Perhaps you agree with me. The abdomen is the concern of many people, both women and men.
It is by far the part we involve the most when we try to roughly assess our fitness level.
How many efforts and sacrifices are made in an attempt to reach the goal... The dear waistline... truly a real torment for many.
However, there are two situations in which you would not achieve any significant effect, even if you were to run a marathon every day.
I'm talking about the condition that women could find themselves in after one or more pregnancies. Or, more broadly, those who have lost several tens of kilograms. People in whom such excess skin can be generated, often associated with relaxation of the muscular wall.
People who have only two viable options: either you keep it and accept it, or you start considering a visit to the surgeon for an abdominoplasty. Other serious possible choices are not known today.
Before continuing, I would like a concept to be clear to you: if you only have an excess of adipose tissue without true skin relaxation, the abdominoplasty procedure would not bring you any results. It would not be effective, as liposuction is recommended in these cases.
Always assuming that the other more commonly used methods usually applied to burn fat do not yield results, of course.
Before the Visit for Abdominoplasty Surgery
In preparing for the preliminary visit, you will need to evaluate your abdomen based on what has just been said.
In particular, observe the presence and distribution of any excess skin, whether limited to the lower abdomen or also in the upper part. Also, note the state of your abdominal muscles to assess the before and after of abdominoplasty. And maybe even if there is an excess of adipose tissue that seems out of place.
All these aspects will then be evaluated more thoroughly together with you.
Abdominoplasty Surgery: The Preliminary Visit
When we meet, my main goal will be to have your expectations as clear as possible. What bothers you the most and what you would like to eliminate. I will try to understand well together with you how you want your new abdominal contour to be.
After that, I will proceed to examine the abdomen in an upright, sitting, and horizontal position. Carefully assessing the state of the muscular wall and the presence or absence of any hernias.
At this point, I will delve into the details of the abdominoplasty surgery that is most suitable for you. Discussing possible complications, how functional recovery will occur postoperatively, and in what time frame.
Before Abdominoplasty Surgery
Now it's time to prepare for surgery. This mainly involves getting blood tests and an electrocardiogram. I might also ask for an ultrasound of the abdominal wall to examine the before and after of the abdominoplasty.
On the day of the surgery, during the marking of the skin, you will see exactly where the scar will fall. I will then ensure that the informed consent has been signed.
You are now ready for surgery.
Abdominoplasty Surgery
Let's start with a procedure that will greatly impact your daily well-being. Here are the various phases. I start by telling you that it has a duration of about 2 hours and is usually performed under general anesthesia, although it is possible under local-regional anesthesia with sedation.
Once the skin flap is lifted, I will ensure that the abdominal muscles are in good tension with internal sutures. I will then be ready to remove the excess skin that bothers you so much.
As I explained to you during the preliminary visit, the resulting scar will run transversely in the lower part of the abdomen from one side to the other. There will also be a small scar on the inside of the navel.
There is a more extensive type of abdominoplasty: the so-called "Fleur de lis." It is named after the shape of the removed skin, which has the shape of a lily.
It is wider than what is removed with traditional abdominoplasty. The benefit is significant from the point of view of the abdominal contour, but the final scar is longer, also having a vertical component along the midline: an anchor or inverted T-shaped scar.
I would usually recommend this more aggressive surgery only if you have successfully battled obesity, eliminating several tens of kilograms. In this case, the operating time can be 3 hours or more.
I'm not a fan of drains in plastic surgery. In the vast majority of cases, they are just a hindrance that would slow down your recovery. In fact, their use becomes unnecessary once the skin flap is internally adhered to the underlying musculature through internal attachment points.
They allow closing the potential dead space that is created. Moreover, without drains, you will be able to get up and move more quickly.
I want you to know that, in the field of plastic surgery, abdominoplasty is one of the most challenging procedures in terms of postoperative recovery. But it is also an operation that, in most cases, ensures an immediate and drastic improvement in the abdominal body contour.
There is also a "softer" version called mini-abdominoplasty, which is, as easily understood from the name itself, a surgery similar to the previous one but of lesser magnitude from a surgical point of view, allowing an even faster functional recovery.
You would be an ideal candidate for this surgery if you only have moderate skin flaccidity and muscle relaxation, mainly limited to the infraumbilical region. The resulting scar is similar to that of traditional abdominoplasty but shorter. Also, there is no umbilical scar. With this procedure, you would definitely go home on the same day.
However, as you may have understood, only during the preliminary visit will we determine which abdominoplasty procedure is most suitable in your case. In any type of abdominoplasty, it is possible and quite common to combine liposuction on the flanks if indicated.
This would allow you to further optimize the final result.
What to Do After Abdominoplasty Surgery
As mentioned, the sooner you stand up and start walking, the better. Both from a functional recovery point of view and to prevent complications such as deep vein thrombosis. At the beginning, and for a few days, you will walk slightly bent forward due to the tension on the skin and muscles.
You will need at least 2 weeks of rest, even for moderate physical activity. You can gradually resume sports after about 8 weeks and at full capacity after 12 weeks.
I recommend the first shower after 48-72 hours, daily thereafter. Changing the dressing each time, of course.
Routine postoperative check-ups will be after 1, 2, and 4 weeks, 3 and 6-12 months. If necessary, additional check-ups would be added.
