Abdominoplasty is a surgery consisting in the removal of the excess loose skin and fat from the abdomen and, in some cases, in the muscle stitching. The excess of tissues is frequently a result of pregnancy or a weight loss, thus the aim of this action is to achieve tightened abdominal muscles and generally a flatter abdomen.
What does the surgery consist in?
The complete abdominoplasty consists in making an incision from hip to hip, near the pubic area and another incision around the navel. If your muscles are stretched in line, they are put together and stitched in order to reduce the circumference of your abdomen and strengthen the abdominal muscles, which in future will prevent an abdominal hernia. When the underskin tissue and muscles are stitched, the skin is tightened down, which enables the removal of the excess skin. Subsequently, a small hole is made to stitch the navel in a new place. Simultaneously a minor liposuction of the abdomen is performed, which enables achieving better cosmetic effect, and additionally with a small skin tone it is possible to remove a major abdominal lappet and collop.
Mini abdominoplasty is similar to the complete abdominoplasty, but requires much less tissue detachment, which enables leaving the navel intact. The simplified surgery is suitable for the patients with the excess skin and fat only below the navel.
Both complete and mini abdominoplasty are usually performed in general anaesthesia.
What are the risks and side effects of the surgery?
Thinking about a plastic surgery we want it to be a very positive experience. Indeed, complications are rare and usually insignificant, but there is some risk related to every surgery depending on patient’s individual features. Thus it is important to be aware of such possible problems. All of them will be extensively discussed with you during the consultations with a plastic surgeon in the Aesthetic Med clinic.
From time to time, a small blood tumor or an accumulation of body fluids may occur. The drainage made during the surgery should reduce it. Any further accumulations may often be removed with a needle and syringe during control visits. The situation when these complications make it necessary to undergo another surgery happens extremely rarely.
Scars resulting from abdominal surgery may be covered with normal clothes, but they are not invisible. The scars may be expected to flatten and lighten in colour within a year. In some cases the scars may become red and overgrown, which is recognized as keloid (keloidal scar).
You will feel numbness in the area of the abdomen for a period to six months after the surgery. Sometimes the numbness persists. During the post surgery period an infection and skin necrosis may occur. This may also cause skin deprivation, which in rare cases may require another surgery. Though this complication is rare, it is more likely to occur with smokers.
A general risk related to every surgery may also occur, e.g. a blood clot in a leg, which would require treatment (so called deep vein thrombosis), however the risk of this complication is extremely low. Some of the clots may also travel to lungs, causing severe breathlessness and pain in the chest. These symptoms are known as pulmonary embolism, which occurs very rarely, by may threaten your life. A respiratory tract infection is also very rare and the possibility of this complication is increased with smokers.
All these risks will be discussed with you in detail during the surgery consultation. However do not hesitate to discuss with your surgeon any questions or doubts you may have.
What is the estimated time of the absence from work and the return to normal activity?
The recovery time may vary depending on the patients’ health condition and their general predispositions. The hospitalization usually takes from 3 to 5 days and then the patients are discharged. After 2 to 3 weeks you can return to work, of course if the work is not too physically demanding. The final cosmetic effect will be visible after 6 to 12 months, when the scars flatten and lighten in colour.
How do I prepare for pre surgery consultations?
A surgeon is going to ask you for your general health condition and medical history, such as previous illnesses or surgeries, allergies, medications taken and if you smoke.
The surgeon will certainly ask for your reasons of considering the surgery and will ask you to describe the changes you would like to make. Surgeons would also like to know if you are planning to achieve a major weight loss with an appropriate diet. Most frequently it is suggested to wait for you to achieve your target weight before you make up your mind about the surgery.
Then the surgeon is going to examine you, focusing on the condition of you abdomen muscles, skin colour and the quantity of the excess skin.
Having known your reasons for deciding about the surgery, the factual condition of your abdomen and your expectations, the surgeon will have all the information necessary to discuss the possible effects of the surgery in your case.
How do I prepare for the surgery?
The surgeon is going to suggest you the possible time scopes of the surgery and ask you to choose the most convenient one. When planning the surgery its date should be set for the time to two weeks after the last period, which reduces the possibility of complications after the surgery. Depending on your age and general health condition, prior to your admission you may be asked to make standard blood tests (morphology, protein level, sugar level, blood coagulation, electrolytes, cholesterol level) and heart tests (electrocardiogram), chest RTG. All the time you may also ask questions that have appeared to you during the process or in any way have raised your fear.
