Abdominoplasty: types, methods and cost
One of the most popular in the world, aesthetic operations is abdominoplasty or tummy tuck. This procedure consists of removing excess skin and subcutaneous fat from the abdomen. Having a perfect taut tummy even after childbirth or significant weight loss is an attractive idea for many. Especially when the visual results of successful abdominoplasty are demonstrated by Kim Kardashian, Britney Spears and Kate Gosselin, a reality show star and a mother – attention to eight children. Such an operation is also quite popular among men. For representatives of the stronger sex, the example of Al Pacino, who has thrown off those extra pounds and turned the “beer” belly into attractive forms with the help of abdominoplasty, can serve as an example.
What problems can solve plastic belly: minus the folds, plus the waist
Do not confuse abdominoplasty with liposuction. These are completely dissimilar operations designed to solve various problems.
Abdominoplasty allows you to cope with the following negative phenomena:
- stretching of the skin and loss of its elasticity after the birth of a large fetus or multiple pregnancies
- skin sagging due to significant weight loss
- an excess of the subcutaneous fat layer, from which it is impossible to get rid of in another way
- ptosis, i.e. sagging of the anterior abdominal wall
- diastasis, or divergence, as well as a strong stretching of the rectus abdominis muscles
- multiple stretch marks (striae), scars and scars from operations and injuries
- excess subcutaneous fat
- A hernia: umbilical, abdominal white line, inguinal.
The presence of one of these problems, and most often their combination, also becomes an indicator for carrying out a procedure of tummy tuck.
Abdominoplasty is not a way to combat obesity. This operation may be associated with liposuction, but by itself, the problem of excess weight does not solve.
Contraindications for Abdominoplasty
Since abdominoplasty is one of the most difficult plastic operations and is performed under general anesthesia, it has a fairly wide range of contraindications: both absolute and relative.
Absolute contraindications for abdominoplasty:
- autoimmune diseases
- inflammatory diseases in the acute phase
- acute and chronic heart failure
- breastfeeding period
- blood diseases in a patient or a relative
- obesity caused by endocrine pathologies.
- chronic diseases in remission
- the desire to have a baby – for women. After abdominoplasty skin on the abdomen becomes smaller, and the scar after the procedure is quite large, pregnancy can cause the appearance of large stretch marks, deformation of the abdomen after the birth of a child. Inelastic skin and the inability of the rectus muscles “to disperse” will not allow the stomach to “grow” forward, the increasing pressure of the fetus can cause a disturbance in the bowels and urinary system. Therefore, doctors strongly advise not to resort to surgery before delivery.
If no contraindications are identified, and the patient’s decision is unshakable, then it is time to prepare for the operation.
Preparation for the Abdominoplasty
The first stage of preparation is to consult with a plastic surgeon. He will clarify the reason for treatment, collect anamnesis to clarify possible contraindications, talk with the patient in order to determine his psychological state. It will also conduct a visual inspection of the anterior abdominal wall, determine the skin turgor, muscle tone, and thickness of the subcutaneous fat. As a result, the surgeon will say whether he will undertake the procedure. If the answer is yes, 3D modeling can be performed, the results of which predict the result of the operation.
Next, the patient will undergo the following studies
- blood chemistry
- clinical blood test
- tests to determine the group and Rh factor (if not previously conducted)
- blood test for HIV and RW
- general urine analysis
Two or three weeks before the operation, it is necessary to stop taking anticoagulants, that is, drugs that slow down the blood clotting process. These include “Warfarin”, “Fenian”, “Heparin”, acetylsalicylic acid, etc. If the reception cannot be canceled – you need to consult with a specialist. At the same time, it is worthwhile to start taking vessel-strengthening drugs.
