Aesthetic plastic surgery of the body Tummy tuck Abdominoplasty

Excess skin, the presence of stretch marks below the navel, the presence of a small-medium amount of fat on the anterior and lateral abdominal wall and finally the dissection of the abdominal muscles can only be treated surgically and the surgery is called abdominoplasty. The purpose of the surgery is to sculpt a slimmer and tighter torso. In a classic tummy tuck, excess skin and fat between the navel and pubic area is removed, with the navel remaining at its original height. There is always one incision around the navel and one horizontally just above the pubic bone that extends to the pelvic bones. The operation is combined with liposuction and, when there is a dissection, with suturing of the muscle. In addition to the classic, there is also the vertical (fleur de lis), mini abdominoplasty and apronoplasty. The doctor will explain which technique is indicated for you based on your history and clinical examination.

Vertical abdominoplasty is usually recommended for patients who have lost a lot of weight and who have horizontal excess skin above the navel and vertical below the navel. As a result of the surgery, in addition to the horizontal incision, there is also a vertical one in the midline. The issue of postoperative scars should be discussed extensively with the patient before surgery, while the choice of vertical abdominoplasty is easier when there is a previous midline abdominal incision from previous surgery.

A mini-tummy tuck is useful for patients with a small excess of skin in the hypogastrium, i.e. the skin below the navel. The operation leaves a smaller scar, approximately 15cm, at the level of the classic abdominoplasty incision. The umbilicus is not prepared, it remains united with its neighboring skin, but it is pulled down 2-3 cm from its original position. And the mini abdominoplasty, like the classic one, can be combined with liposuction, correction of abdominal hernia, umbilical hernia or dissociation of the rectus abdominis muscle.

Apronoplasty (apron = apron) is a reconstructive and not an aesthetic operation. Patients are usually women, older, with a hanging belly, and excess skin mainly in the hypogastrium. This excess causes difficulty in walking and dressing while often causing chronic dermatitis from friction. The purpose of the operation is to relieve the patient and improve his/her quality of life. The operation eliminates the horizontal scar of the classic abdominoplasty. The umbilicus is not prepared, it remains united with its neighboring skin, but it is pulled down 2-3 cm from its original position. And apronoplasty, like classic abdominoplasty can be combined with liposuction, correction of abdominal hernia, umbilical hernia or dissection of the rectus abdominis muscle.

Candidates for abdominoplasty are patients with the aforementioned characteristics, who have stabilized their body weight, have obtained a normal BMI (body mass index) and have no other serious health problems. Female patients should have completed their family planning. If there is an umbilical hernia or abdominal hernia, it is corrected by a general surgeon during the abdominoplasty, without additional incisions.

Abdominoplasty is performed under general anesthesia in an organized clinic. The duration of the surgery is 2.5 to 4 hours. After surgery, it is advisable to stay in the clinic for a few hours and immediately mobilize the patients.

The type of scars depends on the surgery that will be chosen. If a classic abdominoplasty is performed, in addition to the horizontal low incision at the height of the caesarean section, there will be an incision around the navel. In mini abdominoplasty and apronoplasty there is only the horizontal incision and the navel is pulled a few centimeters lower. In the vertical (fleur de lis) abdominoplasty, which is performed when there is already an incision in the midline of the abdomen and the patient has a large excess of skin throughout the torso, there is also a vertical incision. The scars are covered by the swimsuit and underwear. For the majority of women however, even with vertical abdominoplasty, these are negligible compared to the relief they feel from the improvement in contour and strength of their torso. To avoid misshapen or hypertrophic scars, you will be given instructions immediately after the stitches are removed, and you will be put on a follow-up program if you have a history of keloids.

The results are almost permanent and will remain stable as long as patients do not gain much weight or women do not become pregnant. Scars will be visible for the first 8 months, after which they fade and sag.

In a tummy tuck, the skin below the navel is removed, along with old stretch marks and scars. Surgery will not correct the quality of the skin above the navel and patients should be aware that stretch marks and thinning of the skin will remain after surgery but will be less noticeable because the skin that is preserved is stretched.

Among the most serious limitations of the abdominoplasty surgery are the existence of old incisions in the abdomen, serious problems of the gastrointestinal and respiratory systems, large hernias and the possibility of future pregnancy. Also, patients with serious health problems, who cannot receive general anesthesia or those with dysmorphic syndrome should be prevented from cosmetic surgeries.

The doctor will assess your general condition and your history and, if she decides that you are suitable for surgery, she will inform you about the possible complications and what needs to be done to reduce the possibility of their occurrence. You will also be asked to stop smoking and refrain from using supplements that affect blood clotting. The anesthesiologist will then talk to you about the type of anesthesia you will receive and the possible complications.

Depending on your age, you will be given instructions on the medications you may be taking and should be stopped or replaced, as well as on the additional testing you may need to do to investigate hernias. Your weight should remain stable at the lowest levels, because possible fluctuations may postpone the surgery.

The doctor will explain the value of smoking cessation and proper nutrition in wound healing. One week before the surgery, measurements will be taken to order a special pressure garment, you will be photographed and the consent form will be signed.

You stay in the clinic for the first 24 hours, but your time off work must have been calculated at 2 weeks. This doesn't mean you won't be able to do light work much sooner, but you'll generally feel overwhelmed. It is also recommended to refrain from sports for 1 month.

When you leave the surgery you will wear a special pressure garment which you will keep for 6 weeks. You will likely have a drain that will be removed in the first 24 hours, and you will need to be mobilized as soon as possible. You will be given antibiotics for a few days. Pain and swelling when present are easily treated. Because the sutures are intradermal there is no need to remove sutures.