Introduction

It is possible that after a pregnancy or after losing a lot of weight it is difficult for the stomach to lie flat. Sometimes not with sport or with a good diet can be the seminar excess abdominal skin and fat. It is in these cases, where despite the efforts no change is possible, the tummy tuck becomes a good solution.

What is a tummy tuck?

Abdominoplasty, also known as Tummy Tuck, is a surgical operation that aims to remove excess skin and fat from the middle and lower abdomen. In addition, it tightens the muscles of the abdominal wall, achieving a flat stomach effect and a narrower waist. These cases usually occur in patients who have had weight gain and subsequent loss or in women who have had several pregnancies.

This cosmetic surgery operation allows to reduce the bulging aspect of the belly but it must be taken into account that it leaves a scar that, depending on the surgery required to correct it, will be more or less long. This is why many patients, after undergoing this surgery decide to eliminate it, going to treatments such as the Fraxel laser with which at least three sessions make it disappear or reduce.

The type of anesthesia to perform abdominal surgery may be general or local assisted by sedation, the choice will be the most appropriate for each case and will be in charge of your surgeon and the anesthesia team that works with him. A tummy tuck or mini-tummy tuck is recommended when we have a flaccid abdominal volume that can be caused either by weight gain and loss or after pregnancy.”

Who can do it?

The ideal candidates are usually men or women who have a fairly good figure but who have an accumulation of fat or excess skin on the belly. When this area does not improve with diet or exercise, abdominal surgery is usually indicated.

This surgery is usually done in women who have had multiple pregnancies. After these, the skin and abdominal muscles can relax and not regain their initial tone. It is one of the treatments included in the one known as “Mommy Makeover” since it is possible to return the figure before going through the pregnancy process.

abdominoplasty can also be improved:

Abdominal diastasis
Abdominal hernias
The cesarean scar
The presence of stretch marks below the navel

The loss of skin elasticity in older people, a situation frequently associated with moderate obesity, may also be better.

In patients who must lose a lot of weight, it is recommended to postpone the surgery. This will also happen with patients who plan to have more children since during surgery, the vertical muscles of the abdomen are tightened and they can relax again. If there are previous scars on the abdomen, this surgery may be contraindicated. In other cases, it manages to remove the scars. It will be the surgeon who will determine the results of each case.

The states that ” it is not indicated in patients with excess skin (called skirt or dermatochalasis) or alterations of the abdominal wall .”

How to choose my surgeon?

As with any cosmetic surgery procedure, the choice of the surgeon is crucial for the operation to go smoothly and have excellent results.

As a first step, we recommend that you certify that your surgeon appears on the website to ensure that he or she has the title of Specialist in Aesthetic and Reconstructive Plastic Surgery in Spain.

It is also important to search the internet. Read the opinions of patients who have already had surgery and look at the images of the results to get an idea of the type of work that this surgeon does. *

It is usually a good option to contact several surgeons and go to several consultations. This will allow you to listen to different points of view, know the different solutions they offer you, and, especially, see which surgeon makes you feel more comfortable and safe. You must choose someone who transmits security to you. A cosmetic surgery intervention is always based on a trusting relationship with the surgeon.

* Important information: You have to bear in mind that the excellent result of a previous operation does not guarantee the success or the results of your future intervention.

How is the first consultation?

During the first visit with the surgeon, the patient’s health status is usually seen as well as the skin tone in the abdomen area and the extent of fat accumulation. It is important that in this consultation you explain if you are a smoker or take any medication.

Try to be honest with your expectations and ask him all the questions you have about the surgery, the incisions, the scars, and the postoperative period. The surgeon will explain the most recommended options for your case and the possible risks or complications.

According to it is essential not to negotiate for the scar, it is imposed by the need for the procedure. The size is determined by the amount of tissue to be removed. ”

In this consultation, you should also talk with the specialist about the anesthesia that will be used in the operation and if it will be necessary for you to enter the clinic. Take the opportunity to ask the total price of the intervention and if it includes, for example, the postoperative girdle.

A good way to learn about the surgeon’s work is by asking for photos of this surgery from other patients, although it must be taken into account that each case has its peculiarities.

The stresses the importance of differentiating between abdominoplasty and mini-abdominoplasty, “the latter is indicated to remove only sagging that is below the navel”. This intervention is performed in less time and has a shorter period of stay in the clinic. In other cases, liposuction of the hips can also be performed to improve the body silhouette.

explains: “When there is no volume abdominal flab but in these cases, I recommend making a lipo laser, is the best alternative.” It will be the plastic surgeon who will determine the optimal procedure to achieve better results for each patient.

