• Abdominoplasty

Abdominoplasty

Introduction

Abdominoplasty or “tummy tuck” is a  surgery that aims to get rid of excess skin, unwanted scars, stretch marks, and fat from the middle and lower abdomen.

Abdominoplasty involves surgery that tightens the muscles of the abdominal wall thus significantly reducing the appearance of a protruding abdomen.

An abdominoplasty procedure improves the shape and contour of the tummy although it can cause permanent scars which can run from hip to hip.

The range of techniques available depends on your particular problem. The operation will be individualized and customized to suit you.

Candidate

An abdominoplasty patient has to be of good health.

The operation is mostly recommended for senior or middle-aged patients with a history of previous pregnancies. There are also other patients who have no plan to be pregnant and would wish to maintain a perfect body shape. The operation works best on individuals with high-quality elastic skin since they get to heal quickly.

However, people with a problem of the excess abdominal skin or even little pot belly can undertake the surgery. It is a procedure that solves the issue of big tummies or loose abdominal skin that doesn’t respond to diet and exercise.

Not suitable for

  1. The operation is not recommended to people who intend to lose a lot of weight.
  2. Patients planning to lose lots of weight should postpone the operation until reaching the desired weight.
  3. Women planning to get pregnant soon should wait since vertical muscles in the abdomen get tight during surgery and can draw apart gain during pregnancy.

Evaluation before the operation

  • Assessment of sagging skin of the lower abdominal area.
  • Assessment of sagging skin of the upper abdominal area
  • Establish the strength of the abdominal muscle.
  • For patients with excess fat around their lateral abdominal region, a liposuction can be done if the need arises.

Operation techniques

1. Partial abdominoplasty / Mini Lipectomy

This procedure involves the removal of a segment of skin and fat in the area below the umbilicus. The bikini incision made for this operation is much shorter thus making the whole process less complicated. The procedure is suitable for individuals who have had no previous pregnancies as the healing process is much faster.

People who have lost significant weight and wish to get rid of the excess skin on their tummy can also go for this operation. Since the procedure is less complicated, it takes 2 to 3 hours. As much as the surgery is simple and takes a shorter time to heal, individuals with a lot of fat on the upper part of the abdomen should avoid this operation.

2. Full abdominoplasty (full tummy tuck)

The radical abdominoplasty is a surgical operation that is suitable for women who have had previous pregnancies. It involves the removal of the extra fat and skin from the umbilicus region to the bikini line with the repositioning of the umbilicus. The incision is made from hip to hip and results in the tightening of the underlying muscles. The procedure takes 2-4 hours.

3. Suction Assisted Lipectomy and Full Lipectomy

This procedure involves a combination of the full lipectomy operation as well as the suction assisted lipectomy. The procedure can, however, be done with a full lipectomy or a mini lipectomy.

The doctor conducts a liposuction in the lateral abdomen area of the body before stitching off the wound. This kind of operation does not cause additional incision because liposuction can be achieved in the same area where the incision of the lipectomy occurs.

Pre-Operation

Pre-operative Consultation

  • It’s important for the patient to decide whether they will need to combine the operation with liposuction before the actual surgery day.
  • The patient should also understand the different techniques involved in the operation and know what technique is suitable for them.
  • Design umbilicus shape
  • The patient must be informed about incision and other treatments that can be done after the operation to achieve quick recovery.

 Pre-operative preparation

  • Two weeks before the surgery, the patient must avoid taking any anti-inflammatory drugs such as aspirin, smoking and other supplementary drugs that can cause anticoagulation.
  • The patient must also prepare the stay in Thailand around 10-14 day
  • The patient should abstain from taking any food substances and water 6 hours before the operation.
  • Patient shouldn’t have any risk of DVT (Deep Vein Thrombosis)
  • The patient should make sure that pubic hair is well shaved before seeing the doctor.
  • Patients with critical conditions or other kinds of diseases should inform their doctors so as to be properly guided on the steps to take.
  • A thorough medical checkup is mandatory before and after procedure
  • The patient should also avoid eating any kinds of food substances that might cause diarrhea.
The Procedure

The surgeon makes an incision that starts at the hipbone all the way to the other side slightly over the pubic area. Another incision is made to clear the umbilicus from its surrounding tissues.

For the case of a mini lipectomy, there will be a much shorter incision whereby the umbilicus may not be shifted, though it may be tugged into an abnormal shape while the skin tightens and then gets stitched.

The surgeon sets apart the abdominal skin all the way to the ribs and raises a big portion of skin flap to expose the abdomen’s vertical muscles. The muscles are made tight by pulling them closer together and stitching them into a new position which provides a much stronger abdominal wall with a narrowed waistline than the previous one.

The extra flap of skin is then removed, and a new umbilicus hole is cut and stitched in place. The final process involves stitching up of the incision and dressing up the wounds.  A temporary tube may be inserted to drain the excess fluids, from the surgical site.

Post Operation

How to take care of the incision

  • The bandage, tube drainage, and urinary catheterization can be removed in 2 -4 days
  • The incision will be visible after treatment and will improve after half a year to 1 year
  • If you have partial abdominoplasty surgery, you will only be given the chance to go home when fully awake and strong.
  • Painkillers will be given for you to take home.
  • At home you should rest on the first night. You can choose to use a pillow under your knees to get more comfortable.
  • On the first day after surgery, you should try to get up into a comfortable chair and walk to the toilet.
  • When the drainage has reduced, the drains are removed. This is usually 3 days after the surgery.
  • The swelling and busting will take about 3 weeks to settle and the patient should wear the pressure garments to help reduce swelling. One can also start using arnica on day 2 post operation.

 

How to take care of yourself

  • The different surgeries have different recovery periods but in general, you will be able to get back to normal life 3 days after the liposuction. The mini tummy tuck can take about a week and the full tummy tuck can take at least three weeks for a full recovery.
  • The patient should sleep with their head and legs raised. This can be done by using pillows to support the knees for the first two days.
  • The process of mobilization should be done early and should only last for two days after the surgery. The patient should begin by making knee and ankle movements to prevent leg clots.
  • Gentle exercises should start on week 3 after the operation. However caution must be taken and patients must be careful not to engage in intense exercises.
  • Once the patient is awake after the surgery, they will be allowed to eat .The in-patients will be taken care of by the hospital staff and be guided through the mobilization exercises.