Tummy Tuck, Abdominoplasty
- Tummy tuck
- Who is candidate for tummy tuck ?
- The first consultation
- Review about the tummy tuck
- Tummy tuck risks and complications
Plastic surgical procedures have to be done by plastic surgeons!
Tummy tuck is a common plastic surgical procedure. In the case of weight gain, pregnancy and breast-feeding the abdomen can significantly increase, thus the body contour will change unfavourably. It is very common that the stretching of the skin is caused by the excess fat in the abdomen. Because of the extreme weight the stretched skin will loose its flexibility and become floppy, bulging and sagging. Skin irritation can be presented in the interfaces as well. Neither the strict diet and serious exercising can make the skin stretched again. Liposuction only results in a slimmer shape, since the tummy tuck also makes the body younger. It is a natural expectiations of the women and men to have a slimm and youthful body shape. Tummy tuck removes excess fat and skin, and in most of the cases restores weakened or separated muscles. You have to notice that the operational scars will never be invisible, but will pale by the time and fade into their environment. Before the operation we can not predict the quality of the scars. In ideal cases there will be slight scars under the umbilicus, in a natural skin fold. These will be hidden by the underwear between the two hip bones and around the umbilicus.
The final result of the abdominoplasty usually can be visible after the total cessation of swelling. As a result of the operation the abdominal skin will become tighter, slimmer and more youthful because of the removal of a significant amount of excess fat and the reconstruction of the abdominal muscle. With the removal of the appropriate amount of excess skin and fat, and with the stitches in the abdominal wall a long-lasting and beautiful result can be achieved. The biggest part of the stretch marks and striae of pregnancy are presented under the belly button, thus these can be removed with the abdominoplasty. If You have wider hip and a wider outer part of the thigh ( cello-siluette ), with a simultanous liposuction the result will be more beautiful. The plastic reconstruction of the abdomen makes the body shape slim, tight and more youthful again.
WHO IS CANDIDATE FOR TUMMY TUCK ?
- The abdominal skin and fat is large and sagging.
- The abdomen is bulging and is not proportion to the body.
- The abdomen bends on the pubic hair, thus the skin has irritation.
- The abdominal muscle is weakened and separated.
- Excess fat in the area of the abdomen.
The abdominoplasty can not correct all the expectations -sometimes unreal-, which were dreamt by the patients. We can not resolve everything with the operation. On the one hand it has limits by the technics of the operation, on the other hand just only those corrections can be performed which are fit to the harmony of the body.
THE FIRST CONSULTATION
At the consultation we will discuss Your problems, expectations and desired outcome. We will talk about everything which is in connection with the abdominoplasty and important in the aspect of the dermolipectomy procedure. We will examine the abdomen in standing and lying positions. We will check the tone of the abdominal wall and the level of sagging. The difference between the stretched and floopy abdominal wall shows the tension of the abdominal wall. We will draw attention to the amount of underlying fat and the weakened and separated abdominal muscle. We will check the quality of the abdominal skin and the connective tissue, and occurent previous operational scars. There are scars which can have effect on the operational plan and the final result of the plastic surgical method. Usually the dermolipectomy will only remove the stretch marks and striae of pregnancy under the belly button. The possibility to remove the stretch marks above the belly button is limited.
We will take some photographs –from different directions- about the present condition. The photographs allow the patients to examine and evaluate the abdomen from different directions.
You will be asked about Your medical conditions, medical treatment, drug allergies, use of current medications and previous surgeries, procedures. It is very important to get accurate information about every medical conditions to plan the procedure with the best thoughtfulness. After the proper information the well-planned dermolipectomy procedure will ensure You the biggest satisfaction.
Weight loss, pregnancy and breast-feeding after the tummy tuck can influence the further result of the abdominoplasty.
REVIEW ABOUT THE TUMMY TUCK
THINGS TO DO BEFORE THE OPERATION
Before the abdominoplasty some examinations are necessary to be performed: blood test, ECG, chest X-ray and sometimes abdominal ultrasound. With these data the operation will be performed in the best security. If You smoke, take aspirin or other blood thinner medications, or any anti-inflammatory drugs or other medications, please let us know! This drugs can increase bleeding or can cause other interactions during the general anaesthesia.
The tummy tuck is almost always performed in general anaesthesia ( in some assorted cases it can be performed in intravenous sedation and local anaesthesia, this is called mini abdominoplasty ) with hospital background. The last two methods is only possible in little procedures. For Your security during the surgical procedure which is performed with general anaesthesia we check Your heart rate, heart beat, blood pressure and blood oxygen level with monitors.
For Your bigger security antibiotics are administerd during the abdominoplasty.
The incision of the dermolipectomy is always chosen individually. Not everybody is candidate for any type of incisions. To chose the most appropriate technique and the amount of the removal tissue is influenced by the size and shape of the sagging abdomen, the level of sagging, the position of the belly button and the patient’s expectations. The direction of the incision is influenced by the structure of the abdomen, the type of the underwear or swimming suit and the patient’s expectation. The previous operational scars in the abdomen can influence the result of the tummy tuck. We aim to minimize visible scarring and to achieve the most beautiful shape.
