Introduction

Most of the women have problems with the unpleasing aspect of the abdomen, even if the overall aspect is a harmonious one. Overweight is the worst nightmare of women as well as of men, and when any other method alternative to surgery is fruitless, the last resource remains the scalpel.
Abdominoplasty aims at the removal of the fat pouch of the lower abdomen and leaves a permanent scar running across from one hip to another. Abdomen reconstruction has been done since the '60s and if it is done by an experienced plastic surgeon the results turn out well. Abdominoplasty is a major surgical operation, by means of which excess skin and fat is removed from the lower abdomen. During the same operation one can mend the flaws of the abdomen wall and one stitches up the abdomen median straight muscles.

What sort of patients can benefit from abdominoplasty?

Abdominoplasty interests both men and women who evince a skin excess accompanied by a fat tissue that cannot be removed by diet or physical exercise. From this operation women can benefit who, owing to multiple pregnancy evince abdomen muscles that are stretched too wide apart. Through this surgery the vibes and the scars under the navel can be removed.
Abdominoplasty may not be carried out on women who wish to remain pregnant again or on patients who intend to follow one or more slimming diets.

Operation hazard

There is no operation without risk. As it is a large scale operation, the risks should be discussed in detail with the surgeon and the anesthesiologist before the operation.
Beside the risks any complete anesthesia may involve, infections, haematoma, embolism conditions or bad looking scars may crop up.

Before surgery indications

  • do not eat and drink anything after midnight before the surgery;
  • it is forbidden to take aspirin and other drugs that contain aspirin for 2 weeks before the surgery;
  • with women the surgery must usually be done outside the menstruation period;
  • you must tell the doctor or the anaesthesiologist if you have medical problems (hypertension, vascular problems, heart failure, diabetes, lung problems, bleeding problems, epilepsy, neurological problems, allergies to certain drugs);
  • you must tell the doctor if you wear dental prosthesis or contact lenses;
  • if you smoke, plan to stop smoking for 2 weeks before the surgery and do not start smoking until at least 2 weeks have passed from the surgery;
  • avoid extra exposure to sun before the surgery, especially of the abdominal area;
  • do not keep a strict diet before the surgery because it can delay the healing;
  • if you catch a cold or you have an infection of any kind, the surgery must be postponed.

Surgery

Abdominoplasty is done under complete anesthesia. It lasts between 2 and 5 hours, depending upon the complexity of the case. The surgeon performs the first cut in the lower abdomen, under the line of the pants and the second cut round the navel in order to remove the tissues around it. The skin and the subcutaneous tissues are then peeled off till the proximity of the ribs. If it is necessary, the muscular aponeurotic wall is strengthened by stitching up the median muscles. The peeled off tract of skin and fat tissue is stretched downwards and the tegument below the navel together with the fat tissue is removed. Usually, in such an intervention (abdominoplasty), the whole sub-umbilical tegument is removed together with the adipose tissue.
A new hole for the navel is drilled, which is afterwards fastened onto this. Finally, the cut is stitched up and 1 or two draining tubes will be left on the spot for several days.

Post-surgery hospitalisation

As abdominoplasty is deemed to be a large-scale operation, we prefer a longer hospitalization of 5 to 7 days for the patient, in order to increase his/her safety and in order to keep the number of complications down to a minimum. In this time the patient will wear a bandage and an elastic girdle, will receive anti-thrombotic medication and antibiotics. Starting with the day after the operation one will encourage the mobility of the patient in order to avoid thrombo-embolical complications.

Post-surgery recovery

After the patient checks out the stitches will be removed 12 days after the operation. This can be accomplished by the family general practitioner. The patient is to wear the girdle for at least another two weeks after the stitches have been removed. Recovery after abdomen reconstruction occurs at an individual pace. Some persons go back to work after 2 weeks; other persons take three or four weeks to rest and recover. Light physical exercise is recommended in order to strengthen the abdomen muscles. As far as the scars are concerned, they turn red and swell up until 6 months have passed and after 9 months to one year they go flat and turn a lighter color. We recommend that you avoid sun exposure one year after the surgery lest your scars should take on different colors. They will never go away completely, but they can be hidden by your pants or even by your bathing suit.
In order to maintain the obtained results it is important that you should follow a diet recommended by a nutrition doctor and do not shrink back from going in for a sport.

Conclusions

We have a long-standing experience with this surgery, over 1500 cases solved over a period of 20 years. If you are realistic in your expectations and are prepared to bear the consequences which are a permanent scar and a rather long period of recovery, the abdominoplasty is the solution for you.

Find out how you can benefit from this intervention. Make an appointment for an examination at Prof. Dr. Bratu.