ABDOMINOPLASTY

Who is a candidate?
A flat stomach is important to a physically fit appearance. However, a healthy diet and regular abdominal workouts can sometimes do little to eliminate accumulations of excess fat and loose sagging skin in the abdominal area. If you are bothered by these appearance problems, abdominoplasty (also called tummy tuck) may be a good choice for you.

Abdominoplasty is designed to firm and smooth the abdomen. This cosmetic procedure removes excess skin and fat from the abdomen and may also tighten the muscles of the abdominal wall. The result is a flatter, tighter abdominal profile.

Is an abdominoplasty right for me?
Abdominoplasty is best suited to women and men who are in relatively good shape, but have a loose abdominal skin and/or a significant amount of abdominal fat that won't respond to dieting or exercise.

You may be a good candidate for abdominoplasty if you have one or more of the following:

• Excess or loose, sagging abdominal skin.
• An abdomen that protrudes and is out of proportion to the rest of the body.
• Abdominal; muscles that have been weakened by pregnancy or aging.
• Excess fat that is concentrated beneath the abdominal skin.

If you plan to become pregnant or to lose a significant amount of weight, you should discuss these plans with your surgeon . Scars from previous abdominal surgeries may limit the results of an abdominoplasty. However, in some cases, an existing scar can be used for the new incision, as is often the case for women with Cesarean section scars.

What Should I expect from the consultation?
A personal consultation is the first step for every patient considering abdominoplasty. During this meeting, you surgeon will assess your physical and emotional health and discuss your specific cosmetic goals for the surgery.

You should arrive at the consultation prepared to provide complete information about:

• Previous surgical procedures
• Past and present medical conditions
• Medications you are taking, including herbal remedies or nutritional supplements.

When examining your abdomen, your plastic surgeon will evaluate:

• The quality of your abdominal skin.
• The location of any existing scars.
• The amount and location of any excess fat.
• The status of the underlying muscles.

Your plastic surgeon may suggest other treatment to better meet your appearance goals. For example, some patients may benefit from liposuction alone or a more limited type of abdominoplasty.

How is abdominoplasty performed?
Generally, a horizontal incision is placed just within or above the pubic area. The length of the incision, which extends outward toward the hipbones, depends largely on the amount of skin to be removed. In other words, the more loose skin that needs to be removed, the longer the incision will be. For women, plastic surgeons keep the incision within swimsuit lines, when it is possible. Working through this incision, your surgeon may tighten the underlying muscles by pulling them together and stitching them in place. Any excess skin from the lower abdomen is trimmed away. Skin that contains stretch marks may be removed as well; however, it may not be possible to remove them all.

In patients with larger amounts of loose skin, a second incision may be made around the navel. This way, the excess skin above the navel is separated from the deeper tissues so it can be pulled downward and removed. Although the navel's position remains unchanged, its appearance may be slightly altered.

Are there other options?
Traditional abdominoplasty isn't the best choice for everyone. Your surgeon will advise you if either of these other options will work well with your anatomy and meet your surgical goals.

The "mini" abdominoplasty - This procedure may benefit you if you are primarily dissatisfied with the appearance of the abdominal area below the naval. A mini abdominoplasty requires only a short horizontal incision and no navel incision. It's important to realize, however that the mini abdominoplasty will not correct loose skin above the navel.
Liposuction alone - If you have good skin elasticity and muscle tone, liposuction alone may be used to remove abdominal fat. This alternative may appeal to patients who are planning to become pregnant in the future.

How will I learn about the safety of abdominoplasty?
Each year, thousands of people undergo abdominoplasty and experience no major complications. However, abdominoplasty is an extensive procedure and it is essential for you to be informed of the risks as well as the benefits. One of the most important parts of your consultation is the discussion that you and your surgeon will have about the possible complication of abdominoplasty. In addition to listening carefully to what your surgeon tells you, be sure to raise any questions or concerns that you may have about the safety of the procedure.

What can I do to prepare for my surgery?
When the date for your surgical procedure has been set, your plastic surgeon will provide you with specific instructions for the days immediately before and after your surgery. A number of points may be covered, including:

• Avoiding certain medication that may complicate surgery or recovery.
• Stopping smoking for a period of time before and after surgery.
• Arranging for help or special care following surgery.

How will I be cared for on the day of my surgery?
Abdominoplasty may be performed in a hospital, an outpatient surgery center or an office-based surgical suite. If you are admitted to the hospital, your stay will be a short one, perhaps one or two days.

Medications are administered to keep you comfortable during the procedure. Often a general anesthetic is used so that you will sleep throughout the procedure. Abdominoplasty may also be performed using local anesthesia with intravenous sedation.

How will I look and feel right after surgery?
When surgery is complete, you'll be taken to a recovery area. In many cases, small drainage tubes will have been placed beneath the skin to help prevent fluids from accumulating. Any discomfort you may feel can be controlled with medication prescribed by your plastic surgeon. Dressing may be applied to your abdomen and covered with tape or an elastic bandage.

Although you may not be able to stand perfectly straight at first, you will be encouraged to get out of bed soon after surgery to promote blood circulation. In this early phase of healing, straining, bending and lifting should be avoided. Your surgeon may instruct you to sleep on your back with your knees up.

Although everyone heals at a different rate, you can expect that your recovery will follow this general time line:

Within the first week

• Surgical drainage tubes will be removed.
• Stitches will be removed (may take 10 days).
• Bruising and swelling will reach its peak.

After several weeks

• You will no longer need to wear support garment.
• You may gradually increase your activity and exercise.
• You may return to nonstrenuous work (typically within the first 3 weeks).
• Bruising and swelling will continue to subside and you'll begin to see your results.

After a few months

• You'll see a truer picture of the final result of your surgery.
• Feelings of numbness or tightness will disappear. Your incision line may begin to fade from its reddish color (full fading may take a year or more).
• In the months following surgery, it's important to treat your healing skin with extra care - that means avoiding sun exposure and not wearing black or other dark colored clothing when you are outdoors. Heat absorbed by dark-colored clothing can actually burn your healing skin and complicate recovery.

What should I know about my results?
Quite soon after surgery, you will see a noticeable difference in the shape of your body. Many people find that their firmer, flatter abdomen boosts their confidence and makes them feel more comfortable in clothing.

As the months pass, your incision line will continue to fade; however, it's important to realize that your scar will be permanently scar as a small tradeoff for their firmer, sleeker appearance.

Abdominoplasty produces long -lasting results. Unless you gain or lose a significant amount of weight, you can expect to retain your new shape for many years. Over time, gravity and aging may cause your skin to loosen somewhat. If this occurs, your plastic surgeon may suggest additional treatment for restoring a more youthful abdominal contour.

How long will I continue to see my plastic surgeon?
After the initial period, you will return to your plastic surgeon's office for a postoperative follow-up visit so that your healing and progress can be evaluated. In the following months, your surgeon may ask you to return for periodic checkups. It's important to keep these appointments so that your surgeon can assess your long-term results and address any questions or concern you may have.