Abdominoplasty

Abdominoplasty

Abdominoplasty is one of the most frequently performed plastic surgeries. Desiring to have a beautiful abdomen despite getting older, correcting the negativities in the abdominal area after pregnancy and getting rid of the sagging that occurs after excessive weight loss also play a role in the frequent performance of this surgery.  Abdominoplasty operation is also called ‘Tummy Tuck’ surgery. During this procedure, three different surgeries are performed. First of all, liposuction is performed, especially VASER liposuction has a very positive effect on abdominal aesthetic surgeries and improves the results. First, the patient is laid face down and waist liposuction is performed, then he or she is laid on his back and fat removal continues. Fat on the belly can be removed more safely with VASER liposuction. Classic liposuction may disrupt the blood supply to this area. Then, the abdominal muscles separated from each other due to pregnancy or increased intra-abdominal fat are brought closer together, this is called ‘diastasis recti’ repair. Finally, the sagging skin is removed, and after all this, you will have a flat, tight and beautiful abdomen, and since the abdominal cracks, called striae, are removed with the sagging skin, their amount decreases and sometimes they may disappear completely. The surgery scar is planned to be hidden under panties or bikini bottoms.

What Should Be Considered Before Abdominoplasty?

It is very important that patients do not use blood thinners approximately 7-10 days before this operation. These medications are often used as painkillers and can cause bleeding during or after surgery. Similarly, it is necessary to stay away from some supplements (fish oil) and vitamins (vitamin E). Before the surgery, complete biochemical tests should be performed and the functions of organs, especially the liver and kidneys, should be checked. If the patient smokes excessively or has a previous lung disease, lung functions should also be reviewed. Smoking should be stopped at least for a while before the surgery. Smoking worsens scars and impairs wound healing. The potential danger in this operation is clots that may arise from varicose veins in the legs and should not be overlooked. One of the most common mistakes is to overeat right before the surgery in order to get rid of the fat that I will have surgery for anyway. Going into surgery with as ideal weight as possible has a very positive effect on post-operative results. Therefore, not gaining weight before surgery is necessary for good results.

Can People with Diabetes or High Blood Pressure Have Abdominoplasty?

High blood sugar can both cause a sugar crisis during surgery and impair post-operative wound healing, increasing the risk of infection. For these reasons, people with high blood sugar should undergo Abdominoplasty surgery after their blood sugar is reduced to normal levels with medical treatment.

Serious bleeding may be observed both during and after surgery in individuals with high blood pressure. However, there is no obstacle for people who have high blood pressure but whose blood pressure is kept within normal limits with medical treatment, from undergoing Abdominoplasty surgery. Otherwise, the operation should be postponed until these values ​​come to normal limits with treatment.

Can Smokers Have Abdominoplasty Safely?

People who smoke are at higher risk when having abdominoplasty. Smoking can impair wound healing by reducing blood flow and can cause wound healing problems. Since the blood flow to the cells decreases, the risk of infection may increase. Additionally, smoking can cause the skin to lose its elasticity, making the scar more visible. For abdominal aesthetic surgery, it is recommended that smokers quit smoking at least 2 weeks before the surgery. This time may help improve blood flow and wound healing.

Is there risk to perform abdominoplasty for those who have had surgery in the abdominal area before?

Previous surgeries in the abdominal area may cause some problems in performing abdominal aesthetics (abdominoplasty). This may vary depending on the type of previous surgery, the surgical site, the scarring, and the condition of the tissues. Here are some general factors you should consider in this regard. The type of previous abdominal surgery affects eligibility for abdominoplasty surgery. Abdominoplasty may become difficult, especially if major abdominal surgeries (for example, intestinal surgery) have been performed. If the previous abdominal surgery involved a horizontal and long incision in the abdomen, such as open gallbladder surgery,  liposuction operations can be performed, but it is not appropriate to perform a classical full tummy tuck surgery. In such cases, reverse tummy tuck surgery can be performed. In reverse tummy tuck surgery, the scar remains under the breasts. If there is a vertical scar left on the front of the abdomen after the previous surgery, abdominal aesthetic surgery can be performed using this scar. Abdominal aesthetic surgeries can be performed if it is performed laparoscopically, that is, by entering through small holes on the abdominal wall. However, it should not be forgotten that previous surgeries, including laparoscopic procedures, may cause abdominal hernia.

What Techniques Are Used in Abdominoplasty?

The problem of each abdominoplasty candidate is different. The same technique is not used for everyone. Appropriate techniques are selected according to the problems of the person who will undergo surgery.

If there is only limited fat accumulation in the abdomen and waist, and there is no sagging of the skin, these fats can be removed by liposuction. Meanwhile, if you want to tighten the skin or if liposuction has been performed before, ultrasonic liposuction (VASER) can be used. In cases where liposuction has been performed before, VASER liposuction is preferred because there may be more adhesion in the tissues.

