*Real image of a patient
Like all plastic surgery, abdominoplasty does not aim to lose weight either. However the volume of the abdomen can be reduced by treating extra-abdominal fat (fat that remains outside the abdominal cavity).
Even with my bow bikini abdomen, will I have a large scar?
The big difference of the bow-lace bikini abdomen scar is the shape of the scar, which is straight on top of the pubis and rises on the sides, becoming more easily hidden even by the small bow-lace bikinis.
But what about the size of the scar?
With the abdomen of the bow-lace bikini, your scar will be smaller than with conventional abdominoplasty, but they still often go from one iliac crest (palpable hip bone) to another because they depend on the amount of skin (flaccidity). It is necessary to be patient with the scar and wait for its phases: 1. Immediate period - these are the first 30 days, at this stage it usually looks good and can be very unapparent. In some cases you may have some skin reactions. 2. Meditation period - goes from the 30th day to the 12th month, from now on, care begins to try to avoid unsightly scars, it is now that the risks of keloids and hypertrophies increase, the scar becomes thicker and tends to go from violaceous red to brown, at this stage I recommend the use of creams and silicone tapes depending on the case, but it needs to be known, that there is nothing to avoid unsightly scars. They depend on the healing of each patient; 3. Late period - goes from the 12th to the 18th month. The scar typically begins to become lighter and becomes definitive.
Will I have a new navel with this abdominoplasty plastic surgery?
Not really. Your navel will remain, what is done is an incision (cut) in the new tissue that will cover it. Here is where the bikini bow abdomen differs, the incision is different, as well as the fixation of this tissue in its navel that remains fixed in the musculature. At this moment that I leave your navel with a more hidden scar and with a more elliptical and natural shape.
How long until the final result of abdominoplasty?
You will already be able to appreciate a new abdomen from 6 months, but we cannot consider definitive results before 12 to 18 months. At first you will feel the skin with little sensitivity, an instability with edema (days more and others less swollen) that over time will gradually reach the definitive result.
Can I have a high stomach?
In abdominoplasty, the correction of diastasis of the rectus abdominis (removal of the abdominal muscles) can improve this aspect, but it may not fully correct if you have a biotype with the most anterior ribs, but especially if you have a large amount of intra-abdominal fat.
Can I have children after abdominoplasty?
Yes, you can. Abdominoplasty does not prevent you from becoming pregnant. However, you need to be careful with your weight to avoid losing your result. That is why it is recommended to perform this surgery after having had all the children.
Does the postoperative period of abdominoplasty hurt?
The postoperative period does not usually hurt. There is a discomfort that is greater in the first week.
What type of anesthesia is performed?
It can be done with a block (epidural or from here) or general anesthesia.
How long does the surgery take?
It lasts around 2 to 3 hours.
What is the length of stay?
Usually 24 hours in a normal evolution.
Are dressings used?
Yes, the scar can be covered by micropores and gauze or surgical glue can be used.
Is a drain used in abdominoplasty?
“Yes." Even performing the adhesion points, which are internal points that reduce the shearing (dragging) of the tissue and consequently decrease the seroma (fluid that forms between the wall of the abdomen and the muscle). The use of the drain is still necessary to reduce the accumulation of this liquid, especially when associated with liposuction.
When are stitches removed in abdominal surgery?
The navel stitches are removed around 15 days. In the abdominal scar, the stitches are absorbable and do not need to be removed.
Does removing the drain in abdominoplasty hurt?
Usually not. In the postoperative period, it is common for these areas to become numb, so the removal of the drain does not usually hurt.
After the surgery, when will I be able to take a full bath?
After 48h, taking care not to wet the drain outlet you can take a shower. But this can also be completed with the same care with the drain outlet, the next day, if you are using the glue.
Is lymphatic drainage necessary after abdominal surgery?
“Yes."Lymphatic drainage, which today I like to call post operative care because it includes: the use of low-power laser, placement of tappings. Drainage is mandatory for a good result and should be started from the 4th day.
In abdominoplasty, what is postoperative evolution? Abdominoplasty can be considered ready after 12 to 18 months. More frequent in overweight patients, there may be fluid accumulation without this being considered a complication. The drain is placed precisely to try to avoid this accumulation of fluid that we call seroma. When in smaller quantities it can be resolved with lymphatic drains or in case of greater amounts of fluid it is punctured in the office itself and without pain.
Preoperative guidelines
Postoperative guidelines
Step by step of abdominoplasty:Surgery is always performed in a hospital environment; Anesthesia can be blockage (rachis or epidural ) or general anesthesia; First the infiltration is performed for liposuction of the flanks and waist; Then the drawing is performed, straight over the pubis and rising on the sides (such as the lacing bikini), then the detachment is performed and the muscles are exposed; Then the treatment of diastasis is performed, I usually make two plicurations ( sutures to bring the muscles closer); The skin is then repositioned by passing over the navel that is stuck in the abdominal wall; So the tissue (fat and skin) that are in excess is resected (removed) is resected (cut); Now a new hole is made in this tissue to expose the navel; From now on the drain is placed and sutures are made with non-absorbable thread in the navel ( stitches that will be removed later ) and absorbable threads where the abdominal incision ( cut ) was made (which will not need to be removed). Finally, the dressings are made, at which time the glue is applied and then the compressive strap is placed. The surgery lasts 2 to 3 hours.
