Introduction
A pleasing abdomen has toned muscles, firm skin and shapely contours due to the right distribution of fat. The abdominal muscles provide structural support to the abdominal cavity, protect the abdominal organs and also give counter-support to the spine. There are four major muscles namely: external abdominal oblique, internal abdominal oblique, transversus abdominis, and rectus abdominis.
Many women are unable to achieve a flat and toned abdomen even with proper diet and exercise; particularly after pregnancy or major weight loss. In many of them, the rectus muscles are separated or weakened. Some also have exercise resistant fat on the tummy and flanks as well. Abdominoplasty or tummy tuck is a cosmetic procedure which removes excess skin and fat from the abdomen and tightens the abdominal wall muscles to restore a firm and toned abdomen even in such subjects. However deep internal fat has to be lost only by diet and exercise.
Indications
Abdominoplasty is suggested for people who have good overall health, but are worried about excess skin and fat deposits on their stomach that do not respond to lifestyle modifications. It is better if they do not have an excess of deep abdominal fat. A tummy tuck can be performed on men and women who have gained or lost a lot of weight resulting in excess fat or loose skin. It can also be beneficial to women who have had multiple deliveries, causing loose abdominal wall muscles and excess skin around their midsection.
A tummy tuck may not be advisable if you are planning for a future pregnancy and is not a weight reduction procedure
Preoperative Assessment
Before your procedure, a detailed medical history is obtained, and a thorough physical examination is performed. During your consultation, your doctor will advise you to stop smoking, if you smoke, so as to avoid post-surgical complications and delayed healing. You should eat a healthy diet and avoid any restrictive dieting during this time. You should inform your doctor of all medications that you are taking and also about significant medical conditions and previous surgeries if any.
Treatment
Abdominoplasty is performed under general anaesthesia. There are two types of tummy tuck procedures: complete abdominoplasty and partial or mini abdominoplasty.
Complete abdominoplasty is one where a long incision is made from hipbone to hipbone along the bikini line. The abdominal wall muscles are tightened, excess skin and fat are removed and the belly button is relocated with respect to the abdominal skin.
Partial or mini abdominoplasty removes pockets of excess fat and tightens the abdominal muscles but only below the naval. It can be done with a much smaller incision than a complete abdominoplasty. The belly button will usually not need to be moved but depends on the case. The incisions will be closed with sutures. You may or may not have a drain in place depending on your surgeons’ preference.
In a newer procedure called lipoabdominoplasty extensive liposuction of the abdomen and flanks is done first before making the cut on the lower abdomen. The excess fat is thus already removed and the skin is ready to move down by sliding. The remaining procedures become easier, there is almost no bleeding and the recovery is also quicker. This procedure gives excellent contouring as well.
Selected cases can also be performed by a less invasive procedure called Endoscopic abdominoplasty. In this procedure, your surgeon inserts an endoscope through a tiny incision. The scope has a miniature video camera attached.
Video images will be displayed on a large screen, which will guide the surgeon during the procedure. Tiny surgical instruments are inserted through other small incisions over the abdomen for your surgeon to carry out the procedure. This can be used to tighten the muscles. The procedure is only suitable for highly selected cases.
Postoperative Care
After abdominoplasty medications will be prescribed to relieve pain. You will be advised to rest with your hips and knees bent to minimise tension on the repair. You will wear a contoured elastic garment for extra support around the abdomen. Most patients are discharged 1 to 2 days after the surgery, and instructed about proper wound care at home. Stitches are usually dissolving and internal. Specific after-care regimen will help to fade the scar in 3 to 6 months. Strenuous activity is prohibited for the next four to six weeks. You will be able to resume work in 2 to 3 weeks.
Risks
Abdominoplasty is a relatively safe surgery, while lipo-abdominoplasty renders it even safer. However, as in any surgery, there are chances of potential complications including bleeding, blood clots in the lungs or legs, delayed healing, fluid collections, thickening of scar and infection.
Summary
Abdominoplasty is an elective cosmetic surgery that provides aesthetic enhancement to the abdominal region. Proper exercise and a healthy diet regimen are necessary to maintain the results of the tummy tuck.
