Abdominoplasty is a surgical technique that allows the stretching of the abdomen, so it is indicated when its tissues present flaccidity and sagging. It is also called abdominal dermolipectomy.
Its main objective is the removal of excess skin so it will always leave a scar. There are many technical variants of abdominoplasty depending on where the flaccidity is located, highlighting the following:
- Miniabdominoplasty: treats the flaccidity present exclusively between the navel and the pubis. The scar is horizontal and extends along the lower abdomen, being covered by underwear.
- Classic abdominoplasty: it corrects the flaccidity of the entire abdomen, both above and below the navel. In addition to the horizontal scar you will also have another one around the navel.
- Extended abdominoplasty: in the most severe cases of abdominal flaccidity, as occurs when there is extreme thinning, it is necessary to tighten the tissues in two directions, both vertically and horizontally. Therefore, in addition to the horizontal scar there is a vertical scar that descends from the sternal area around the navel and reaches the pubis, drawing a figure that may resemble an anchor or a letter T placed upside down.
- Inverted abdominoplasty: indicated in some cases when the flaccidity is only present between the breast area and the navel. The scar is horizontal and extends below both breasts.
When an abdominoplasty is performed, it should always be assessed whether some type of internal repair on the muscle wall is necessary. In the so-called rectus diastasis there is a weakness in the midline of the abdomen as the rectus muscles (those that mark in athletic people the popularly called “chocolate bar”) appear separated from each other, causing a bulging that is manifested especially when tightening the muscles. It is very frequent after pregnancy. Plication of the rectus muscles solves this problem by bringing the muscles closer together by means of an internal suture extending vertically from the sternal area to the pubis.
A hernia is another type of weakness of the muscular wall that allows the exit of the abdominal contents. Typical are hernias of the umbilicus and those related to previous abdominal surgeries. The herniorrhaphy allows the closure of the hernia and should always be considered in conjunction with abdominoplasty.
Abdominoplasty or liposuction What is the difference?
Abdominoplasty should not be confused with abdominal liposuction. This is another type of surgery focused on the aspiration of subcutaneous fat through the use of cannulas that are introduced through various punctiform incisions.
Although it allows reducing its volume, it never tightens the abdominal tissues. Its best results are obtained when the abdominal skin is sufficiently elastic to adapt to the new contour because, otherwise, we could cause the appearance of flaccidity.
However, in selected cases, abdominoplasty can be combined in the same surgery with abdominal liposuction, a technique known as lipoabdominoplasty. Its objective is to add the benefits of both techniques, stretching the abdominal tissues and reducing the volume of fat.
Abdominoplasty after pregnancy and childbirth
Pregnancy entails a drastic change in a woman’s anatomy, and the abdomen is one of the regions where its repercussions are most evident. Its extreme distension, more pronounced in twin pregnancies, does not always recover completely after delivery and is the cause of frequent complaints due to the appearance of stretch marks, flaccidity, sagging of the tissues and the appearance of diastasis recti.
If the delivery required a cesarean section, this can be an additional source of dissatisfaction. The resulting scar is not always located in an ideal position or may present problems such as discomfort, marks due to surgical sutures or depressions due to deep adhesions.
Abdominoplasty will correct most of these sequelae described after pregnancy by removing the excess skin and the cesarean scar and tightening the abdominal wall by plication of the rectus abdominis muscles. It is important to note that only those stretch marks present on the skin to be removed will disappear but all others will remain because abdominoplasty does not change the skin but only stretches it.
How long to wait for abdominoplasty after childbirth?
The involution of the changes caused by pregnancy is not fast. A healthy lifestyle, the return to their initial weight, exercises to strengthen the pelvic and abdominal muscles and various dermo-cosmetic treatments on the skin can help your recovery. Although it depends on each person, an abdominoplasty should not be indicated before one year after childbirth, giving enough time for the maximum spontaneous recovery of the abdomen.
Abdominoplasty is possible even if you want to become pregnant.
The realization of an abdominoplasty in no way should be understood as a contraindication to a future pregnancy. However, the woman must understand that part of the benefits obtained with this surgery may be lost with pregnancy so it should always be a personal decision.
Results of abdominoplasty What to expect from the operation?
To summarize, an abdominoplasty allows to recover the tension of the skin of the abdomen and repair the weaknesses of the muscle wall, recovering a flat and smooth belly. There are however some factors that may condition the final result. One of them has already been mentioned, is the presence of stretch marks, since only those located on the skin to be removed can be eliminated. Another is the bone structure, especially an exaggerated degree of curvature of the lumbar spine, which can favor a protruding and bulging attitude of the abdomen. And finally, especially frequent in men, is the intestinal fat content, which often causes a tense abdomen that is unlikely to be flat if it is not accompanied by the corresponding slimming of the individual.
Postoperative period and recovery after abdominoplasty
During the postoperative period the patient should take anti-inflammatory drugs, analgesics and keep relative rest. During the night rest he/she will benefit from placing a cushion under the knees and elevating the headrest a little to relax the abdominal region.
The wounds will require daily application of antiseptics until the sutures can be removed, usually after 10-15 days. An elastic girdle should be worn for at least the first month after surgery, especially if liposuction or plication of the rectus muscles was required. For the same reason it is not advisable to resume a physically active life before that date.
The main inflammatory signs may take up to three months to improve. The skin of the operated area initially manifests a deficit of sensitivity that the patient describes as a corkiness and that sometimes may not recover completely. The scars will not have their definitive appearance for at least the first year. Sun exposure should always be avoided until the inflammatory signs have subsided.