Skin laxity, stretch mark and separation of anterior muscles of the abdominal wall can all be caused by pregnancy or drastic weight changes. They can be corrected solely by means of a surgery called abdominoplasty, or tummy tuck.
Sit ups, diets and massages can contribute to improve muscle tone, and in some degree, trunk shape, but they never correct this condition permanently.
At initial consultation in the plastic surgeonís office, he or she will rule out the presence of hernias of the abdominal wall, determine the quality of scars, if present on the abdominal skin, and examine the current state of abdominal wall muscles. According to these parameters, the surgeon estimates how much skin he or she will extirpate, and plans if necessary navel mobilization.
Routine lab exams are mandatory, as well as a consultation with the anesthesiologist. The hospital or clinic where the surgery will take place must count with all the technical and scientific resources to assure patient safety in case of complications during or after the procedure.
Abdominoplasty is performed under general anesthesia, and requires one to two days of hospitalization.
Before the surgery starts, the surgeons makes some markings on the abdominal skin, according to the site of skin resection and the placement of scars in the lower portion of the abdomen and around the navel if it has to be moved.
The anesthesiologist then places an IV line on one of the patientís arms, and initiates general anesthesia.
The surgeon starts the tummy tuck by cutting through the previous markings, he or she separates the skin and fatty tissue from the underlying abdominal wall muscles. The extent of this tissue separation can change according to the patientís features. The belly button is either separated from itís original site or it is left in place within the abdominal wall.
Next, the muscles are brought together in the midline of the abdomen with sutures to ďtuckĒ the tummy in, and also to reduce waist diameter.
Lax skin, along with stretch marks and scars are pulled down, and cut off according to the surgeonís initial markings.
Wounds are sutured with deep stitches which do not need to be removed, nylon sutures are placed in the skin and are removed 10 to 12 days after surgery. A drain catheter is left in place through the skin, to allow evacuation of any oozing from the wound. The wound is covered with surgical tape.
A specially designed pressure garment is fitted on the patient before she leaves the operating room. This will have to be worn day and night for approximately 2 months after surgery.
The patient is left in the recovery room for two hours, after which she is transferred to a regular hospital room. Pain is treated with intravenous medication for 24 hours. If no complications occur she is allowed to go home one or two days after surgery.
Drains are removed 3 to 5 days after surgery. Physical therapy and specialized massages are initiated on the second week after the procedure. Permanent results are evident after 2 to 3 months.
2 Months after surgery
|In order to achieve long lasting, pleasing results, the patient should maintain a healthy diet and practice physical exercise on a regular basis.|
|Maripaz Duque, M.D.|