Dr. De Fazio Plastic Surgeon :: Procedures :: Body :: Abdominoplasty in Italy

Abdominoplasty ("Tummy Tuck")

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Abdominoplasty (or "Tummy Tuck") consists of a surgical procedure to remove excess adipose tissue and subcutaneous folds from the middle and lower abdomen, in order to tighten the muscle and fascia of the abdominal wall. Diet and exercise only cannot get the same result because, apart from the condition explained above, the abdominal muscles are stretched out and the abdominal wall is weakened.

ANESTHESIA:
spinal or epidural / general
TREATMENT LENGTH:
3 hours
STAY IN HOSPITAL:
1 day / day surgery
RECOVERY TIME (BACK TO SOCIAL LIFE):
2 - 4 weeks
The procedure

Abdominoplasty is not a procedure conceived for weight loss. On the contrary, its purpose is to remove as much as possible excess tissue and loose skin and to reconstruct the abdominal wall.
Stretch marks are, when possible, removed together with the loose skin. Anyhow, it is not possible to remove stretch marks in the abdomen skin that has not been removed.

Adbominoplasty is considered a major procedure and is normally performed in a surgery room and the patient is hospitalized (inpatient surgery). Hospitalization is normally  1 day.

This type of surgery is performed with spinal/epidural or general anesthesia. A complete abdominoplasty takes about 3 hours.

Generally, this surgery requires two incisions: the first one, just above the pubic area, making a long line across the lower abdomen; the other one is around the navel, since very often the procedure requires a relocation of the navel to a higher and, consequently, more natural position. The skin and the subcutaneous adipose tissue are lifted up; if necessary, in this stage, the adbominal muscle fascia is also tightened to reconstruct the abdominal wall. Then, the superficial skin tissue is stretched downwards and inwards, and excess tissue is removed. Sometimes, the surgeon may insert two small soft tubes called drains to allow fluid (blood and serum) to drain out of your cut. These drains will be removed the first time the patient returns for follow-up care after the surgery. The surgeon will close your cut with absorbable sutures (stitches) which don't need to be removed. At the end, firm elastic dressing (bandage) will be placed over the abdomen and it should be kept on for 4 weeks.

Preoperative preparation

The patient will be asked to stop taking aspirin or other drugs containing it 4 weeks before and 2 weeks after surgery.

The surgeon will prescribe blood tests and ECG before the operation. During hospitalization, it is recommended to wear cotton clothes, which can be opened from the front.

The patient must stop smoking for at least 2 weeks before surgery. Some research studies have shown the risk for complications becomes10 times higher if you smoke. If the patient stops smoking at least 10 days before the operation, the risk of complications will be the same as for non-smokers.

It is recommended to female patients taking oral contraceptives to stop taking them one month before surgery.

Post-operative care

The dressing will be changed when removing the drains or, anyhow, one week after surgery. Before that, the patient should not remove or wash the dressing. Patients are advised to avoid strains for the first week after surgery and, then increase their physical activity gradually during the two following weeks. It is also recommended not to lie down on the abdomen (face down, prone position) for two weeks after surgery.
After surgery, it is possible to lose skin sensitivity in the lower abdomen. This is, normally, a temporary condition which will disappear within a few months.

After the procedure

Physical activity. After surgery, the patients can take short walks already from the same day, or the morning after.

Pain. Pain is normally minimal in this operation. Nevertheless, pain killers can be prescribed to keep it under control, to be taken both during hospitalization and back home. Coughing, sneezing and any other activity, which involves the abdominal muscles, could cause discomfort and minimal pain.

Scars. The scars left by this procedure, become less visible with time, but they are, anyhow, permanent. In some cases, a scar revision (surgery to improve or reduce the appearance of scars) could be necessary to in some areas in order to achieve the best cosmetical result as possible. Minor surgery (Mini Abdominoplasty) can be performed with local anesthesia. After surgery, the tissue just above the incision lines might stick out a little bit; this is also a temporary condition which disappears within a few months, while the scars are getting softer and the tissues more outstretched. Needless to say that the final result of the procedure cannot be judged until all the swelling (edema) disappears and the area treated has completely softened, which normally takes from 3 to 5 months.

Already from the first day after surgery, a course of Tecar® Therapy is recommended to facilitate the absorption of edema (swelling) and ecchymosis (bruises). The surgeon, together with the physiotherapist performing the therapy, will decide the number of sessions.

Possible complications

Complications are rare and, if they occur, they are responding readily to proper treatment, without affecting the final result of the procedure.

Bleeding. If bleeding occurs after surgery, the blood can accumulate in the surgical area and, as a consequence, it can be necessary to re-open the wound in order to remove it and prevent any further bleeding.

Infections. They are normally rare and, when occurring, responding quickly to antibiotic therapy.

Tissue loss. It is extremely rare; when occurring, a further reconstructive surgery can be performed to get the best result.

Recovery time (back to social life)

Social Life and work must be reduced for about two weeks after surgery.

Sports can be resumed after 3 weeks, but intense and heavy sports should wait until at least 4-6 weeks after surgery.
Driving can be resumed after1 week; sexual activity, sun exposure and travelling can be resumed within 3 weeks.

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