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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.
 |
 |
| 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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