The most common method is when we make an incision around the belly button and we remove a horizontal bay leaf-shape area under the navel. As bigger the abdomen, as longer this horizontal incision will be. With abdominoplasty we remove the unstretched skin with the underlying fat tissue. This is mostly the area under the belly button. In the case of weakened or separeted abdominal muscles ( there is a significant difference between the stretched and floppy abdomen ) we also perform an abdominal reconstruction. After the reconstruction we will determine the new position of the belly button and perform a little incision in the skin. In a lot of cases there is excess fat at the two ends of the incision as well, which is removed by liposuction. During the operation the abdominal skin is preparated in a large area, totally till the ribs. Because of the large operational area even with the most careful haemostasis (stopping of bleeding), there will be a little amount of leaking blood and oedema, which is eliminated by drains from the operational area. With this the recovery will be faster and saftier and the post-operational pain will decrease.
The drain will be removed in the next 3-5 days of the operation, when the leaking blood will cease.
In the case of mini abdominoplasty we only perform an incision under the belly button, it is not necessary to reposition the belly button, thus the scars are more smaller. In this case the excess fat and skin are only presented under the navel. This procedure can only be performed in small abdomens.
At the end of the abdominoplasty we cover the wounds by bandages and help the patient to take on a special, flexible corset belt.
THINGS TO DO AFTER THE OPERATION
In the case of the operation, which was performed with general anaesthesia, it is practical to spend one night in the hospital. If the operation was performed in intravenous sedation or local anaesthesia, after the surgical procedure it is allowed to go home. When You leave the hospital it usually occurs that there is still some blood coming out through the drains. After the abdominoplasty it is suggested to relax and spare Your abdomen with due foresight. Between the first and the third days after the operation You can feel more discomfort, but this is just a temporary problem, which is caused by the stretching effect of the operation. It is allowed to get out of the bed and make short walking in the room on the next day of the operation. With this You can enhance the blood circulation. It is forbidden to sit or be in bed for a long time. During the nights it is practical to sleep with pulled up knees, and put a pillow under the knees.
The initial decoloration and swelling are just temporary symptoms and disappaer fast. These are natural consequences of the operation. The stitches will be removed after 2-3 weeks, when the tension is significantly decreased.
It is recommended to wear the special corset belt in the first 4-6 weeks. Two weeks after the tummy tuck do not drive car and for six weeks avoid any stiff sports and physical activity! During this period You have to avoid sunbathing and going to the solarium! After the sparing period You have to cover the scar with sun protection cream for a long time!
After every plastic surgical procedures You have to return for follow-up care regularly, thus after the dermolipectomy as well. The regularity of this depends on the type of the procedure and other personal feautures of the patient. At the previously discussed follow-up cares we will examine the operational area and discuss about the things to do in the future. Please remember that if You have any questions or problems, please do not hesitate to contact us independently the appointment!
TUMMY TUCK RISKS AND COMPLICATIONS
If the operation is performed by a qualified plastic surgeon, the operation and the post-surgical recovery period will be without any unexpected episodes. The tummy tuck as all other surgical procedures can have complications, even ideally. Besides the generally presented complications (bleeding, infection, poor healing of incisions and thrombosis) – which are very rare -, can occur some special complications because of the dermolipectomy.
In the case of large abdominoplasty there can be a little excess skin formation at the two ends of the incision, since the upper horizontal line is always longer than the lower line. This can be removed by a little procedure. This is rather typical in the case of large, sagging abdomen, where the amount of excess skin and fat is huge. Poor wound healing and circulatory problems can present especially in those patients who are smoking or have diabetes, where the circulation of the skin is not perfect. In these cases persistent discharging and rarely skin necrosis can occur. These, little wound healing problems can be corrected with a smaller reconstructive procedure in a latter time. Temporary numbness or other changes in skin sensation of the abdomen can occur. This will cease and become normal again in a few weeks or a months.
With the most modern devices, materials and stitches which were inserted by the most friendliest techniques it can happen that the colour of the scar will be brisk and red, thick in touch and a little bit widened. This depends on mostly personal liability, thus it can have significant differences. This malformation decreases by the time, thus the scar will be thinner and its colour will fade. If this does not occur, we remove the scar and treat the new scar with other special scar-treating methods.
The complications can be vanquished or revised with the appropriate treatments and procedures, thus they do not effect the final result of the operation or slightly influence it.
The abdominoplasty will result in a flatter, firmer and more youthful abdominal contour.
The tummy tuck surgery makes the women and men more assertive and gives them back their self-confidence. The result of the dermolipectomy is long-lasting if the weight does not change. In the case of significant weight gain, weight loss and the changes in the water-content and flexibility of the tissues and other changes by aging have effect on the whole body, thus on the abdomen as well. If the weight-changing has effect on the abdomen, a reoperation can be necessary to perform, which is usually smaller procedure than the original one.