Estetska kirurgija - Abdominoplastika - Lege Artis 001

Abdominoplasty

Abdominoplasty is a surgical procedure that removes excess skin, subcutaneous tissue and fat tissue of the abdomen and tightens the musculature of the abdominal wall.

Loose or saggy abdomen most commonly occurs after a significant weight loss or in women after several pregnancies. Genetic factor plays an important role here as well: type and quality of skin, i.e. connective tissue.

Excess skin and fat tissue in that area most commonly represents a great esthetic and psychological burden. Likewise, it can lead to significant health problems due to the occurrence of skin defects caused by pressure, friction and sweating.

The goal of the surgery is to reduce fat tissue of the abdomen and form esthetically acceptable appearance – flatter and tighter abdominal wall.

Description of the procedure

There are several types of abdominoplasty – abdomen tightening or ‘tummy tuck': from the removal of small amounts of sagging skin and fat tissue, to major procedures which strengthen the entire abdominal wall. Stretch marks can be removed when they are limited to the area of resection and are removed along with excess skin. Often it is necessary to correct the position of a belly button as well. A corset is worn for 1-1,5 months.

Candidates

Except in women, after several pregnancies with great weight gain, this problem occurs in both sexes after significant weight loss. It is not possible to correct it with exercise, diets, or different creams and cosmetic treatments, and often, not even with liposuction.

After the examination and interview with our surgeon and anesthesiologist, you decide jointly on the procedure. It is very important to create trust between the doctor and the patient, and clarify what are the expectations in regard to the possible outcomes of the procedure.

Preparation

As well as with all other procedures done under general anesthesia, it is necessary to do laboratory tests and ECG, and bring other previous medical documentation – all information on this topic will be provided during the consultative examination with Dr. Čandrlić.

It is necessary to stop smoking a month before the procedure due to a detrimental effect on microcirculation; a week before, it is necessary to stop taking preparations based on acetylsalicylic acid (Aspirin, Acisal, etc.) and other medications and preparations that can affect blood clotting in order to avoid unwanted bleeding.

Course of the procedure

The procedure is done under general anesthesia; it takes about 2-4 hours. The incision is horizontal, placed in the lower part of the abdomen, above the pubic hair line, lateral towards the pelvic bones. Length depends on the level of looseness and volume of the tissue. Commonly, it is in line with a bathing suit, hidden very low, so it is not visible beyond the line of the underwear. Sometimes, an additional cut towards the belly button and around the belly button is required, due to a more complete skin and subcutaneous tissue mobilization.

Skin and subcutaneous tissue are re-stuffed all the way to the muscle fascia, upwards toward the ribcage. The abdominal muscles are tightened and put together, shaping new body contours. Excess tissue is tightened and removed. Belly button is moved, or a new one is formed that looks like the current one. In some cases, drains are placed during the next few days; however, they are mostly unnecessary.

Sometimes, along the abdominoplasty, it is necessary to do a hydroliposuction at the same time, during the same procedure.

Postoperatively, a custom-made corset is immediately put on. Patient stays in a suite during the next few hours for the sake of surveillance, analgesia and bleeding control. If necessary, the patient stays overnight. The patient should be lying with knees bent – in order to avoid abdominal tension around the incision. Corset is worn for 6-8 weeks after the procedure.

Recovery

24 hours after the surgery: patient should get out of bed periodically, with mild stroll, in a bent position, in order to stimulate circulation. Patient should avoid straightening up suddenly and physical strain.

7 days after the surgery: first control examination; still avoid strain, physical and sexual activities

2 weeks later: 10-14 days postoperatively, sutures are extracted, and the patient can return to his private and professional activities. Swelling will reduce and hematoma will disappear in a few weeks; in a couple of months, real results of abdominoplasty will be evident. Some parts of the abdomen will be numb – due to cutting of the skin nerves – it will last for a couple of months. In the beginning, the incision will be red or pink colored; such color will remain for the next couple of months after the procedure, but will fade over time.

Precautions and limitations

During the first couple of days after the surgery, swelling and hematoma can be expected. Within the first 24-48 hours, cold compresses should be applied to the area, avoid smoking and physical strain. During the first week, operated part of the body will be tightened and painful, swollen and bruised, which can be alleviated and reduced with analgesics, compresses and wearing a corset.

Side effects and complications

Complications after abdominoplasty are rare; they can be early and late.

Early complications are: hematoma, infection and necrosis around the incision; most commonly in smokers and diabetics. Serum can be accumulated as well in lower parts of the abdomen, under the skin; it can be present for several months after the surgery.

Late complication can be the occurrence of a hypertrophic scar.

Package

Package includes: first consultation examination with the doctor, preoperative examination by an anesthesiologist, surgery under general anesthesia, a corset, postoperative supervision, necessary medications, reviews and bandaging during the first postoperative days, extraction of sutures and necessary control examinations one year after the surgery.
Package does not include: preoperative laboratory tests (blood tests), ECG, intern’s examination, consulting with other specialists (specialist for diabetes, asthma, high blood pressure, thyroid gland, transfusion), medications that you will take at home.
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