Having received the results of tests, the patient again visits the surgeon and also consults with the anesthesiologist
The doctor may prescribe a special diet: it will help reduce body weight and clean the intestines as much as possible. During the month before the operation, you should refrain from alcohol and smoking. A week before abdominoplasty, it is worthwhile to limit the use of gas-promoting products, as well as fatty, sweet, starchy foods. A couple of days should reduce physical load, stop using decorative cosmetics. Doctors most often prescribe a light sedative: motherwort or valerian.
Come to the clinic need to fasting. Before the procedure, the specialist makes a markup on the patient’s body, then the anesthesiologist injects anesthesia.
Possible complications: what you need to know when deciding on an operation
Unfortunately, even the filigree work of a surgeon cannot 100% protection against the occurrence of complications. In most cases, the negative effects of the operation are caused either by an individual reaction of the organism or by a violation of the rehabilitation regime by the patient.
Local complications are more common. These include:
- Suppuration in the postoperative suture area. Suppuration occurs due to the violation of the rules of sterility during surgery or improper treatment of the seam.
- Seroma, ie accumulation of exudate in the wound. Causes: a loose fit of the wound edges, simultaneous liposuction with abdominoplasty. To minimize the risk of complications, be sure to wear compression underwear.
- Hematoma, or accumulation of blood in the soft tissues. A rather rare complication. Maybe caused by improper bleeding.
- Regional necrosis. Too stitched seams, excessive preparation of tissues – all this can lead to the insufficient blood supply to the edges of the seam and the death of soft tissues.
- Scarring. The appearance of scars can be associated with both the reaction of the organism and the low qualification of the surgeon who has sutured the wound.
In the list of common complications:
- Anemia due to massive blood loss during surgery.
- Abdominal compartment syndrome – increased intra-abdominal pressure. It causes excessive tension of the tissues of the anterior abdominal wall. Maybe caused by non-compliance with the rules of rehabilitation.
- Pulmonary edema caused by a previous factor – high abdominal pressure.
- Congestive pneumonia is dictated by the patient’s low mobility in the postoperative period.
- Thromboembolism. Clogged arteries with blood clots can occur due to irregular heartbeats, patient immobility and failure to wear compression underwear. In some cases, requires the appointment of anticoagulants.
Common severe complications are rare. If the surgeon complies with all the rules of the operation, and the patient – recommendations for recovery, such negative consequences should not arise.
How abdominoplasty is performed: methods of surgery
As we have said, abdominoplasty is a complex intervention that requires treatment under general endotracheal (gas) anesthesia. Depending on the complexity and volume of tissue removal, the procedure lasts from two to five hours. The method of operation is determined by the doctor depending on the nature of the defect and the degree of its development.
Classical tummy tuck
This operation is prescribed to patients with an “apron”, that is, sagging skin in the lower abdomen. The surgeon makes a horizontal incision above the groin area, as well as around the navel. Then the specialist removes excess subcutaneous fatty tissue and skin, connects the loose rectus muscles, corrects the white line of the abdomen, forms the umbilical hole. Next, the surgeon stitches. Such an operation is quite traumatic because during the procedure a large amount of tissue is usually removed.
Abdominoplasty through a vertical incision
In this case, the incision is not made above the pubis, but in the midline of the abdomen. In this case, the extra tissues are not moved downwards, but from the sides to the middle. Surgeons half-jokingly call this type of operation male, since in men the “fat trap” is often formed not at the bottom but at the top of the abdomen. This species is less traumatic than the previous one since the area of intervention is smaller. However, there is a minus: the scar from the seam cannot be hidden under the underwear.
Abdominoplasty combined with liposuction
In some cases, the patient may be shown a combination of two procedures: removal of adipose tissue, together with strengthening the abdominal muscles and excision of excess skin. Plus for the patient in need of only one time to transfer anesthesia, as well as in finding the desired forms after a single intervention. Usually performed when liposuction of the wound edges is required, or when liposuction is performed on the flanks of the abdomen. It should be borne in mind that the healing after the manipulation will be slower, and the risk of complications will increase.
