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Abdominoplasty
is becoming more and more common. Women of all ages are
requesting abdominoplasty to tighten saggy abdomens. A
loose, saggy abdomen disproportionate to the rest of the body
can make clothing selection a nightmare.
Many
times these concerns are caused by previous pregnancy or weight
gain and loss; however, sometimes just the normal aging process
can be the culprit no matter how much you exercise or diet.
During
an abdominoplasty excessive skin and fat are removed primarily
from the middle and lower abdomen. In some areas
liposuction can further help to improve contour and help with
the redraping of the skin. There’s typically an incision
from hip to hip above the pubic area and a second incision is
generally needed around the navel so it can be repositioned.
Many times a vertical incision from the navel downwards
can help us get better shape, tightness and curves particularly
in the patient who has a fair amount of loose skin.
Internal muscles may or may not be repaired. The outer
incisions are closed with sutures that are removed over the next
few weeks. There is usually a drain on each side for a
time after surgery.
Patients
considering abdominoplasty should be in good medical condition
and close to their ideal weight. Those planning to loose
weight should do it before the surgery. Abdominoplasty
should also be deferred until you have all your children since
subsequent weight gain and/or pregnancy can undue the benefits
of abdominoplasty.
Of
all the procedures we do, abdominoplasty can have the most
difficult and annoying recovery. The recovery is not
unlike any other major abdominal surgery. Because it is a,
‘want and not a need,’ we have it in our head that it
shouldn’t be but it is. Depending on your needs, healing
capabilities, etc., most patients can expect to be off work for
2-4 weeks. Most will need help with small children
and household chores for 1-2 weeks. At first,
you may not be able to stand up straight; none the less, you
must do some light exercise and activity to avoid blood clots in
the legs. Most patients go home after the surgery and come
to the office the next day for a 24 hour checkup. You will
need a driver for this visit. Although the need for
hospitalization would be unusual, if it were required or
requested, my admitting privileges are at Alton Memorial and St.
Anthony’s Hospital in
Alton
,
IL
.
The
drains stay in until the drainage has become minimal.
Sutures are partially removed at 7-10 days and the
rest are usually out within an additional week. All fresh
scars are thick and red and it may take a year or more for them
to reach their individual maximum healing, softening and fading.
Your compliance with the prescribed scar therapy is important.
Although scars never disappear they typically fade
with time and are typically hidden under most clothing including
the average bathing suit.
In
plastic surgery we often times talk about touchup
surgery…….this is one of those times when, if you want to
achieve the maximum improvement, it may take more than one
procedure to get to there. This is particularly true
in those with lots of loose skin and massive weight loss
patients. A touch up is generally a small outpatient
procedure but there’s expense and inconvenience with any
surgery.
Of
all the surgeries we do smoking, in my opinion, can cause the
most havoc with the facelift and abdominoplasty patient.
When we ask you to comply with a no smoking regiment, it is for
your own safety. Please take our request seriously.
If you are planning surgery………….get off the cigarettes.
Using nicotine gum causes the same problems with restriction of
blood supply so that’s not the answer. You must quit to
give yourself the maximum chance of having surgery without
complications.
The
primary complications/consequences seen with abdominoplasty
include, but are not limited to, blood clots, infection,
bleeding, poor healing, scars and the need or desire for
additional touch up surgery which, of course, includes more
expense. We will go over everything in great detail at the
time of your consultation.
A
dose of patience is also required. All surgeries take time
to settle in. Although you are back to your daily activity
in fairly short order, it takes a year or more for you to be at
your final result. I can tell you that no one likes the
navel in the beginning. Unless there is a medical reason,
I do not even consider a touch up until after a year. Why,
because most of the time the issue that is concerning you….. a
pucker here, a poof there, etc., takes care of itself as the
normal healing process takes place. The area right above
the horizontal scar always remains puffy and thick longer than
anywhere else because of our old friend gravity.
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