Abdominoplasty of the abdomen. What kind of operation is it, how is it done, photo before and after, indications and contraindications, consequences

Plastic correction of the abdomen is resorted to as the last resort, when nothing else helps, or when there is no way to play sports intensively.

Today, abdominoplasty of the abdomen is almost the most popular procedure in aesthetic surgery, along with Botox injections and liposuction, since these procedures give the most effective result of appearance correction. Photos before and after the methods provide an excellent opportunity to verify this.

Types of abdominoplasty

The specific type of tummy tuck chosen by the doctor depending on the nature and volume of body fat, the age of the patient, the individual characteristics of the body and some other factors that affect the complexity of the operation.

Surgery lasts an average of 2 to 5 hours. The patient at this time is under general anesthesia, gas endotracheal anesthesia is used.

With aspiration of adipose tissue

This is a classic method of surgery, including correction of deformities of the anterior abdominal wall and liposuction – removal of fat depots. The technique allows you to create a thin waist, removes excess skin from all parts of the abdomen and most of the adipose tissue.

Abdominoplasty with aspiration is performed in patients with high ptosis of the abdomen (3-4 degrees of deformation), with a skin fold like an apron. If necessary, the surgeon touches the area on the sides of the body. Classical intervention is prescribed to get rid of diastasis (divergence of the rectus abdominis muscles) and hernial formations.

The operation is carried out in several stages:

• Marked contours of skin to be removed.
• According to the planned line, the surgeon makes an incision in the lower abdomen (in the skin fold along the line of the pelvic bones and above the pubic part).
• By successive exfoliation, the skin is dissected to the edges of the ribs and lateral lines of the body.
• The skin is dissected in the navel, then the umbilical exfoliates.
• Excessive skin tissue and fat mass are removed.
• The hernia or diastasis is removed (cases of rectus muscles are sewn along the white line of the abdomen).
• The aponeurotic system of the abdomen is strengthened by pulling the upper part of the skin towards the pubic part.
• Planned areas of excess skin are excised and pulled.
• The incision is stitched with a cosmetic seam.
• Drainage tubes are placed under the skin to avoid fluid accumulation in the wound area.

Miniabdominoplasty

A common type of surgery takes about 2.5 hours. Experts recommend it to patients without an excessive amount of fat accumulations, if there are imperfections in the waist and abdomen, for example, severe diastasis after pregnancy, stretch marks, stretched sagging skin. In this way, the abdomen is pulled along the lower sector; belly button transfer is not required.

Features of mini-abdominoplasty include the execution technique:

• By an primical method with two circular cuts in the umbilical (goal: to get rid of saggy skin and small folds near the navel). The wound is stitched with a purse string suture. After a while, the seam is almost invisible.
• The technique of making a cut along the “bikini line” (to get rid of stretch marks in the area below the navel). Excess tissue is pulled to the level of the umbilical, and muscle tissue is sutured and strengthened. A cosmetic seam is applied.
• Atraumatic skin de-epidermisation technique , i.e., only the surface layer of the skin is removed. The method is intended for restoration of the abdomen with minor defects.

Middle abdominoplasty

The main goal is to excise sagging tissues of the abdomen (“getting rid of the apron” – the name of this type of operation (apronectomy) is translated. In essence, this operation is a cross between classical adominoplasty and mini-abdominoplasty. This operation is prescribed for patients with a clear excess of skin in the lower abdomen, which will not be enough to conduct a mini – operation.

The process of secondary abdominoplasty includes:

• general anesthesia lasting 2.5 hours;
• short scar on the skin;
• elimination of a small amount of adipose tissue.

Complete abdominoplasty with or without umbilical ring surgery

An operation of this type (abdominotorzorafiya) affects, in addition to abdominal tissues, the lateral surfaces, the back with the buttocks. The result before and after can be compared by photographs. Surgical intervention ensures that the navel is moved to the correct position (in the middle part of the abdomen relative to the pubis and sternum of the xiphoid process).

It is done to patients with a large mass of body fat, stretched skin and stretch marks on the back and sides, pronounced umbilical hernia.

The following umbilical ring defects are distinguished:

• the navel protrudes and protrudes;
• the umbilical fossa is too deep, due to the accumulation of secretions of the sebaceous glands, it is prone to inflammation;
• the navel is too wide, stretched longitudinally or transversely;
• sagging of the navel;
• lateral displacements or very low / high location;
• scars from previous operations.

Details of the operation with plastic umbilical ring:

• Excess skin is excised.
• The navel is transposed either to its usual place or to a new one with the formation of a new hole in the skin.

Vertical abdominoplasty

Recommended by surgeons to patients with a vertical scar that runs along the midline or pubic area – from past operations. Often there are oblique scars on the right in the iliac abdomen (after removal of appendicitis) or on the right under the ribs (after cholecystectomy).

The vertical method is used if a significant excess of tissue is observed on the sides of the patient and above the umbilical (suitable for people with obesity). The method works well with a strong divergence of the abdominal muscles (stage 3 diastasis). Method of execution: an incision is made vertically, in addition, horizontal access is performed, which is characteristic of classical abdominoplasty.