On the surgery date you are going to come to the clinic at 12.30-1.30pm. On the surgery day you should not eat or drink for 6 hours prior to the planned surgery, this addresses also to the chewing gum. If you smoke, it is advised to quit six weeks before the surgery. There is a rule: the longer you smoke and the earlier you quit, the better, because smoking reduces the quantity of the oxygen in blood and may significantly increase the risk of post surgery complications.
On the surgery date it is also important to inform the surgeon, anaesthesiologist and the nurse about all the taken Rx and OTC medications, as well as about any recreationally used drugs.
For 2 weeks before the surgery you should avoid medications with acetylsalicylic acid, since they increase the risk of bleeding during the surgery. For 30 days before the surgery you may also be asked to stop taking contraceptive pills or a hormone-replacement therapy. Your doctor will give you an appropriate advice in the scope.
After the surgery you should make sure someone takes you home, because you will certainly not be able to drive.
What happens after the surgery?
When you regain consciousness and the anaesthetic stops working, we will encourage you to sit in your bed. You can have a roller under your knees, which will help you sit in a more comfortable position.
You may also have an oxygen mask on your face till the anaesthetic diminishes, but in case of some patients the time may be prolonged to 24 hours. You may feel sleepy after the treatment, so you may expect awakening and sleeping for the rest of the day.
Your whole abdomen will be wrapped with a pressure belt or a jacket. It should be worn for the first four to six weeks all the time except for the bath. This way it should decrease any swelling and make you feel more comfortable.
A small, plastic tube (cannula, venflon) will be put into a vein of your hand or arm. This tube enables giving you liquids (so called drip or intravenous infusion) to be sure you are not dehydrated and receive appropriate dose of painkillers and antibiotics. The vein tube is usually removed after 72 hours. After such an extensive surgery there may be a need to give blood in order to replenish its volume.
Additional two or three small tubes (so called drainage) may be put on both sides of the wound and the navel in order to drain excess blood or body fluids. They are usually removed before you return home. After the surgery you may also have a ureteral catheter inserted to remove urine from the bladder. Thanks to this, you will not have to stand up to go to the toilet. The catheter is usually removed the next day.
Special stockings will also be applied to prevent blood clot formation. The stockings may be removed as soon as you start walking, although it is advised to wear them for the period to six weeks.
For the first few days your abdomen will be quite painful. Of course you will receive painkillers to make you feel more comfortable. Prior to your going home you will again be examined by a surgeon and/or a nurse. All the durable stitches will be removed 7 to 10 days after the surgery together with your drainage.
Once again we would like to draw your attention to the fact that you will not be in condition enabling driving, so it would be better to have somebody with you at home for a few days. Having any doubts in that time, contact the Aesthetic Med team and ask for an advice.
For the first few days you may feel uncomfortable trying to straighten out, but it is important to try to walk every two hours during the day and in the early evening. Staying in bed for too long increases the risk of blood clots in your legs. So gradually increase you physical activity for the following few days.
Tension and pulling of skin and muscles may be painful when coughing or using the toilet. It is possible that you will feel uneasy for about a week, but the painkillers should help. Drinking a lot of liquids and eating a lot of fruit and food rich in fibre may reduce the risk of constipation.
You should expect some loss of sense in the area of the abdomen. This condition should gradually return to normal within the following months, but in some cases it is never the same as before.
The scars will be red up to a few months and then they should soften and reduce. The scars are also more sensitive to sun so they should be covered and protected with a sunscreen for the next six months. You should also avoid lifting heavy objects or intensive exercises for six weeks after the surgery.
Abdominoplasty after the surgery step by step
– Day 1 to 5
You stay in the Aesthetic Med clinic under care of doctors and nurses and follow their recommendations. The ureteral catheter is inserted for 1 to 3 days. You have a jacket or a pressure belt on your abdomen. You may feel pressure and discomfort in the abdominal area when standing, sneezing and coughing. You are wearing pressure stockings reducing the risk of clots. Dressings are made every day.
• Day 5 to 10
Continue taking painkillers. It is important to start increasing the level of activity. Keep using a pillow or a roller under your knees. Press your abdomen when coughing and sneezing. Recommended stitch removal on day 7 and 10.
• 2 to 4 weeks
Reduction of pain and the feeling of tension in the area of lower abdomen. You may be able to return to work, if the work does not require too much physical effort.
• 1 month
Still expect numbness in the abdominal area. Now it is easier to stand straight. You may be able to take off your jacket and return to work.
• 2 months
Now you can lift heavy object and exercise more intensively.
• 6 months
Post surgery scars soften and lighten. The loss of sense in the abdominal area continues to reduce.
• 12 months
Post surgery scars should seem thinner and lighter. Only now the final result of the surgery may be assessed.
The information included on the web site does not constitute a professional medical advice provided by doctors from the Aesthetic Med clinic.