Generally, abdominal surgery is not covered by Social Security although there are disabling cases.

What types of abdominoplasty can be performed?

Not all surgeons perform the same type of abdominal surgery. Some prefer one technique over another and you must discuss with him what type of surgery he is going to perform based on your specific needs as scars, postoperative period, and the outcome may vary.

Endoscopic abdominoplasty: indicated for those patients who have diastasis recti, it is minimally invasive.
Classic abdominoplasty: o Abdominal lipectomy is the surgical procedure that removes all the fat and skin accumulated in the abdomen over the years and that other treatments cannot remove. In addition, it tightens the muscles of the abdominal wall, relaxed after childbirth, or prolonged obesity to achieve that much-desired flat stomach effect.

Preparation for the intervention

It is just as important to follow postoperative care as well as to arrive at the operation in the best possible conditions. For this reason, it is vital to follow the surgeon’s recommendations so that the body and skin are fully prepared. It is generally recommended:

Use a germicidal soap to wash the whole body and prevent infection
Do not take aspirin or other medications that contain salicylates
Do not smoke as it prevents good healing
Keep the skin well hydrated
Follow a diet that helps you not retain fluids

In addition, it is important that before the operation you have had the necessary appointments with the surgeon to solve all your doubts, a preoperative evaluation, and an appointment with the anesthetist.

Some women may need to stop taking oral contraceptives 1 month before their tummy tuck. Some patients will also need to lose weight to get closer to their ideal weight and to ensure the results of the operation.

How it is performed?

This surgery usually lasts between 3 and 4 hours depending on each specific case. The anesthesia used is general and usually takes one night of hospitalization.

When it comes to a mini-tummy tuck or abdominal liposuction, it can be done under local anesthesia plus sedation so that the patient is awake but without pain. If a mini-tummy tuck is performed, its maximum duration is usually 2 hours.

As in all surgery, it is essential to carry out a previous surgical study in which, in addition, photographs of the area will be taken before treatment to later assess the final evolution of the patient.

For this treatment an incision is made in the lower abdominal region above the pubic area, the size of this will depend on the amount of skin and fat to be removed.

After the incision is made, the muscles of the abdomen are brought together to mark the waist. The excess skin and fat are then removed to achieve a flat abdomen.

The incisions made for a tummy tuck can be closed with sutures, adhesives, tapes, or skin staples.

It should be noted that although a scar remains after abdominal surgery, it is one of the aesthetic operations that provide the most satisfaction to patients. The scar can be hidden since it is very low.

To improve results, flank liposuction or liposculpture, or a fat graft can be performed. This procedure will also remove all stretch marks found in the lower abdomen.

How is the postoperative?

It is an intense intervention, but the pains are variable and bearable. Your surgeon will prescribe analgesics and the appropriate treatment for your postoperative period.

You must bear in mind that in the first days the abdomen will be inflamed and you may notice discomfort that will be relieved with the medication prescribed by your surgeon. On some occasions, the patient will be in the clinic for a few days, it will depend on each case and what is agreed with the specialist.

During the two subsequent days, you should keep relative rest and gradually increase the activity, the total recovery will be spent about 10-15 days.

When you can shower, the surgeon will tell you how you have to do it as well as how you have to change the bandages. In addition, he will recommend that you walk when you are more recovered to avoid venous thrombi.

After a week, the surgeon will remove the external stitches. As for the internal points, it may take up to 3 weeks. You must wear the postoperative girdle day and night for a month as it is essential for recovery and to shape the body.

This surgical medical girdle for daily use helps to mold and support skin that has been or is being exposed to special treatment. The objective is first of all to put pressure on the new space that has been between the skin and the muscle, as a result of having sucked the fat. The compression girdle helps the treated area not result in seromas or swelling and reduces bleeding.

Feeling like before can take a few weeks. If your physical condition before surgery is good and your abdominal muscles are strong, recovery will be faster. Moderate exercise is important as it will help reduce inflammation and tone your muscles.

Some people return to work in about 2 weeks while others require 3 or 4 weeks of rest and recovery.

The scar

It is important to know that there are two possible scars after abdominal surgery:

A suprapubic scar (over the pubis)
A peri-umbilical scar (around the navel), in cases where the navel is transposed.

