This procedure involves removing excess skin and subcutaneous fat from the abdomen. Having a perfectly toned tummy even after giving birth or losing a lot of weight is an attractive idea for many. Especially when the visual results of successful abdominoplasty are demonstrated by Kim Kardashian, Britney Spears and Kate Gosselin, a reality TV star and mother — of-eight-children. Among men, this operation is also quite popular. For representatives of the stronger sex, an example is the experience of Al Pacino, who threw off the extra pounds and turned the "beer" tummy into attractive forms, not without the help of abdominoplasty.
What problems can be solved by plastic surgery of the abdomen: minus the folds, plus the waist
Do not confuse abdominoplasty with liposuction. These are completely different operations designed to solve different problems.
Abdominoplasty allows you to cope with the following negative phenomena:
stretching of the skin and loss of its elasticity after the birth of a large fetus or multiple pregnancies;
sagging skin due to significant weight loss;
excess subcutaneous fat layer, which can not be disposed of in any other way;
ptosis, that is, sagging of the anterior abdominal wall;
diastasis, or divergence, as well as severe stretching of the rectus abdominis muscles;
multiple stretch marks( striae), scars and scars from operations and injuries;
excess subcutaneous fat;
hernias: umbilical, white line of the abdomen, inguinal.
The presence of one of these problems, and most often their combination, becomes an indicator for the procedure of abdominal plastic surgery.
Abdominoplasty is not a way to fight obesity. This operation may be associated with liposuction, but by itself the problem of excess weight will not solve.
I want to, but I can't: contraindications to the operation
Since abdominoplasty is one of the most difficult plastic surgeries and is performed under general anesthesia, it has a fairly wide range of contraindications: both absolute and relative.
Absolute contraindications to abdominoplasty:
inflammatory diseases in the acute phase;
acute and chronic heart failure;
the period of breastfeeding of the child;
blood diseases in the patient or relatives;
obesity caused by endocrine pathologies.
chronic diseases in remission;
the desire to give birth to a child is for women. After abdominoplasty, the skin on the abdomen becomes smaller, and the scar after the procedure is quite large, pregnancy can provoke the appearance of large stretch marks, deformity of the abdomen after the birth of a child. Inelastic skin and the inability of the rectus muscles to "diverge" will not allow the abdomen to" grow " forward, the growing pressure of the fetus can cause disruption of the intestines and urinary system. Therefore, doctors strongly advise not to resort to surgery before giving birth.
If there are no contraindications, and the patient's decision is unshakable, then it is time to prepare for the operation.
Preparation for tummy tuck surgery
The first stage of preparation is to consult with a plastic surgeon. He will clarify the reason for the treatment, collect anamnesis to find out possible contraindications, talk with the patient in order to determine his psychological state. He will also conduct a visual examination of the anterior abdominal wall, determine the turgor of the skin, muscle tone and thickness of the subcutaneous fat layer. As a result, the surgeon will say whether he will undertake the procedure. If the answer is yes, a 3D simulation can be performed, the results of which predict the result of the operation.
Next, the patient will undergo the following tests:
biochemical blood test;
clinical blood test;
tests to determine the group and rh factor (if not previously performed);
blood test for HIV and RW;
After receiving the results of the tests, the patient visits the surgeon again, and also consults with the anesthesiologist.
The doctor may prescribe a special diet: it will help to reduce body weight and clean the intestines as much as possible. During the month before the operation, you should refrain from alcohol and smoking. A week before abdominoplasty, you should limit the use of products that promote gas formation, as well as fatty, sweet, starchy foods. For a couple of days, you should reduce physical loads, stop using decorative cosmetics. Doctors most often prescribe light sedatives: motherwort or valerian.
You need to come to the clinic on an empty stomach. Before starting the procedure, the specialist makes a mark on the patient's body, then the anesthesiologist introduces anesthesia.
Possible complications: what you need to know when deciding on an operation
Unfortunately, even the filigree work of the surgeon can not 100% protect against the occurrence of complications. In most cases, the negative consequences of the operation are caused either by an individual reaction of the body, or by a violation of the rehabilitation regime by the patient himself.
Local complications are more common. These include:
Suppuration in the area of the postoperative suture. Suppuration occurs due to violation of the rules of sterility during surgery or improper treatment of the suture.
Seroma, that is, the accumulation of exudate in the wound. Causes: loose fit of the wound edges, simultaneous liposuction with abdominoplasty. To minimize the risk of complications, it is mandatory to wear compression underwear.
A hematoma, or accumulation of blood in the soft tissues. A fairly rare complication. It may be caused by improper actions to stop bleeding.
Marginal necrosis. Too tight seams, excessive preparation of tissues-all this can lead to insufficient blood supply to the edges of the seam and the death of soft tissues.
Scarring. The appearance of rough scars can be associated with both the reaction of the body, and with the low qualification of the surgeon who sewed the wound.
In the list of common complications:
Anemia due to massive blood loss during surgery.
Abdominal compartment syndrome-increased intra-abdominal pressure. It is caused by excessive tension of the tissues of the anterior abdominal wall. It may be caused by non-compliance with the rules of rehabilitation.
Pulmonary edema caused by a previous factor — high abdominal pressure.