Advantages of the method:

• a large layer of tissue is cut off in the middle zone of the abdomen;
• the surgeon can separate the edges of the skin with adipose tissue in the approximation of the stitched parts of the aponeurosis of the anterior abdominal wall;
• a noticeable decrease in the volume of the waist and body of the patient, as a wide duplicate of the aponeurosis is created along the anterior abdominal wall (this removes excess skin in the epigastric).

Lateral abdominoplasty

It involves making cuts on the lateral parts of the abdomen. Combines the technique of classical and vertical techniques, also called “stress – lateral” abdominoplasty, because skin tension is made at an angle of 90 degrees to the vertical axis of the patient.

Displaced tissues are in the lateral parts of the abdom
en. The method shows good results in order to form a waist.

A small detachment of the skin flap during surgery gives the least complications at the healing stage. A small strand of tissue on both sides of the scar will allow the formation of a thin imperceptible trace of interference.

Abdominoplasty with the allocation of the waist contour

It is performed for patients who want to return a bend to the lateral abdomen or form a waist line if, at the time of surgery, there is a large volume of the abdomen and bulging of the anterior abdominal wall. To achieve good performance and satisfy the patient’s desire, the surgeon removes one or two pairs of ribs of the lower section.

In this type of operation, excess skin is excised in the lower abdomen, while the formed suture is located below the umbilical and, after healing, safely disappears under the laundry, without giving out surgical intervention.

Endoscopic abdominoplasty

This is a method by which a tummy tuck is performed in a gentle atraumatic way, sometimes accompanied by liposuction. The operation is indicated for defects in the anterior abdominal wall and unexpressed obesity, i.e. mainly for young patients with elastic skin (most often, endoscopic intervention is done to women after childbirth to restore harmony).

The low invasiveness of the method is due to small punctures, and not a cut, as with other types of abdominoplasty. Through the punctures, the muscles are sutured with endoscopic equipment, and the skin remains intact. Traces of punctures after a short period of time become invisible.

Indications and contraindications for surgery

Abdominoplasty of the abdomen demonstrates in the photo before and after that people go for surgery not only to give an aesthetic appearance to the body, but also according to weighty indications.

Indications:

• The presence of excess adipose tissue in the anterior abdominal wall and in the lateral parts of the abdomen. Redundancy refers to the mass of adipose tissue that cannot be effectively removed by liposuction, sports and diet.
• If a large area of the skin of the abdomen is covered with stretch marks (cicatricial atrophy).
• If the patient does not have a pronounced waist as a feature of the constitution of the figure or as a side effect of increased pumping of the oblique muscles. The presence of gross scars, hernias.
• When the aponeurotic of the anterior abdominal wall diverges as a result of stretching factors (fullness, pregnancy, or genetic weakness of the structure of the connective tissue). Muscles diverge along the white line of the abdomen (the so-called diastasis is formed), in some cases, in addition to diastasis, hernias of the abdomen and navel are noted.

In addition, the operation is indicated if it is necessary to perform plastic surgery on the umbilical and restore the navel.

This part of the abdomen is often exposed to unpleasant defects due to the following reasons:

• defects during pregnancy due to overstretching of the abdomen;
• as a result of poor-quality piercing (an unsuccessful puncture leads to inflammation, connective tissue grows in the area of the piercing);
• changes in the shape and location of the navel after other operations;
• with various structural features of the umbilical part of the abdomen;
• with age-related ptosis of the abdomen.

There are a number of contraindications for abdominoplasty, about which it is necessary to inform the doctor in order to make a decision on further actions.

Surgical intervention cannot be performed in the following cases:

• in acute infectious diseases or during an exacerbation of chronic diseases;
• in the presence of diabetes mellitus of any type;
• with blood diseases and problems with blood coagulation factors;
• at any gestational age, during lactation and pregnancy planning for less than 1 year after abdominoplasty;
• with a tendency to form a keloid or hypertrophic scar at the incision site;
• with oncological diseases;
• with severe diseases of the internal organs;
• with chronic heart or pulmonary failure;
• if possible the onset of a crisis of arterial hypertension;
• with violations of the thyroid gland;
• in conditions of fresh postoperative scars;
• with allergic reactions and intolerance to the components of local anesthesia;
• with an unstable state of the patient’s psychoemotional sphere or mental disorders;
• under the age of 18;
• with significant obesity of the patient.

In the latter case, he is recommended to maximize weight loss through diet, exercise before surgery. In some situations, liposuction is done before abdominoplasty of the abdomen. As healing proceeds to preparation for abdominoplasty.

Weight gain threatens to increase the postoperative period, problems with sutures.

Also, a recommendation to reduce weight before surgery is received by patients whose plans included losing weight after surgery (this can damage the obtained abdominoplasty results, as the skin will sag, friability and sagging will appear).

Traces of memory: scars and scars

Traces of abdominoplasty performed on the abdomen, shown in the photo before and after, thanks to the professional work of surgeons, become unnoticeable after a while. The use of high-quality suture material and special technique for suturing surgical incisions helps to obtain a thin strip at the scar site.

