What is a tummy tuck and for whom is it used?
The tummy tuck or abdominoplasty is a cosmetic surgery procedure very common on women, especially after having been pregnant or have lost massive weight. Also known as tummy tuck, "the abdominal" or abdominal lumpectomy. This surgery reaches the goal that creams, massages or exercise can’t give you. Even with proper diet and an intense regimen of exercise, they cannot restore loose skin or tight loose abdominal muscles from pregnancy.
If you have an ideal weight, but with skin excess and fat in the abdomen, and you don’t want any more pregnancies and a flat stomach again and without stretch marks, a tummy tuck is indicated for you. On overweight patients a proper nutritional regimen also helps along with but with more modest results.
There are several variants of this surgery, depending on the needs of each patient; the surgeon may tell you some during the consult; for example, mini abdominoplasty, reverse abdominoplasty, tummy tuck circular in conjunction with liposuction. These are the options, but we will agree on one, you according to your case.
How our medical team performs this procedure?
During the consult we will investigate diseases that you have or have had, medications you take or have taken, you laboratory tests depending on your age and will be reviewed by the Plastic Surgeon and Anesthesiologist. The day of surgery you have to come with an empty stomach, stop taking aspirin or extracts from medicinal plants 2 weeks before, this affects coagulation and cause bleeding. The anesthesiologist will talk about anesthesia options, which for safety and comfort is usually with epidural (anesthesia from the chest to the legs) with sedation. Or sometimes you will be under general anesthesia, depending on each case. Before going into the OR, the surgeon will mark the skin in areas where fat has to be removed; nurses sterilize the skin to minimize the risk of infection. The skin and fat is removed from the lower portion of the abdomen, we rearrange your abdominal muscles so they are not loose and stretches the skin to leave a scar that lies below the underwear.
Every case is different, there are times when there is not much skin to remove and the scar is smaller (mini abdominoplasty), other times we make the incision circumferentially always hidden below the bikini line (tummy tuck loop) and sometimes we do liposuction on other areas to improve the outcome of abdominoplasty.
The average time of the surgery is from 1 to 2 hours depending on the complexity. At the end, two drains are placed for 2 or 3 days from where some liquid will form after surgery. These are a small hose (less than 1 centimeter wide) that the patient will care and it emerge from under the skin, helps to avoid infection, accumulation of blood or lymph within the abdomen.
How is recovery and when you see the results?
After the procedure, you need to stay over the night in the hospital; pain is moderate especially if we had to a lot of adjustment on your muscles. Please note you will require from 3 to 8 days of pain medication. The wound will be covered to protect it from dust. The next day you will go home to recover. On day 2 you will begin to wear a bandage that is removed the 4th or 5th day, but if we perform liposuction, you have to use a belt for a month or so. Most times we use special stitches hidden under the skin, and there’s no need to be removed. Drains are removed in the office between the 2 and 14, depending on how much liquid is collected daily. You can walk into your house without climbing stairs or carrying objects the first week. You can return to school to work within 7-10 days, don’t make any efforts and begin to drive once you no longer require pain medication (5-7 days). You can exercise after 4 weeks and to wear a swimsuit, wait a month after the procedure. However the final results get after 6 months, which is the time it takes the scars to heal.
Sometimes after the procedure you require a retouching of the corners of the scar that doesn’t flatten and look like small bags, which can be uncomfortable, much depends in part on the surgeon's ability to place the skin, no one can be sure if you will develop this. This procedure is after about a month, in the office under local anesthesia, your scar will be slightly longer (4 or 5 cm).
Another important point is that the skin is stretched and pubic hair is generally not a problem unless you use bikinis very small q, which in this case you need the currents to the plastic surgeon to modify the incision and is performed below.
What are the complications that can happen?
Consider necessary to always inform the patient about the most common problems that may occur. As with any surgery, abdominoplasty is not exempt from having complications or adverse effects. The healthier you are, fewer risks exist, and if there is a clear indication of not proceeding with the surgery, it is better to postpone it.
Even though infection is rare, we can say that is the most common complication. We avoid it the most; first, making sure that the patient has an adequate nutritional status, use sterile instruments and away from any organism and ultimately reinforce this by using an effective technique in surgery with the use of antibiotics.
The skin necrosis (skin death) can happen if several factors come together, first and by far a very aggressive surgery where the surgeon takes off excess layers of the skin, and patients who have blood circulation problems for being a smoker, diabetic or obese. In this case, what happens is that some areas get darker and eventually die, usually above the pubis. Depending on the magnitude it’s going to be a treatment that goes from healing itself, or even having to remove the necrotic skin.
Other complications include the accumulation of blood under the skin (hematoma) or lymphatic fluid (seroma), which is handled with punctures and aspirations. It is very important that you are well informed of these and other complications that may rise.
It is very important that you are well informed of these and other complications that may arise which will explain during the initial consultation.
Recommendations and Tips
- Make sure you go with a certified plastic surgeon; there are physicians in other areas that offer cosmetic surgery at lower cost but with unfavorable results not to be trained in this area.
- Consider the benefit of removing the excess of your skin and fat for a flatter and firm abdomen, at the expense of having to hide a scar below the bikini line that will fade with time.
- If you are still thinking about getting pregnant is better to wait and not do a tummy tuck, as although there will be no problem with the pregnancy, the results of the surgery will disappear.
- Remember that no surgeon can ensure they do not form the "dog ears" and that if you are annoying can be arranged in the office but having to stretch the scar a few inches.
- Estimate that you will spend a night at the hospital, and pain will be moderated for a week. You are going to be at home a week with the drains, you can go back to work after 5 or 7 days after the surgery, and to use a bathing suit one piece wait 3 or 4 weeks.
- The plastic surgeon may suggest other procedures done at the same time as liposuction, liposculpture of the hips, lifting the breast, or buttocks, thighs or correction in arms, all in favor of showing a harmony in your contour.
- You should not take aspirin or derivatives or extracts of medicinal plants since they alter the coagulability. It also provides detailed information to your plastic surgeon to take drugs and diseases that have or have had.
- If you see complications, it is important to go and talk with the plastic surgeon who will tell you what is happening and how to fix it.
- Perform this procedure only with certified plastic. It is really importance not to stay with any doubt and that the plastic surgeon explains any question so get well informed.
- Just perform this procedure only Certified Plastic Surgeons and asks that you show your credentials to make sure it is someone trustworthy and qualified.
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