Congestive pneumonia is dictated by the patient's low mobility in the postoperative period.
Tromoboembolism. Blockage of blood clots in the arteries can occur due to cardiac arrhythmias, immobilization of the patient and refusal to wear compression underwear. In some cases, it requires the appointment of anticoagulants.
General severe complications are rare. If the surgeon follows all the rules of the operation, and the patient follows the recommendations for recovery, such negative consequences should not occur.
How to perform abdominoplasty: methods of surgical intervention
As we have already said, abdominoplasty is a complex intervention that requires general endotracheal (gas) anesthesia. Depending on the complexity and volume of tissue removal, the procedure lasts from two to five hours. The method of the operation is determined by the doctor, depending on the nature of the defect and the degree of its development.
Classic abdominal plastic surgery
This operation is prescribed to patients with an "apron", that is, sagging skin in the lower abdomen. The surgeon makes a horizontal incision over the groin area, as well as around the navel. Then the specialist removes excess subcutaneous fat and skin, connects the diverged rectus muscles, corrects the white line of the abdomen, forms the umbilical opening. Next, the surgeon applies stitches. Such an operation is quite traumatic, since a large amount of tissue is usually removed during the procedure.
Abdominoplasty through a vertical incision
In this case, the incision is made not over the pubis, but along the midline of the abdomen. Excess tissue is shifted in this case not down, but from the sides to the middle. Surgeons half-jokingly call this type of operation male, since in men, the "fat trap" is often formed not at the bottom, but at the top of the abdomen. This type is less traumatic than the previous one, since the area of intervention is smaller. However, there is also a minus: the scar from the seam can not be hidden under underwear.
Abdominoplasty combined with liposuction
In some cases, the patient may be shown a combination of two procedures: the removal of adipose tissue together with the strengthening of the abdominal muscles and excision of excess skin. Plus, for the patient, it is necessary to undergo anesthesia only once, as well as to acquire the desired forms after one intervention. It is usually performed when liposuction of the wound edges is required, or when liposuction is performed on the flanks of the abdomen. It should be borne in mind that healing after manipulation will be slower, and the risk of complications will increase.
This species is less invasive than the previous ones. The surgeon makes a short incision in the bikini area and excises only a small part of the skin. This operation is suitable for patients with sagging skin and excess subcutaneous fat only in the lower abdomen. The navel transposition, as well as the connection of the rectus muscles, is not performed in this case. This operation can be performed under local anesthesia.
After performing an abdominoplasty, it is very important to follow all the doctor's recommendations: this will minimize the risk of complications and facilitate the patient's rehabilitation.
Recovery after abdominoplasty: the main thing is to follow the instructions
Depending on how extensive the intervention was, as well as on the individual characteristics of the body, rehabilitation after abdominoplasty can take from several weeks to several months.
After leaving the state of general anesthesia, the patient may feel weak, nauseous, and dizzy. Therefore, in the first day or two after the operation, strict bed rest is indicated. Then the patient can sit up, but in bed it is better to spend another three to five days — in the hospital or at home. With a significant amount of intervention, the doctor installs a special drainage to drain the fluid. It should be cleaned daily, following the recommendations of the surgeon. You also need to process the seams. The drainage tube is removed on the 2nd-5th day. The stitches are removed approximately on the 14th day after the operation. Water treatments can only be carried out with the permission of a specialist.
On a note
Within one and a half to two months after the operation, experts recommend sitting, lying down and even walking in a slightly bent position: this facilitates the process of tissue fusion, weakens their tension. It is better to sleep on your back, with your legs bent.
In the first weeks after abdominoplasty, the patient may be prescribed painkillers, antibiotics. After removing the stitches for the next 6-8 weeks, it is indicated to wear special compression underwear or a corset. This rule should not be ignored in any case, otherwise the tissues can grow together incorrectly, resulting in scars, blood clots, fibrosis, and abdominal asymmetry. Also, the refusal of compression therapy is fraught with edema. For the prevention of stagnation during this period, you can do gymnastics according to the therapeutic program,
walking. Physical activity is prohibited until the sutures are completely healed (2-3 months).
For several months, the patient may notice numbness in the abdominal area. Then the sensitivity gradually returns. Within six months after the operation, you should avoid sunbathing, tanning beds, and adhere to the rules of fractional nutrition. Before taking any medications, you should consult your doctor. After 6 months, the patient can start playing sports and training with weight.
Evaluating the results
In addition to compliance with the rules of rehabilitation, the speed of manifestation and the quality of the result of abdominoplasty can be affected by individual characteristics of the body. Usually, after the removal of edema, that is, about 2 weeks after the operation, the patient can already evaluate their new forms.
The effect of the operation can be noticeable for many years after it is performed, especially if the person makes an effort to keep himself in shape. Weight gain can negate the work of a plastic surgeon. Pregnancy also provokes repeated stretching of the abdominal muscles and sagging of the skin. In this case, you may need to repeat the procedure.
Abdominoplasty is one of the most popular plastic surgeries, designed not only for aesthetic correction, but also to solve some health problems. To get the expected result, it is important not only to entrust the procedure to an experienced specialist, but also to strictly follow the doctor's recommendations during the recovery period. And remember — you do not need to demand a waist like Thumbelina, take into account the features of your body!