The condition of the suture is carefully monitored for the first weeks after surgery. Cutaneous sutures must be removed after 2 weeks, intradermal sutures made with suture thread with self-absorbing ability, or glued sutures do not touch, only process.

If abdominoplasty of the abdomen was very serious, photos before and after show the difference, and the scars are visible, you can resort to modern cosmetology. To remove scars and scars, laser resurfacing and radiolifting procedures or retouching with medical tattooing for an aesthetic appearance are used.

The rehabilitation period and possible complications

Abdominoplasty entails a long recovery period. The first 1 – 1.5 months are particularly difficult, in general, rehabilitation takes 6 months.

After the operation, the patient must be under medical supervision for at least 3 days, of which:

• The first day the patient lies in the ward. Nothing is allowed from food right away, and after restoration of bowel functions you can take light food. Water intake is allowed.
• On the second day, the patient begins to get out of bed gently, lig
  ht food and drink are allowed.
• On the third day after the examination by the surgeon and depending on the state of the operated person, the issue of discharge is resolved.

General well-being after abdominoplasty is noted by painful sensations and tension in the middle of the body. Discomfort can last up to 3 weeks – some patients even need help with lifting from a horizontal position.

The supervising doctor will recommend the patient to maintain bed rest, limit the load, and give a number of recommendations:

• The need to wear compression underwear for at least 1 – 2 months after surgery. Fixation underwear helps healing and prevents seams from dispersing.
• Proper nutrition. The postoperative period is not the time for diets.
• Daily regimen without overloads (ban on fitness, visiting the baths, saunas).
• A minimum of water procedures so that the seam does not come into contact with water. An ordinary shower is allowed a week after the operation, but the seam must be protected from soap and detergents.
• Suture treatment with antiseptic solutions 3 times a day.

Not always the postoperative period goes smoothly. If any complications occur, the patient must necessarily see his doctor.

Individual reactions of the body in the form of such local complications are possible:

• Edema as a response to injury. Edema tends to increase throughout the first postoperative week, but this is a physiological process. Sometimes edema persists throughout the recovery period.
• If nerve branches are affected during surgery, a loss of sensation of the skin at the site of intervention may be noted. After complete restoration of the body, sensitivity usually returns.
• The occurrence of hematomas. Accumulated blood in the upper layers of the skin gradually dissolves. Sometimes hematomas under the skin occur after discharge. Hyperpigmentation of the skin may appear.
• The seam area festers if sterility is not observed or the seam is improperly treated.
• Exudate can accumulate in the wound, seroma occurs due to a loose fit of suture edges. Proper drainage of the separated fluids and compliance with the wearing of compression garments are necessary so as not to complicate the situation.
• If a flap of a tissue larger than necessary is removed during surgery, tension of the seams occurs. This leads toal necrosis – tissue necrosis.
• Rough scars at the healing site of the incision.
• It is dangerous if blood or fluid from tissues accumulates in the abdominal cavity after surgery.
• The wound in the operated part of the abdomen becomes inflamed. In order to avoid, patients receive antibiotic therapy after the intervention.
• There are cases of divergence of sutures along the edge of the wound, if the patient lifted weights or overdid it in the gym.
• A fat roll may form above the seam.
• Chronic pain in the operated areas.

If the muscles were stitched unevenly, asymmetry of the anterior abdominal wall occurs. For removal, the patient will have to undergo another plastic surgery or use alternative methods (filing with his own fat or filling with fillers based on hyaluronic acid).

When can I have sex after surgery

A return to intimate life is allowed no earlier than a few weeks after the operation. Restrictions are introduced due to edema, discomfort, the risk of seam divergence. During sex, a rush of blood occurs in the pelvic area, which is undesirable in the recovery period.

The exact timing of the return of sexual life depends on the well-being of the operated person, on average, they are resolved 1 month after surgery.

Is it possible to give birth after abdominoplasty

Experts recommend that women first give birth, and then engage in bringing the abdomen into an aesthetic appearance. During pregnancy, abdominal tissues are subjected to excessive tension, which may affect the results of the operation.

But if the patient decided to become pregnant after plastic surgery of the abdomen – and this operation affected only the skin and fatty tissue without damaging the muscle fibers – then the front abdominal wall can withstand the load for 9 months. The method of delivery is in no way associated with the presence of abdominoplasty and lies entirely in the field of obstetrics.

Beauty fee: how much it costs and how long the result lasts

The level of costs for surgery, hospital stay, anesthesia, tests and related services can be determined based on the type of surgery. First you need to go through a consultation with a surgeon. On average, the price starts at $ 1904. You can find out approximate prices on the sites of clinics practicing abdominoplasty of the abdomen, there you can see the photos before and after.

It’s difficult to decide on an operation, anesthesia, postoperative recovery, and a considerable cost of the procedure are frightening. However, the result of abdominoplasty will remain for years to come, this is a reasonable contribution to maintaining harmony.

Video about abdominoplasty of the abdomen. Photos before and after surgery

When abdominoplasty of the abdomen is required: