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Professional Cosmetic Surgery and Healthy Ageing Clinic

Mr Jeya Prakash M.S. F.R.C.S.(Ed) 94 Harley Street London W1G 7HX
020 7224 1622

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You are here: Home / Surgical / Body / Abdominoplasty

Abdominoplasty

1. Introduction

2. Indications & Contraindications

3. Types Of Procedure and Special Instructions

4. Surgery

5. Recovery & Combination Procedures

6. Results

 

Introduction

Abdominoplasty is a 3-dimensional sculpting procedure that helps to return the abdomen to an appealing shape and strengthens the associated muscles.  This is often complemented with lipoplasty which provides an all-round improvement of the front and sides of the abdominal area.

Substantial weight loss, muscle weakness following multiple pregnancies, single pregnancy with a large baby or heredity can all contribute to loose and wrinkled abdominal skin and excess fat in the abdomen.  In most cases diet and exercise alone cannot remove the skin laxity or muscle weakness that is caused by these issues.

In the case of a protruding abdomen with marked excess fat and lax skin, it is recommended to have a 2-stage procedure for maximum improvement.  Liposuction to remove the excess fat is performed as the first stage, followed by abdominoplasty to remove the loose skin and tighten the muscle.

Abdominoplasty is only recommended when your family is complete and you do not intend to have more children.

What is Abdominoplasty?

Abdominoplasty is a major surgical procedure that tightens the abdominal skin by removal of excess skin and, if necessary, it can reduce fat and modify muscles.  It will also help to reduce stretch marks.

Women who have had pregnancies may have developed a condition called Diastasis (divarication of rectus muscle) in which the muscles of the abdominal wall have separated vertically and cannot return to normal.  This can also be successfully treated at the time of abdominoplasty and hernias can also be repaired during this surgery.

Mr Prakash achieves excellent results due to close attention to incision placement, careful skin and fat removal, clever re-creation of a natural umbilicus (belly button) and proper - but not excessive - tightening of the loose stomach muscles.

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Indications & Contraindications

Indications for surgery

  • Loose abdominal skin.
  • Lack of tone in abdominal area.
  • Abdominal wall weakness.
  • Conspicuous stretch marks in the lower abdomen (in conjunction with loose skin).

Contraindications for surgery

  • Patients whose abdominal fullness is primarily due to intra-abdominal fat (fat that surrounds or forms a protective cover over the internal organs) are not good candidates for abdominoplasty. Such patients are advised to work on their diet, exercise and life style modification as these are often the only solutions to intra-abdominal fat.
  • Plans for substantial weight loss. In this case it is recommend that you postpone the surgery until you reach the desired weight, so that any excess skin laxity caused by the weight loss can be treated all at once.
  • Patients with high expectations and perfectionists.
  • Patients who cannot accept the resultant scarring
  • Patients with a high risk of complications.

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Types Of procedure and Special Instructions

Types Of abdominoplasty

  • Full abdominoplasty
  • Mini abdominoplasty

Special instructions for abdominoplasty

It is a major surgery that requires careful consideration and planning. You will require plenty of help in the first 3 weeks of recovery and it is ideal to have home help through that time.

Weight fluctuation will compromise the final results, so it is recommended to reach your desired weight prior to surgery and then maintain it post-surgery.

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Surgery

Anaesthetic and hospital stay

A combination of general and local anesthetic is usually recommended. The surgery requires 1 – 2 nights stay at the hospital, but sometimes longer.

Surgical procedure

The surgery usually takes between 2 and 4 hours to perform. The duration depends on the size and weight of the individual, degree of skin and muscle laxity to be corrected and amount of fat removal.

The excess fat is first removed to create shape and further skin laxity. An incision is made along the groin, the belly button is released by making a cut around the belly button skin; the abdominal skin and fat is then lifted from the muscle towards the ribcage.. The muscle is tightened with non absorbable strong suture material, from the chest margin to the pubic area (this corrects the muscle separation). The excess skin and fat is removed from the lower flap. Strong sutures are placed in the middle, of the lower end of the skin, to the pubic margin . The belly button is repositioned by excising the right amount of skin, refashioning and anchoring in place with 2 layers of stitches. 2 drains are inserted one to the top and another at the bottom of the wound and the main wound is closed from the outside to the inside with 2 layered stitches. Good approximation with suture strip and bandages are applied.

Incision site and scarring

The most common incision for full Abdominoplasty extends from hip bone to hipbone, within or just above the pubic area either as a curved W shape or a gentle U shape. The scar will be placed in the natural skin fold and is usually hidden within the bikini line. A second incision is made all the way around the naval to reposition it.

Sometimes patients with a long lower abdomen (greater vertical distance between belly button to pubic area), less lax skin and more muscle separation need an additional vertical scar from the midline, towards the belly button.

In a limited abdominoplasty the incision is shorter and an incision around the navel is not necessary.

The scars are permanent and it is normal for them to worsen before they begin to look better. It usually takes a year to 18 months to settle completely. Some people may need scar revision at the end of this period to further improve the scar. Do not expose scars to sunlight for at least 3 months after your operation as the scars may become pigmented

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Recovery & Combination Procedures

Immediate post-op

Patients are encouraged to drink plenty of water. They are advised to keep the feet mobile even in bed and wear anti-embolic socks. Following the day of surgery the patient will be advised to go for short walks around the room. The drains are removed in a day or 2 and pressure garments are fitted to reduce swelling, fluid collection, pain and give comfort. Pain killers and  anti-biotics are prescribed for a week.

It is advised to avoid climbing steps for 10 days following surgery. A typical patient will not be able to straighten up completely for several days.  During this period, the patient is encouraged to stand and walk (little steps leaning forwards without pressure on the wound).

Initially straining, bending and lifting must be avoided. The bandages and dressings come off  after 10 days. The support garment will need to be kept on for 4 – 6 weeks following surgery. Most of the bruising will disappear around the 3rd week although arnica cream and tablets may hasten the process.

Abdominal swelling is normal after the operation and generally takes upto 6 weeks to subside.  Final shape may take up to 6 months.

Sensitivity around the area of the operation will be diminished but generally improves over a year.  However there will be patches of permanent lack of sensation around the scar.

Generally, most people need four weeks to recuperate from the operation although strenuous exercises are strongly discouraged for approximately 2 months.

Follow-up schedule

10 days and 4 weeks (suture removal), 3 months, 6 months, 1 year.

Usual combination procedures

  • Liposuction.
  • Occasionally breast augmentation (in a slim, small-built individual).

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Results

Longevity of results

All body contouring surgery results are not permanent. The longevity varies, depending on a number of factors such as weight fluctuations, pregnancy and hormonal changes.

Limitation of end results

  • This procedure is not a substitute for weight loss.
  • Abdominoplasty alone will not narrow your waist.
  • Any localised fat deposits can be corrected only by means of a liposuction procedure.
  • Upper abdominal fat cannot be removed radically.
  • Upper abdominal stretch marks cannot be removed.

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