Types of abdominoplasty
Above was described the step by step of abdominoplasty, but there are others: Classic abdominoplasty: It aims to remove skin and fat and is very suitable for those who have an apron abdomen, have diastasis (removal of abdominal muscles). Mini abdominoplasty: For patients with little excess skin , especially supra-umbilical and with little distance from the abdominal muscles (diastasis). Anchor Abdomen: Indicated for patients who already have a vertical abdominal scar and/or have a large flaccidity skin. Care before surgery: Ten days before surgery discontinue medications mainly those intended for weight loss , anti-inflammatory, herbal medicines (such as Gincobiloba). Avoid taking teas and vitamin E, follow correctly the guidelines that will be given preoperatively. On the day of surgery, arrive at the scheduled time for hospitalization. Make sure everything is arranged for a 2-week rest. Abdominoplasty recovery: Abdominal surgery is not a surgery that causes a lot of pain , however it is common for patients to experience discomfort and difficulty with lying down positions; It will not be possible to be fully erect , but usually the erect position will be returned after 15 days; It is important to use a brace that must be used for 30 consecutive days, withdrawing only for bathing; Lymphatic drains are essential and should start from the 3rd postoperative day; With the use of surgical glue there are no dressings to make and protecting the drain hole, bathing is already allowed after 24 hours; The drain is usually removed with 1 to 2 weeks postoperative; It should avoid making physical efforts, especially impacts, until 30 days after surgery, and can usually return gradually after this period. Abdominoplasty scars: The laced bikini abdomen scar is straight and just above the pubic hair line and rises on the sides and can be hidden even in bikinis with thin sides like the laced ones. In the first 30 days the scar tends to be very imperceptible but after this period the healing process leaves it redder and may change to brown or evolving to a very imperceptible color. But this definitive appearance can take 12 to 18 months.
Can I have liposuction in conjunction with abdominoplasty?
Yes, and it is very common and frequent, I almost always perform liposuction of the abdomen before performing abdominoplasty; Today it can leave a more defined abdomen aspect; It is also frequent the association with liposuction of other areas such as back flanks and culottes and the grafting of the glutes and sides of the glutes (trochanteric region); Today always performed with modern technologies, such as laser, vibro lipo, bodytite and Morpheus.
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What tests do I need to do before abdominoplasty?
It is necessary to undergo several exams that are requested after the consultation. These are: Blood count: evaluates the amount of red blood cells , leukocytes , platelets and some that help assess risks for thrombosis; Coagulogram: evaluates the coagulation capacity, analyzing increased risks for bleeding or hemorrhage; Fasting glucose: detects risks for diabetes and when increased in the blood, increases the risks for example of infection; Measurement of urea and creatinine in the blood : analyzes the functioning of the kidneys; Urine test: identifies renal changes and possible infections; electrocardiogram: analyzes cardiac changes; Ultrasonography of the total abdomen and abdominal wall: evaluates the organs within the abdomen such as gallbladder , stomach, kidneys … and evaluates the presence of diastasis , hernias, etc…
When is abdominoplasty indicated?
Abdominoplasty is a surgery that removes skin and abdominal fat, in addition to being able to treat diastasis and hernias. It can be performed on men and women . Some of the changes that can be fixed:Flaccidity; stretch marks; diastasis; hernias. These situations are very common after pregnancies , patients who undergo bariatric surgery or who have lost a lot of weight in a short time. Genetic conditions are also related to appearing more excess skin generating abdominal flaccidity.
Are there contraindications to abdominal surgery?
It is important to understand that abdominal surgery may have some contraindications: Women who still wish to become pregnant, abdominoplasty will not prevent you from becoming pregnant but if it happens it can compromise your result; Performing previous surgeries - these may also not prevent you from performing abdominoplasty , but depending on the location of the previous scar you may not be able to design the bow tie bikini or the natural navel; Patients with collagen diseases, autoimmune condition affects the connective tissue of the body; Patients with heart diseases; diabetes or hypertension without control with medications; Smokers. It is important to remember that abdominoplasty is not a method for weight loss. What are the benefits of postoperative lymphatic drainage? Lymphatic drainage is mandatory postoperatively , starting from the 4th day. It is she who stimulates the functioning of the lymphatic system, responsible for eliminating the linda (fluid retained between the cells) and reducing edema. There is a greater sensitivity of the patient in this recovery period. One of the reasons why I recommend the manual technique is that it will also make it more regular than with the use of any aesthetic device. The drainage technique reduces the following signs and symptoms: Post-surgical edema; Sermon; Post-surgical hematomas; Formation of fibrosis; Fluid retention. Drainage should be done by a trusted professional, physiotherapist. Nowadays there is also the use of tapping that will also help in reducing all these symptoms and signs above , acting as if it were a delicate manual pressure on the skin. The tappings are placed shortly after the end of the surgery and can be reapplied by the physiotherapist who will monitor your postoperative period. The low-power laser is also used, which in addition to improving the signs and symptoms mentioned above, also improves the healing process.
Can I lose the results over time?
Abdominoplasty removes excess skin from the abdominal region, however different factors can influence the return of flaccidity. Among the most common factors is getting pregnant, especially when the woman does not maintain her weight during pregnancy. Gaining weight after the procedure also compromises the result of losing a lot of weight after surgery as well. By maintaining a healthy routine and with physical exercise, the results can be maintained for life.
How to choose a trained professional to perform abdominoplasty?
Abdominoplasty is a complex surgical procedure and as such can only be performed by a plastic surgeon. It is the professional indicated to perform the surgery safely and effectively. It is important to know the following information about the professional: Registration with the Federal Council of Medicine; Member of the Brazilian Society of Plastic Surgery, remembering that the full members occupy the Society's and only these teach classes at congresses; The Hospital where the surgery will be performed needs to be credited to perform medium-sized surgeries; Know about the professional's experience in performing this surgery; I recommend reading the testimonies of patients already undergoing this surgery; After collecting this information, the patient will have more confidence and will be safer to perform the abdominoplasty, knowing that it will be performed in a safe environment and with a qualified professional.
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