This type of intervention is prescribed to patients with a pronounced problem of laxity of the skin of the lateral parts of the abdomen and loss of tone of the musculofascial system. During the procedure, the surgeon produces a tension of the abdominal wall not down, but down-sideways. Thus, the specialist gets the possibility of excision of skin patches from the sides, which contributes to the creation of a thin waist. The risk of seroma is minimized. Cons – stubborn seams.
This species is less invasive compared to previous ones. The surgeon makes a short incision in the bikini area and excises only a small part of the skin. Such an operation is suitable for patients with sagging skin and excess subcutaneous fat only in the lower abdomen. Transposition of the navel, as well as the connection of straight muscles, in this case, is not performed. This operation may be performed under local anesthesia.
After abdominoplasty, it is very important to follow all the recommendations of the doctor: this will minimize the risk of complications and facilitate the rehabilitation of the patient.
Recovery from an abdominoplasty
Depending on how extensive the intervention was, as well as on the individual characteristics of the body, rehabilitation after abdominoplasty may take from several weeks to several months.
After getting out of the state of general anesthesia, the patient may feel weak, nauseous, dizzy. Therefore, in the first day or two after the operation, bed rest is shown. Then the patient can sit down, but in bed, it is better to spend another three to five days – in the hospital or at home. With a significant amount of intervention, the doctor establishes a special drainage for drainage. It must be cleaned daily, following the recommendations of the surgeon. You also need to process the seams. The drainage tube is removed on day 2–5. The stitches are removed approximately on the 14th day after the operation. Water procedures can be carried out only with the permission of a specialist.
period of one and a half to two months after the operation, experts recommend sitting, lying down and even walking in a slightly bent position: this facilitates the process of tissue accretion, weakens their tension. Sleep better on the back, legs bent.
In the first weeks after abdominoplasty, anesthetics and antibiotics may be prescribed to the patient. After removing the stitches for the next 6–8 weeks, wearing special compression underwear or a corset is shown. In no case should this rule be neglected, otherwise tissues may grow together incorrectly, resulting in the formation of scars, blood clots, fibrosis, asymmetry of the abdomen. Also, the rejection of compression therapy is fraught with edema. For the prevention of stagnation during this period, you can do gymnastics according to the treatment program, walking. Exercise is prohibited until the sutures are completely healed (2–3 months).
The patient may notice numbness in the abdomen for several months. Then the sensitivity gradually returns. For six months after the operation, sunbathing, tanning should be avoided, follow the rules of fractional nutrition. Before taking any medication you should consult your doctor. After 6 months, the patient can begin to engage in sports and weight training
Evaluate the results
In addition to compliance with the rules of rehabilitation, the individual features of the body can affect the speed of manifestation and the quality of the result of abdominoplasty. Usually, after the disappearance of edema, that is, approximately 2 weeks after the operation, the patient can already evaluate their new forms.
The effect of the operation can be noticeable for many years after it, especially if a person makes an effort to keep himself in shape. Weight gain can negate the work of a plastic surgeon. Pregnancy also provokes repeated stretching of the abdominal muscles and sagging skin. In this case, you may need to repeat the procedure.
The abdominoplasty cost
- The price of abdominal correction, like any other plastic surgery, is affected by several factors:
- the method of operation and the volume of tissue removed – extensive intervention is more expensive
- type of anesthesia
- length of stay in hospital; related problems: a hernia, scars, stretch marks; fame clinic
- the experience and the name of the surgeon – the operation at a distinguished doctor can be several times more expensive than the procedure for the “private”
Abdominoplasty is one of the most popular plastic surgeries, intended not only for aesthetic correction but also for solving some health problems. To get the expected result, it is important not only to entrust the procedure to an experienced specialist but also to strictly follow the recommendations of the doctor during the recovery period. And remember – no need to demand a waist like Thumbelina’s, consider the peculiarities of your body!