If excess fat is accompanied by excess skin under the bell, the excess skin under the bellybutton is removed. Fat from other areas is removed by liposuction. If the abdominal muscles below the belly button are loose, they are tightened at the same time; this operation is called mini abdominoplasty.

If the problems concern the entire abdominal wall, a full abdominoplasty is performed. Excess fat is removed by liposuction, abdominal muscles are stitched together and excess sagging skin is removed. A new belly button is prepared and this operation is called full tummy tuck. The incision scar is placed so that it is hidden under underwear of the patient’s choice during pre-operative planning.

Which Anesthesia Method is Preferred in Abdominoplasty?

Two types of anesthesia methods are generally used in abdominoplasty surgeries: general anesthesia and regional anesthesia (epidural or spinal anesthesia). Which anesthesia method is preferred may vary depending on the patient’s general health condition, the extent and type of surgical intervention, the surgeon’s preferences and the patient’s comfort. General anesthesia is generally preferred in abdominoplasty operations. The person who will undergo surgery will be completely anesthetized. In regional (epidural or spinal) anesthesia, a local anesthetic substance is injected into the spinal cord or spinal membrane, which numbs the waist and lower abdomen. The person who has surgery retains consciousness, but the lower body becomes senseless. It may be preferred more in mini abdominoplasty surgeries or when the general health condition of the patient is taken into consideration. The surgeon and anesthesiologist evaluate the patient’s condition and determine the most appropriate anesthesia method.

Can Other Aesthetic Surgeries Be Performed together with Abdominoplasty in the same time?

If the general health condition allows, other aesthetic procedures can be applied together with abdominoplasty surgery.

Breast lift or breast augmentation surgery can be performed together with abdominoplasty in suitable patients. In patients undergoing breast reduction surgery, if an inverted T-shaped incision will be used and full abdominoplasty surgery is planned in the same session, great care must be taken as the vascularisation  of the abdominal skin may be impaired.

Fats removed during abdominoplasty can be used in the same session for butt enlargement surgery. Abdominoplasty surgeries can often be performed together with genital plastic surgeries.

If the patient is suitable, excess fat in the legs can be removed by liposuction. Thigh, arm and back lift surgeries can be performed.

Facial plastic surgery can also be combined with abdominoplasty.

However, when planning all these combined surgeries, it should be kept in mind that abdominoplasty surgery is a major surgery and a careful intra and post-operative process is required. A person who has abdominoplasty surgery to solve all aesthetic problems at once should not be put at risk.

Are Drains Used in Abdominoplasty?

Yes, drains can often be used during abdominal aesthetic surgeries. Drains are tubes used to drain excess fluid accumulated in the surgical area and to prevent postoperative complications. Drains, which are commonly used after abdominoplasty, are usually placed  the lower part of the  abdomen and sometimes on the sides. Drains are used to prevent complications such as blood collection (hematoma) or fluid accumulation (seroma) that may occur after surgery. The use of drains varies from case to case. Especially if VASER liposuction has been performed, a drain is preferred to completely remove the fluid given before liposuction and the fragmented fat tissue. When the amount of fluid coming from the drain decreases to around 40 cc per day, the drain is removed.

Is It Painful After Abdominoplasty Surgery?

Pain is generally expected after abdominoplasty (abdominal aesthetics) surgery. The level of pain may vary depending on factors such as the nature of the surgery, the techniques of the surgery, and the person’s general health condition. During abdominoplasty surgery, the abdominal muscles are tightened, especially this procedure may cause pain.

To relieve postoperative pain, local anesthetic drugs are administered both into the fluids given to the liposuction area and into the abdominal muscles that are stitched together to create a tight abdomen. These medications make our patients very comfortable after surgery. In addition, painkillers are given intravenously and then orally in the early postoperative period.

Can Special Support Garments Be Wearied After Abdominoplasty Surgery?

After abdominoplasty (abdominal aesthetics) surgery, patients are generally recommended to wear specially designed corsets or tight clothing. These garments can help support the postoperative period and reduce unwanted dead spaces and tissue swelling. It is recommended that such supportive clothing be worn continuously for the first month and at night for the next 2 months.

What Should Be Considered After Abdominal Aesthetic Surgery?

It is recommended to bend slightly for protection during walking in the first week. Especially in the first days, it should not be taken suddenly, one should first sit in bed, and then a slow, controlled walk should be done with the support of the bed. The first week should be rested carefully. During this time, you should drink plenty of fluids and eat a diet rich in protein.

It is very important to take deep breaths and remove any phlegm. When leaving the hospital, a trifle device will be given for respiratory problems, and these exercies must be done. If not enough good breathing exercise is done, pneumonia may occur. Quitting smoking should be avoided after the surgery.

Light activities and work life can be continued in the second week, but excessive exercise should be avoided. In the third week, the swelling begins to decrease. It shows completely normal activity for four to six weeks.

Are the Results of Abdominal Aesthetic Surgery Permanent?

As long as a healthy lifestyle is maintained and excess weight is not gained, the good results of abdominoplasty surgery are long-lasting.