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Abdominoplasty, see before and after, risks, scar and postoperative of plastic surgery that removes excess fat and skin from the belly and even estria

Abdominoplasty, see before and after, risks, scar and postoperative of plastic surgery that removes excess fat and skin from the belly and even estria

Dermolipectomy of abdomen and plastic of abdomen

Indications of abdominoplasty

Abdominoplasty can not remove be considered as a treatment for obesity or an alternative to substitute a balanced diet and the practice of physical exercises. Tummy tuck candidates should be healthy and relatively fit, both women and men.

Plastic surgeon Carlos Alberto Komatsu, director of the Brazilian Society of Plastic Surgery, explains that in patients whose abdominal wall muscles are very weak, sewing performed during surgery can be compromised, since the muscles are not stabilized so easily. Even with weak muscles, plication of the rectus abdominis muscles provides correction of diastasis and stabilization of the abdominal wall. In general, abdominoplasty is often required by women who have had multiple pregnancies, people who genetically have accumulation of fat in the belly region or who had substantial weight loss. What these patients have in common is the development of sagging skin, fat deposits and stretch marks in the belly region. In addition to the diastasis of the rectus abdominis muscles, the main indication of this surgery.

Tummy tuck step by step

Marks for surgery- photo: Getty Images

The plastic surgeon will evaluate the patient's abdomen, checking the quantity and location of accumulations of fat, excess skin or diastasis of the muscles of the abdomen. Typically, abdominoplasty requires two incisions:

- The first is horizontal in the region just above the pubic hairs that extends close to the hips, slightly curved upwards. The extent of this incision and the shape will vary depending on the amount of skin being removed. An ellipse marking is made, where the first incision is made at the bottom. There is no vertical incision. According to the marked ellipse, the skin is removed.

- The second incision is made vertically, ending around the navel, where excess skin of the upper abdomen is separated from the deep parts. Here a subcutaneous detachment is made exposing the edges of the musculature of the rectus abdominis. At this point the abdominal muscles are sutured to become stiffer, which will provide a flatter belly and a more defined waistline. This excess skin is stretched down so that it is removed and a hole is made to reposition the navel in its original position.

After surgery, aspiration drains are placed in the abdomen to prevent fluid accumulation in the region abdominal. These drains are inserted into the lower part of the belly, near the pubis, allowing the scar to be disguised between the pubic hairs, but they are not always necessary. Usually patients have the drain removed on the day of surgery or they can be released home with the drains, which are simple to handle. The drains only cause pain at the time of withdrawal, which can be done at the surgeon's clinic. Once this is done, the surgical incisions can be completely closed, resulting in a single suture in the pubic region and one inside the navel, and dressings and bandages are placed.Types of abdominoplasty

When the extent of treatment is minor, it is called mini-tummy tuck because it removes accumulations of fat and skin only from the lower belly, resulting in a smaller scar. Both tummy tuck and mini-tummy tuck can be associated with liposuction for better results and better body contour.

Anesthesia required for abdominoplasty

In general, epidural or epidural anesthesia is used with sedation and no more than one day of hospital stay.

Surgeon Carlos Alberto Komatsu says that in many cases, it is recommended to have another surgery at the same time that the abdominoplasty is performed. Liposuction, for example, helps define body contours. Breast surgeries and even minor face procedures can be done. "However, it is necessary that the associated procedures do not require a lot of time, which can increase the duration of the surgery beyond the recommended one."

Length of abdominoplasty

The duration of abdominoplasty can vary greatly, but most procedures last between one and three hours. The time varies according to the extent of the treatment, the amount of tissue to be removed and the association or not of liposuction.

Abdominoplasty Contraindications

Abdominoplasty is not recommended in cases where future pregnancies or large or weight-bearing scenarios are predicted after plastic surgery.

People with Obesity and smokers are at greater risk of necrosis, so they should not undergo this surgery. In the case of people with obesity, it is important to lose weight or undergo liposuction before tummy tuck.

There are cases that need to be evaluated individually by the plastic surgeon, for example: people who have had previous surgeries and have scars in the abdominal region, people with some types of collagen disease and some types of smokers. Depending on the scar that already exists, it may even preclude abdominoplasty. Plastic Surgeon Wagner Montenegro, of the Brazilian Society of Plastic Surgery, emphasizes that, in this sense, transparency is very important during consultation with the plastic surgeon regarding all the details that are asked by the doctor. "The relationship of trust and honesty between patient and plastic surgeon is essential for good results."

Preoperative abdominoplasty

In the days prior to surgery all laboratory tests prescribed by the physician must be performed, the use of anticoagulant drugs - such as acetylsalicylic acid - and cigarette and alcoholic beverages, avoided. On the use of medicines it is crucial to inform the doctor, all medicines are being used and over how long. In addition, an absolute fast of solids and liquids must be performed within 8 hours of the procedure.

Abdominoplasty Recovery

For a minimum period of 35 days, the use of a compressor mesh, also known as a post-surgical brace, of adequate size, should be used. to the patient. It is also necessary to avoid physical exertion, such as carrying weight, as well as trying to maintain a slightly curved posture during the first 15 days.

Prior to medical release, the patient should also not drive and can not wear tight clothing (underwear, jeans, etc.). It is important to be careful when sitting down so that you do not overtighten your torso and do not bend too far forward. Exposure to the sun, excessive heat and hot compresses at the site of abdominoplasty suture are also prohibited.

The patient should follow all guidelines until medical release is achieved to resume normal routine gradually.

The plastic surgeon should prescribe analgesics for use if the patient experiences pain in the post-surgical period. It is common for the patient to feel uncomfortable in the first few days, but this will disappear gradually.

Before and after the abdominoplasty

Soon after the abdominoplasty is performed, the patient can already notice the new contours. It is normal for there to be swelling during this period, so all the necessary care is taken for a smooth, uncomplicated recovery. The final result, in which the patient already shows complete healing, called the involution phase, occurs between the eighth and twelfth month after the abdominoplasty.

Tumors of the abdominoplasty

The greatest risk of complication related to abdominoplasty is of thrombosis and pulmonary embolism, so it must be done with a suitable surgeon.

In addition, there is a chance that there is an abdominal flap, which occurs in the skin of the abdomen and compromises the final result, as tissue necrosis occurs. This risk is greater for smokers. It can occur the appearance of keloids, which depending on the severity need to be treated with medicines, surgery to until radiotherapy. According to the plastic surgeon Carlos Alberto Komatsu, there are also the complications common to any surgery, such as bleeding, infection and death.

Abdominoplasty coadjuvant treatments

According to the medical indication, a few days after abdominoplasty it is recommended to perform drainage sessions lymphatic, respecting its healing process, without hurting or presenting risks to the patient. "For all plastic surgeries, postoperative lymphatic drainage helps a lot in healing and healthy recovery," says surgeon Wagner Montenegro.

Check before abdominoplasty consultation:

- The doctor you will see must have registration at the Federal Medical Council (CFM), it is possible to check the institution's website;

- The professional must be a member of the Brazilian Society of Plastic Surgery. Other institutions do not evaluate the training and experience of the professional in this area;

- The surgery should be done in a hospital that has credit for performing medium-sized surgeries. Contact the hospital to check

- Talk to someone who has had surgery with the same doctor and find out about the procedure and the results;

- The length of hospital stay after abdominoplasty should be , at least 24 hours.

Plastic Surgeon Wagner Montenegro, member of the Brazilian Society of Plastic Surgery (CRM: 51769)

Plastic Surgeon Carlos Alberto Komatsu, director of the Brazilian Society of Plastic Surgery (CRM: 59334)


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