This indicates that the tummy tuck scar is horizontal, always going in the pubic area and its location can hide or conceal the panties.

On the other hand, this type of suture is the one corresponds to cosmetic surgery interventions, so it is performed with special materials and techniques that allow it to be noticed as little as possible.

In this case, time is our great ally, and each year that the scar passes it will be less evident. It is important to monitor the correct evolution with the surgeon. In addition to the expertise of the professional, the patient’s ability to heal is very important since not all people heal in the same way.

Some patients have unsightly scars in the abdominal region caused by previous surgical interventions. Although a scar cannot completely disappear, its appearance can be improved with a new intervention in which the scar is removed and sutured again. These operations are normally performed under local anesthesia with or without sedation and the patient does not usually need to be admitted. The intervention usually lasts 1 hour and recovery is quick.

The results

The results are visible from day one. The skin of the abdomen is tight, and the belly is flatter and thinner, even if it is swollen during the first months. The first week after the operation, it is common to feel tightness and tension in the abdomen. During the first few months, it is normal to also notice some numbness and swelling.

Patients are generally happy with the result, which allows them to feel better in their bodies and have better self-esteem. The final results will be visible after one year and the scar will continue to evolve for the next two years.

In most cases, the results are definitive, as long as it is accompanied by a healthy diet and physical exercise. If you are realistic with your expectations and can tolerate the presence of a definitive but concealable abdominal scar and a long recovery period, abdominoplasty may be right for you.

Complications

Hundreds of successful abdominal surgeries are performed each year. When performed by a qualified plastic surgeon, the results are usually very good. However, the SEC points out that whenever surgery is performed there are risks. Complications after surgery can be:

Infection: resolves with antibiotics and drainage, but will prolong the stay in the clinic.
Venous thrombi: prevented by moving the legs and getting up as soon as surgery allows.

Sometimes the result may not be what patients expected, especially about the scar, which may be too visible, asymmetrical, adherent, or ascending. In some cases, it can even become thick or become a keloid. Another unwanted effect is fibrosis, which can appear if there is abnormal scarring of the tissues.

Sometimes poor results are due to a belly button that sticks out too far or is not positioned correctly, giving an unnatural result. This discontent can also be due to excess skin that has not been removed.

As we have already pointed out if you smoke you should stop it a few weeks before the surgery since tobacco increases the possibility of complications and delays healing.

You can reduce the risk of complications by carefully following the instructions of the plastic surgeon before and after surgery, especially those that refer to when to resume physical activity.

According to Article Abdominoplasty: Risk Factors, Complication Rates, and Safety of Combined Procedures published by Plastic and Reconstructive Surgery, “Abdominoplasty is associated with a higher complication rate compared to other cosmetic procedures. L os procedures combined can significantly increase rates of complications and should be carefully considered in patients at higher risk.

Frequent questions

Can stretch marks on the abdomen be removed? Stretch marks are the consequence of the rupture of the elastic fibers of the dermis due to skin distension, such as that which occurs in pregnancies or temporary gains. They are real scars and cannot be removed. However, most stretch marks are located on the skin below the skin of the navel, which is the area of the abdomen that is usually removed; therefore, after abdominal surgery, a large part of the stretch marks on the abdomen are removed.
What about the belly button? With this surgery we are also able to give the obligor a rejuvenated appearance since in the operation it is removed and repositioned, thus allowing treating it.
Can you use any cosmetics to help the scars improve? It must be taken into account that the healing and final result depends on several personal factors and each skin. However, various cosmetic treatments help to heal to be fast and mark minimal.
How long should the girdle be worn? After surgery, it is very important to wear a compression girdle for the first month.
Is the resulting final? Unlike liposuction, it is more complicated for the patient to regain the volume they had before the operation. For the results to continue over time, the patient must have a balanced diet that, if complemented with exercise, could further enhance the results.
How long do you have to wait after giving birth to have tummy tuck surgery? You have to wait about 6 months after delivery. As a result of pregnancy and abdominal distention, the rectus abdominis muscles will separate from each other (diastasis) and therefore your abdomen will appear bulging and not flat as before. This is corrected by joining these muscles using special sutures known as a plication. This way your belly will be flat and stronger.
Is it advisable or can several surgeries be done at the same time? This depends on each patient, as a general rule there is no problem in performing this surgery together with another and in this way taking advantage of the surgery. It is very common for women after childbirth to undergo abdominoplasty together with mastopexy the combination called Mommy Makeover.