Post bariatric surgery reconstruction emerged as new subspecialty of plastic surgery in the last few years. This constitutes a group of procedures that are utilized to tighten excessively loose skin, frequently after massive weight loss. A smaller group of patients, who are normal weight and have never been overweight, will present with loose enough skin to warrant surgical tightening in the inner arm, posterior trunk, buttocks or thigh regions.
Abdominoplasty, or a "tummy tuck," is designed to correct a protruding abdomen resulting from weak abdominal muscles, weight gain or pregnancy. Obesity and aging cause the skin to lose its elasticity. These conditions may not respond well to diet or exercise if the skin and underlying muscles have been stretched.
With abdominoplasty, the abdominal wall muscles are tightened and excess fatty tissue and skin are removed to improve the body contour. The goal is a narrower, flatter abdomen. Realistic expectations are important. Abdominoplasty is not a substitute for weight loss.
Your doctor considers age, obesity and smoking habits when evaluating a candidate for this procedure.
Before Surgery
We will take a complete medical history and conduct a careful examination to evaluate your general, overall health. Ideally, the abdominoplasty patient has no health problems, and wishes only to remove an excess deposit of fat or loose abdominal skin. Patients on a weight-loss plan should be close to their target weight before having the operation. Women planning future pregnancies should delay abdominoplasty, as pregnancy may promote further abdominal stretching.
Photographs will be taken before and after surgery.
Antibiotics will be prescribed prior to surgery to prevent infection. To minimize the possibility of excess bleeding, you will need to avoid taking drugs containing aspirin. You will also be advised to bathe with an antiseptic soap for several days prior to surgery.
The Procedure
Abdominoplasty is performed using general anesthesia. You may be given medication beforehand so you will feel relaxed. The surgery may take 2-5 hours, depending on your overall condition. You may be released after a few hours, or you may require a couple days of hospitalization.The procedure is most commonly performed by making a U-shaped incision below one hipbone, across the pubic area and under the other hipbone. A second incision is made around the navel. The skin is then separated from the abdominal wall and lifted up to the hipbone, exposing loose tissue covering the abdominal muscle.
Loose, stretched out muscles are tightened with sutures, and excess skin and fat are removed. The skin is lowered over the abdomen and the navel is reconstructed. The incisions are then sutured together. Drains are often inserted to eliminate fluid buildup, and firm elastic bandages are applied to the area.
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