The
best candidates for abdominoplasty are men and women who are in relatively
good shape but are bothered by a large fat deposit or loose abdominal skin
that won't respond to diet or exercise. The surgery is particularly helpful to
women who, through multiple pregnancies, have stretched their abdominal
muscles and skin beyond the point where they can return to normal. Loss of
skin elasticity in older patients, which frequently occurs with slight
obesity, can also be a reason for surgery. Patients who intend to lose a lot
of weight should postpone the surgery.
Also,
women who plan future pregnancies should wait, as vertical muscles in the
abdomen that are tightened during surgery can separate again during pregnancy.
If you have scarring from previous abdominal surgery, your doctor may not
recommend abdominoplasty or may caution you that scars could be unusually
prominent.
Abdominoplasty
can enhance your appearance and your self-confidence, but it won't necessarily
change your looks to match your ideal, or cause other people to treat you
differently. Before you decide to have surgery, think carefully about your
expectations and discuss them with your surgeon.
All
Surgery Carries Some Uncertainty And Risk
Thousands
of abdominoplasties are performed successfully each year. When done by a
qualified plastic surgeon who is trained in body contouring, the results are
generally quite positive. Nevertheless, there are always risks associated with
surgery and specific complications associated with this procedure.
Postoperative
complications such as infection and blood clots are rare, but can occur.
Infection can be treated with drainage and antibiotics, but will prolong your
hospital stay. You can minimize the risk of blood clots by moving around as
soon after the surgery as possible. Poor healing, which results in conspicuous
scars, may necessitate a second operation. Smokers should be advised to stop,
as smoking may increase the risk of complications and delay healing.
You
can reduce your risk of complications by closely following your surgeon's
instructions before and after the surgery, especially with regard to when and
how you should resume physical activity.
Planning
Your Surgery
In
your initial consultation, your surgeon will evaluate your health, determine
the extent of fat deposits in your abdominal region, and carefully assess your
skin tone. Be sure to tell your surgeon if you smoke, and if you're taking any
medications, vitamins, or other drugs. Be frank in discussing your
expectations with your surgeon. He or she should be equally frank with you,
describing your alternatives and the risks and limitations of each.
If,
for example, your fat deposits are limited to the area below the navel, you
may require a less complex procedure called a partial abdominoplasty, also
known as a mini-tummy tuck, which can often be performed on an outpatient
basis. You may, on the other hand, benefit more from partial or complete
abdominoplasty done in conjunction with liposuction to remove fat deposits
from the hips, for a better body contour. Or maybe liposuction alone would
create the best result.
In
any case, your surgeon should work with you to recommend the procedure that is
right for you and will come closest to producing the desired body contour.
During
the consultation, your surgeon should also explain the anesthesia he or she
will use, the type of facility where the surgery will be performed, and the
costs involved. In most cases, health insurance policies do not cover the cost
of abdominoplasty, but you should check your policy to be sure.
Preparing
For Your Surgery
Your
surgeon will give you specific instructions on how to prepare for surgery,
including guidelines on eating and drinking, smoking, and taking or avoiding
certain vitamins and medications. If you smoke, plan to quit at least one to
two weeks before your surgery and not to resume for at least two weeks after
your surgery. Avoid overexposure to the sun before surgery, especially to your
abdomen, and do not go on a stringent diet, as both can inhibit your ability
to heal. If you develop a cold or infection of any kind, your surgery will
probably be postponed.
Whether
your surgery is done on an outpatient or inpatient basis, you should arrange
for someone to drive you home after surgery, and to help you out for a day or
two after you leave the hospital, if needed.
Where
Your Surgery Will Be Performed
Many
surgeons perform both partial and complete abdominoplasties in an outpatient
surgical center or an office-based facility. Others prefer the hospital, where
their patients can stay for several days.
Types
Of Anesthesia
Your
doctor may select general anesthesia, so you'll sleep through the operation.
Other surgeons use local anesthesia, combined with a sedative to make you
drowsy. You'll be awake but relaxed, and your abdominal region will be
insensitive to pain. (However, you may feel some tugging or occasional
discomfort.)
The
Surgery
Complete
abdominoplasty usually takes two to five hours, depending on the amount of
work required. Partial abdominoplasty may take an hour or two. Most commonly,
the surgeon will make a long incision from hipbone to hipbone, just above the
pubic area. A second incision is made to free the navel from surrounding
tissue. With partial abdominoplasty, the incision is much shorter and the
navel may not be moved, although it may be pulled into an unnatural shape as
the skin is tightened and stitched.
