An Abdominoplasty comes in several forms. A Standard Abdominoplasty involves an incision from hip to hip and usually a diastasis repair (an internal tightening of the abdominal tissue that loosens after pregnancy and weight gain.) This procedure involves complete elevation of the excess skin and fat of the abdomen, repair of the muscles in the abdominal wall, and removal of all excess skin and fat from the belly button to the pubic region. The umbilicus requires relocation.
A Mini Abdominoplasty is performed when only a small amount of the excess skin is required to be removed. This can frequently be performed with Liposuction. Usually, the umbilicus location is not removed during a Mini Abdominoplasty. Careful consideration during your preoperative consultation needs to be made before choosing this type of less-invasive procedure.
An Extended Abdominoplasty involves a longer scar usually extending almost to the back. This procedure is used for patients with significant skin and fatty excess but with fairly normal skin tension and fat deposits in the back.
A Circumferential Abdominoplasty is performed usually in patients with massive weight loss and involves an incision that completely encircles the body. The surgery is performed with a change in surgical position starting on the back and finishing on the front. This allows the benefit of elevating the buttock tissue to relieve sagging and also improve some degree of thigh laxity.
This procedure can take anywhere from 1 to 5 1/2 hours depending on the degree of excess skin that needs to be removed. Raleigh Plastic Surgery Center performs all types of Abdominoplasty surgeries in our AAAHC accredited surgical suite under the care of our board certified anesthesiologist. Patients with pre-existing health problems or with excessive weight may have to have the procedure performed in a hospital. However, when the procedure is performed in our surgical facility the patient remains in the recovery room for at least 1 to 1 1/2 hours until they are comfortable enough to go home. Pain is managed intra-operatively with the use of long-lasting numbing medications, such as Exparel, which is injected into surgical sites during the surgery to provide postoperative pain relief. Oral narcotic medications are also necessary. Risks of surgery include hematoma, fluid collection, infection, tissue loss, numbness, and wide scars as well as deep venous thrombosis and pulmonary embolus. Prevention of these is very important in the safe performance of this procedure and may involve the use of blood thinners post-operatively.
An Abdominoplasty procedure requires at least 2 weeks of recovery from most jobs, housework, and moderately strenuous activities. Exercise at the gym is avoided for at least 1 month. Drainage tubes are frequently used, especially when Liposuction is added to help eliminate the excess fluid. The drains are removed painlessly in the office about 1 week after the operation. You will see your surgeon at least 2 or 3 times in the first few weeks. An abdominal is used to hold the dressings in place for the first week and then switched out to a lightly compressed garment. We counsel our patients to plan family help and assistance during the recovery since day to day activities are limited in the first week to 10 days. Driving is best avoided for the first 10 days or when taking pain medicine.
For more tips on how to create a post-op recovery space at home visit our blog!
Q: Can Liposuction take the place of an Abdominoplasty?
A: Most patients who have skin excess and stretch marks are best served with an Abdominoplasty. Liposuction may be used to improve the result and decrease other stubborn areas. Liposuction alone is used to manage excess fat of the abdomen and may be a suitable surgical strategy if you have good skin tone to allow for proper retraction. If this is not present, excess loose skin remains and would be unsightly if not removed.
Q: Will I be able to wear a two-piece bathing suit?
A: The scars are made as low as possible and can be hidden in many two-piece bathing suit styles. However, there will be a scar that will never completely disappear and modifications of the desired bathing suit may be necessary. The belly button scar takes up to 6 months to become less noticeable. We suggest the use of scar cream, such as Biocorneum, for 4-6 months to minimize the appearance of scars.