Overview of Abdominoplasty
The area from the lower part of the breasts to the start of the pelvic area is known as the abdominal trunk. Plastic surgeons often focus on this part of the body for cosmetic improvements. One such method is the “tummy tuck,” or abdominoplasty.
An abdominoplasty is a surgical procedure performed to remove extra skin and fat from the stomach area and to tighten the muscles in your stomach wall. This helps to give the stomach a more toned and attractive appearance. This procedure can include direct removal techniques and liposuction, which is a process that uses a special device to suck out fat from the body.
The popularity of this procedure has grown with the increase in bariatric surgery, which is surgery done to help people lose weight. After substantial weight loss, people can often be left with extra skin on their abdomen. A tummy tuck is a helpful solution for this, as it removes this extra skin, helping patients achieve a more streamlined body shape.
Anatomy and Physiology of Abdominoplasty
The fat around our midsection is separated into different areas. It is divided into two layers, a top, or superficial, layer and a bottom, or deep, layer by something called Scarpa’s fascia. The blood supply for the skin and fat in this area comes from small branches of the superior and inferior epigastric vessels – blood vessels found in our abdomen.
There are also certain areas, like the anterior superior iliac spine (the top front of your hip bone) and your belly button, that serve as structural support for the skin on your stomach. There are additional areas near your groin and the area above your pubic bone, known as the inguinal and mons pubis zones, that are particularly important because they help to keep the structure of your stomach in place, especially after body-contouring surgery like a tummy tuck.
Why do People Need Abdominoplasty
People go for abdominoplasty, also known as a “tummy tuck,” for different reasons. Speaking generally, these are: (1) some men and women simply want to improve the appearance of their stomach, (2) women who have loose skin or a weak abdominal wall after having several kids, or (3) those who have lost a significant amount of weight and now have lots of loose skin around their abdomen.
When deciding if someone is right for this type of surgery, doctors look at the person’s medical history. If the person is in good health and eats a balanced diet, their body should be able to heal well after the operation. People who have recently lost a significant amount of weight pose a different challenge for the doctor. After such a drastic weight loss, the skin can be very loose and require a more intensive surgery. These individuals might also need additional procedures to tighten the skin on their thighs, back, arms and sides, in order to maintain a balanced appearance of their body.
The outcome is generally better in people with lower body mass index (BMI). Those with diabetes may have a higher risk of complications. People with hardly any fat and a firm abdominal wall might only need liposuction. Those with a small to moderate amount of fat and loose skin mainly below their belly button might be a good fit for a “mini” tummy tuck. And for those with a lot of loose skin, extra fat, and a weak abdominal wall, a full tummy tuck might be the best option.
When a Person Should Avoid Abdominoplasty
If a person isn’t in good health, such as having serious heart, lung, or liver disease, or uncontrolled diabetes, they may not be suitable for a certain surgery called “abdominoplasty.” This procedure, often called a “tummy tuck,” involves removing excess fat and skin and restoring weakened muscles to create a smoother and firmer abdominal profile.
Smoking can also be a big problem. It can greatly harm the outcome of the abdominoplasty because this surgery needs a good blood flow to work well. In fact, many plastic surgeons won’t do this surgery on people who are currently smoking.
Equipment used for Abdominoplasty
This procedure does not require any specific tools or equipment. However, if fat removal, or liposuction, is also being done, the necessary tools for that should be on hand. Also, there should be equipment ready to offer closed-suction, which is a method used to remove fluids from the body.
Who is needed to perform Abdominoplasty?
In addition to the main doctor who’s performing the procedure, there should be another medical helper there. This helper can handle tasks like pulling back tissues (which we call “retraction”) during the operation to give the doctor a clearer view. They can also be a big help when it’s time to stitch together the many layers we have to go through in a procedure like a tummy tuck (medical name “abdominoplasty”).
Preparing for Abdominoplasty
Before going into surgery, it’s important that a patient’s health is in the best possible condition. Doctors will generally run tests and check-ups well in advance to detect any hidden health conditions which might make the surgery risky. These tests are personalized based on each patient’s medical history.
Another step taken to prepare for surgery is giving the patient antibiotics before the operation. This helps to decrease the number of bacteria on the skin that could get into the wound during surgery and cause an infection. So, the overall aim is to make the surgery as safe as possible and help ensure a smooth recovery.
How is Abdominoplasty performed
The surgeon makes a large cut along the natural fold above your pubic area, which people often call the “bikini line.” This location helps hide the scar after it heals. Then, they create a flap of skin and fat that extends up to your rib cage, taking special care to avoid causing any problems with blood flow to your belly button. Once that’s done, they fold the flap of skin down to see how much extra to remove before sewing it back into place. The surgeon also tightens up your belly muscles by sewing them together with a type of suture (or stitch) that lasts for a long time. This provides more support for your abdominal wall.
It’s important for the surgeon to be precise when removing the excess skin and when sewing everything back together. That’s because doing so can help you heal better and make the final scar less noticeable. Your belly button is cut out and sewn back into place, but the details of how this is done can vary based on the surgeon’s approach and what’s best for you.
There are certain adjustments that can be made based on your body shape and needs. For example, the surgeon may use a technique called liposuction to remove excess fat from your sides or thighs. If you’ve lost a lot of weight and have loose skin hanging down, the surgeon might do a variation of the surgery that leaves more blood supply intact. There’s also a smaller version of the surgery that might work for people who are at a healthy weight but have loose belly muscles and a little bit of extra skin or fat. This is common in women who have had one or two children and still have good skin elasticity.
After the surgery, it’s important to stay in a slightly bent position for about two weeks to avoid putting too much strain on the stitches. This can help prevent a thick, noticeable scar from forming. If you have a lot of extra fat in your sides or thighs, the surgeon might suggest a procedure that includes a lift for these areas in addition to the abdominal surgery. Whether to use devices like suction drains to remove extra fluid or prescribe antibiotics to prevent infection depends on the surgeon’s opinion and experience.
Possible Complications of Abdominoplasty
After surgery, some people might experience complications such as seromas (pockets of clear bodily fluid) and hematomas (collections of blood outside of blood vessels), which can occur in up to a third of cases. If these aren’t treated, they can lead to the death of the flap (the part of the skin that’s been lifted during surgery) due to inadequate blood supply or infections that can harm the flap and could be life-threatening.
One way that this accumulation of fluids can be reduced is by placing drainage systems that use suction, although high-quality evidence is still needed to show how effective this is. Another complication that needs to be avoided is problems with blood supply to the belly button. Doctors make sure they leave enough fat around the belly button during surgery to ensure it continues to receive blood.
Most common form of these complications are superficial wound complications. If there is too much tension when the wound is closed, this can lead to infection and wound dehiscence, which is a fancy term for when a wound reopens after surgery. To minimize these issues, patients often rest in a ‘semi-Fowler’ position, which involves lying on the back with the head and torso raised. However, despite these precautions, the rate of complications still remains.
What Else Should I Know About Abdominoplasty?
If a skilled surgeon carries out a tummy tuck (abdominoplasty) on the right patient, most patients are happy with the outcome. However, it’s really important for patients to understand that they’ll need to adopt certain lifestyle changes to stop fat from building up around their waist again. This includes regular exercise, a balanced diet, quitting smoking, and avoiding too much alcohol.
