The purpose of abdominoplasty is to remodel the abdominal wall that for many reasons such as maternity, obesity or sudden changes in weight has been deformed.
When we analyze an abdominal wall we must take into account three parameters: the skin, the fatty tissue and the muscular wall.
Regarding the skin it is important to evaluate the flaccidity of the skin, to see if it has an abdominal apron above the pubis, to see if it has stretch marks, if it has scars such as cesarean section, appendicitis, etc. …..
To assess the fatty tissue must take into account that the flanks and back are an important part in the remodeling of the pelvic girdle and waist. It is also important to assess that women in the premenopausal and menopausal period accumulate fat in the back, flanks, the mother’s bottom, etc.
The fat at the level of the epigastrium, around the navel, in the suprapubic region must also be taken into account. Finally, it is very important to assess the muscular wall. The rectus muscles are not two muscles, there are 8, four on each side and then on the sides there are the superior oblique, inferior oblique and transverse oblique muscles.
When a woman is pregnant, not only does the abdomen widen transversely, but a sphere is formed, i.e. the transverse axis and the longitudinal axis increase, and this is the basis of our technique. With the patient in orthostatic position we make a very precise design of the skin area to be removed, measuring well to place the scar as low as possible and that it covers the bikini and liposuction areas.
What does the procedure consist of?
First of all we make a liposculpture of the back, of the flanks, of the mom’s bottom and also of the abdominal wall and the pubis. Then we resect the skin ellipse and proceed to leave the umbilicus in place and lift the entire skin flap to have all the musculature ready to perform a good repair and a good hemostasis. Then we suture the midline to correct the diastasis of the musculature, which is the usual technique.
But this is not the end of our technique because with this we have solved the transverse diameter, but when the woman became pregnant a transverse separation was not formed, but a sphere was formed. It is therefore necessary to correct the distended longitudinal axis so that when she sits down this sphere does not form.
Once the longitudinal diastasis is sutured, we sit the patient down and mark the center of her distension and make a transverse plication to flatten the abdomen. This has given rise to our technique which is referenced in many books and was published in the American journal: Plastic and Reconstructive Surgery.
In this way we get a flat muscular wall both standing and sitting and at the same time we get a very good waist and a very low scar that is covered by the bikini.
With this technique we get that the woman who has had one or more pregnancies, processes of weight changes or accumulation of fat due to hormonal changes, regain a very nice silhouette and a very good waist.