A protruding abdomen as a result of weak abdominal muscles, weight gain or pregnancy is a condition that causes distress to thousands of people. This condition does not respond well to diet or exercise because the skin and underlying muscles have been stretched. Today, a remarkable procedure called abdominoplasty has been designed to flatten a protruding abdomen through the tightening of abdominal wall muscles, and removal of excess fatty tissue and skin.
Abdominoplasty is not a substitute for weight loss. The objective of the surgery is to improve the contour of the body by flattening and narrowing the abdomen. The best candidate for the surgery is the individual who is of normal weight but who has weak abdominal muscles and excess skin and fat. Age, obesity and smoking habits are some of the factors the physician considers when evaluating a candidate for this procedure.
Prior to surgery, a complete medical history is taken in order to evaluate the general health of the patient. A careful examination is also conducted. The physician and patient discuss together what can realistically be expected. Photographs may be taken before and after surgery to evaluate the amount of improvement. The type of anesthesia to be used, the procedure, and possible risks and complications are also discussed. Preoperative instructions may include the elimination of certain drugs which contain aspirin in order to minimize the possibility of excess bleeding. Antibiotics may be prescribed prior to surgery to prevent infection. The patient may also be advised to bathe with an antiseptic soap for several days prior to surgery.
Abdominoplasty is usually performed in a hospital setting under general anesthesia with the patient asleep. Premedication may be administered to relax the patient. Although there are several procedures from which to choose, the one most frequently used by physicians involves a “u” shaped incision made below one hip bone and across the pubic area to under the other hip bone. A second incision is made around the navel. (Fig. A) The skin is then separated from the abdominal wall and lifted up to the breast bone, exposing the loose tissue that covers the abdominal muscle. (Fig. B) Often lax abdominal muscles are sutured in order to tighten loose or stretched out muscles. (Fig. C) The skin is then lowered over the abdomen and excess skin and fat is removed. (Fig. D) Before the incisions are closed with small sutures, the navel is reconstructed, and usually drains are inserted to eliminate fluid buildup. Firm elastic bandages are then applied to the area.
Patients often remain in the hospital for one to three days. Occasionally this procedure is done as outpatient surgery. If drains are used, they may be removed prior to discharge from the hospital or may remain in place for 3 to 7 days until fluid levels decrease. Pain or discomfort from the surgery is controlled with oral medication. Sutures are removed approximately one week after surgery and bandages are applied. Bandages are later replaced with an abdominal support garment which is worn for several weeks. During this time, patients must refrain from heavy lifting, straining or over-activity. Although patients are usually up and around the day of surgery, the physician decides when normal activities may be resumed. This decision is based upon the extent of surgery and the patient’s progress. Bruising and swelling which occur around the treated area will disappear within a few weeks. Scars from the procedure remain but fade significantly in time.
Each year thousands of abdominoplasties are successfully performed. The amount of improvement is individual and depends upon the extent of surgery and the patient’s skin tone, body build and healing process. Complications connected with the procedure are rare. However, there are inherent risks connected with every surgical procedure. Possible risks and complications should be thoroughly discussed with the physician prior to surgery. Patients can minimize complications by carefully following directions given by the physician.
Most insurance companies do not pay for abdominoplasty if it is performed for cosmetic reasons. Some insurance companies pay benefits if the patient has severe laxity of the abdominal wall with back pain, and/or umbilical or ventral hernia. Each insurance carrier is different, and it is recommended that individuals check with their own agents to determine if there is coverage.
If you are interested in learning more about abdominoplasty, please call our office and we will be happy to answer your questions.
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