed on an outpatient basis. If this is the
case, be sure to arrange for someone to drive you home after surgery and
to stay with you for at least the next day or two. When abdominoplasty
is performed in conjunction with medically necessary procedures such as
hysterectomy or hernia repair, a short hospitalization may be required.
What will the
day of surgery be like?
Your abdominoplasty may be performed in a hospital, free-standing ambulatory
facility or office-based surgical suite.
Medications are administered for your comfort during the surgical procedure.
Often, a general anesthetic is administered, so that you will be asleep
throughout the procedure. Abdominoplasty may be performed using local anesthesia
and intravenous sedation. When surgery is completed, you will be taken
into a recovery area where you will continue to be closely monitored. In
many instances, small drain tubes will have been placed within the abdominal
tissues to help avoid accumulation of fluids. Gauze or other dressings
may be applied to your abdomen and covered with tape or an elastic bandage.
You may be permitted to go home after a few hours, unless you and your
plastic surgeon have determined that you will stay in the hospital or surgical
facility overnight.
How will
I look and feel initially?
The day after surgery, you will be encouraged to get out of bed for short
walks to promote blood circulation. Although you may not be able to stand
up completely straight, it is best if you do not sit for long periods of
time during the first several days. Straining, bending and lifting must
be avoided, since these activities might cause increased swelling or even
bleeding. You may be instructed to sleep on your back with a pillow under
your knees.
Any surgical drains probably will be removed within a week following surgery,
at which time your dressings may also be changed or removed. Depending
on the abdominoplasty technique used, you may be instructed to wear a support
garment for several weeks. Generally, stitches will be removed in stages
over a period of approximately one or two weeks.
You will notice swelling and bruising, which is to be expected. The bruising
and much of the swelling will disappear over a period of weeks. However,
it may be months before all swelling subsides and you see the final result
of your abdominoplasty. You may also notice some numbness over portions
of the abdominal area, and this may persist for several months. Incisions
will initially be red or pink in color. They will remain this way for many
months following surgery and may even appear to worsen before they finally
begin to fade.
When can I
resume my normal activities?
It is important to realize that the amount of time it takes for recovery
varies greatly among individuals. Depending on the extent of your abdominoplasty
and your general physical condition, you may be able to return to non-strenuous
work anywhere from one to three weeks after surgery. In many instances,
you can resume most of your normal activities, including some form of mild
exercise, after a few weeks. You may continue to experience some mild,
periodic discomfort and swelling during this time, but such feelings are
normal. Severe pain should be reported to your doctor.
Any sexual activity should be avoided for a minimum of two weeks, and your
plastic surgeon may advise you to wait longer.
Results of Your Abdominoplasty
Abdominoplasty will enhance your body contour by making your abdomen firmer
and flatter. You may find that you feel more comfortable in your clothing
and are more confident about your appearance.
The incisions from the procedure will heal and fade over time. It is important
to realize, however, that the incision lines will be permanently visible.
In some instances, they will eventually be only faint lines. Certain individuals
may have incision lines that are more noticeable. Fortunately, the incisions
for your abdominoplasty are usually in locations concealed by most bathing
suits and undergarments.
How long will
the results last?
Unless you gain or lose a significant amount of weight or become pregnant,
your abdomen should remain firmer and flatter for many years. However,
gravity and the effects of aging will eventually take their toll. If, after
a period of years, you again become dissatisfied with the appearance of
your abdomen, you may choose to undergo a second procedure to restore a
more youthful body contour.
Maintaining a Relationship with Your Plastic Surgeon
You will return to your plastic surgeon's office for follow-up care at
prescribed intervals, at which time your progress will be evaluated.
Please remember that the relationship with your plastic surgeon does not
end when you leave the operating room. If you have questions or concerns
during your recovery, or need additional information at a later time, you
should contact your surgeon. |
Content provided by The American Society
for Aesthetic Plastic Surgery (ASAPS).
For advertising info, please contact Terry McGovern terry.mcgovern@latimes.com at (213) 473-2599
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