Abdominoplasty

Abdominoplasty (also known as panniculectomy, abdominal lipectomy, or tummy tuck) is a surgical procedure performed on the abdomen to remove excess skin and fat, tighten muscles and eliminate or improve scars on the lower abdomen.

The procedure can dramatically reduce the appearance of a protruding abdomen, and may be performed on its own or in conjunction with additional procedures such as laser-assisted liposuction to improve results.

Is Abdominoplasty Right for You?
Good candidates for an abdominoplasty are patients in relatively good health, who have developed laxity in the skin and muscles of the abdomen and stomach areas due to pregnancy or excessive weight gain.

Patients who intend to lose a lot of weight are advised to postpone the surgery until after the weight has been lost. Women who still plan to have children are also advised to to wait until childbearing is over, since the abdominal muscles that are tightened during surgery may separate again during another pregnancy.

How is the surgery performed?
A full abdominoplasty normally takes 2-4 hours, depending on the extent of the work involved. During the procedure:

- An incision is made from hip to hip, just above the pubic area.
- Another incision is made to free the navel from the surrounding skin.
- The skin and fat in the lower abdomen are removed, and the abdominal skin above the level of the navel is then lifted off the underlying muscles up to the lower rib cage.
- The vertical abdominal muscles are tightened with heavy sutures from the ziphoid (solar plexus) to the pubic bone. This provides a firmer abdominal wall and a narrower waistline.
- The remaining skin is then pulled down to the pubic area and sutured.
- A new opening is made for the navel, which can be reshaped to improve its appearance. In some cases, liposuction will also make up part of the abdominoplasty procedure to further improve contour.
- Drain tubes are placed under the skin to drain any excess fluid from the surgical site. The drains exit in the pubic hair region through tiny holes, and are removed approximately a 4-6 days after surgery.
- Incisions are stitched with a self-dissolving suture material, which does not require removal.
- Dressings are placed on the incisions, and a binder is applied to support the abdomen, provide comfort and decrease swelling during the post-operative period.

What to expect after surgery
After surgery, patients remain in the facility, where they are monitored with utmost care for one or two nights depending on the extent of the procedure. When Dr. Lanfranchi considers it safe, patients are transported to a recovery facility to be looked after by trained personnel. Follow up appointments with Dr. Lanfranchi will be scheduled accordingly.

For the first few days, your abdomen may be swollen and you are likely to experience some pain and discomfort. Dr. Lanfranchi’s post-operative pain management protocol should reduce this significantly.

Patients are advised to rest as much as possible for one week, and avoid heavy exercise for at least 30-40 days. Recovery time varies for each individual; however, the average full recovery time is generally one month. There may be some numbness and a feeling of skin tightness for around 6 weeks after surgery, but normally by the third to fourth week, you should look and feel great.

There will be a permanent scar from this procedure, however it is placed very low on the abdomen and hidden by most contemporary underwear and swimwear. Scars may actually appear to worsen during the first three to six months as they heal, but this is normal. It will generally take nine months to a year before the scar flattens and lightens in color.

Risks of Abdominoplasty
Every surgical procedure involves a certain amount of risk. Although the majority of patients do not experience complications, it is important to be aware of the risks, potential complications, and consequences of abdominoplasty surgery.

Bleeding – Although this is highly unusual, some patients may experience problems with bleeding during or after surgery. Accumulations of blood under the skin may delay healing and cause scarring. Should post-operative bleeding occur, it may require emergency treatment to drain accumulated blood. In extreme cases, a blood transfusion may be necessary.

Medical conditions such as hypertension may cause bleeding during or after surgery, so a physical checkup is required before surgery. Patients are also advised not to take any aspirin or anti-inflammatory medications for ten days before surgery, as this contributes to a greater risk of bleeding.

Infection – In rare cases, infection may set in after an abdominoplasty, and prophylactic antibiotics are used to avoid this complication. Should an infection occur, additional treatment including antibiotics or surgery may be necessary.

Scarring – Different people scar in different ways. While most patients heal quite nicely, abnormal scars may occur in individuals who have a genetic predisposition for this. Scars may be unattractive and of a different color than the surrounding skin. Additional treatments are available to treat scarring, if necessary.

Delayed healing – Some areas around the incision may not heal normally, or may take longer time to heal. In rare cases, some areas of skin may die. Should this happen, further surgery may be required to remove the unhealed tissue.

For more information about Abdominoplasty, or to schedule a consultation with Dr. Lanfranchi, please contact us.