Procedures
Abdominoplasty
Medical Term: Abdominoplasty
Abdominoplasty surgery is one of the most desired procedures for women after childbearing and weight fluctuation. It is the ultimate way to contour the abdomen and narrow the waistline by tightening all layers of the abdominal wall. Fat is not the only reason people experience abdominal protuberance. Bulging muscles or weakness of the muscles from genetics or pregnancy can occur in addition to loose, stretched out skin. Liposuction is a procedure which removes fat, it does nothing for underlying muscles or overlying skin. Exercise does not tighten skin or restore underlying muscles to their ideal anatomic location. Therefore, contour improvements in this area are generally resistant to efforts at diet and exercise. Abdominoplasty surgery is the best option to achieve a flat abdomen and narrower waistline when every layer of the abdominal wall is affected.
Both men and women can experience loose, stretched out skin from aging and weight fluctuation. Abdominoplasty surgery is the only way to effectively tighten skin in this area. Individuals may also present with severe stretch marks, contour irregularities, unusual looking belly buttons, or lower abdominal scars from previous surgery. All of these issues are addressed with tummy tuck surgery to restore a flat, well-contoured, symmetric, aesthetically pleasing, youthful-looking, and tone abdomen. Bulging muscles which sometimes become separated or loose are tightened internally with permanent suture material. Resulting scars low hip to hip and around the umbilicus are well concealed in average women’s bikini bottoms or men’s swimsuits.
Dr Brown strives for natural-looking results after abdominoplasty surgery. The goals for all patients are to feel confident and comfortable with their abdomen exposed. Understanding how certain bikini styles fit, Dr. Brown focuses on low-lying scars which hide in typical briefs, as well as a youthful and natural-looking umbilicus without visible stigmata of abdominoplasty surgery. The three-dimensional silhouette is always taken into consideration for optimal contours, and liposuction of contiguous areas such as the hips, flanks, and mons pubis is commonly performed as needed and as part of the procedure.
- Patients who have an excess of abdominal skin and loose or bulging abdominal muscles, with resistant fatty deposits around the waistline
- Men or women after substantial weight loss with overhanging loose skin and residual fat
- Women after pregnancy and child bearing with bulging muscles and loose, stretched out skin to restore pre-pregnancy contours
- Individuals with fatty deposits of the abdomen and hips, resistant to diet and exercise
- Patients with small hernias or muscle separation (rectus diastasis)
- Patients who are of stable weight
- Thin patients with severe stretch marks
- Heavier patients with an abdominal panniculus (overhanging skin and fat)
- Patients with a history of previous abdominal surgeries, preexisting visible scars or contour irregularities desiring lowering or reorientation of their scars with correction of contour irregularities
- Women ideally should be finished childbearing before undergoing a full abdominoplasty with muscle tightening for stable long-term results. Although subsequent pregnancy is not harmful to the individual or growing fetus, recurrent tissue stretch may negatively affect results.
- Patients after lap band or gastric bypass, after one year and with stability in weight
- Healthy non-smokers
- Individuals with abdominal protuberance related to “intra-abdominal distention” are usually not candidates. In this situation the abdominal wall bulges outward from intra-abdominal tension related to increased intra-abdominal (inside the abdomen) contents. In these situations, the abdominal wall feels firm and cannot be pushed in. There is little external fat, and mostly an internal component which cannot be treated with liposuction or abdominoplasty. Also called “beer belly”. Weight loss may be the only way to improve upon this condition.
Goal of Surgery:
- The removal of excess skin and fat below the umbilicus
- The removal of as many stretch marks as possible
- Tightening of the abdominal muscles with narrowed waistline
- A flatter abdomen with a more shapely appearance, that looks fit and tone
- Naturalness, a “non-operated on” look
- Ability to wear form fitting clothing styles without bulges, and to be comfortable in various clothing styles while looking attractive
- Maintenance of a feminine silhouette in women, and a masculine silhouette in men
- Improve overall body proportions
- Attractive, youthful and natural looking umbilicus without conspicuous scars
- Ability to wear a bikini if desired with confidence
- To look fit and healthy
- To increase core strength, by reorientation and tightening of muscles, so that work-outs are more effective, and mild cases of chronic back pain are improved
- To decrease rashes or skin irritation affecting the lower abdominal area from overhanging folds of skin and to improve hygiene
- To raise a sagging mons pubis, reducing disproportionate fatty deposits in the area if needed
- A three dimensional improvement in the waistline contour
- To restore confidence and improve self-esteem
- This is not a weight loss procedure. It does not necessarily decrease clothing size. If those are desired goals, a patient must do their part in following a healthy diet and getting regular exercise to loose unwanted weight. More dramatic results are seen in patients with simultaneous weight loss
Procedure Description:
- The procedure is done under general anesthesia and the patient is admitted to an overnight nursing care facility for one day after surgery
- An incision is made in the lower abdomen, as low as possible and from hip to hip. Final scar lengths depend on the amount of skin excess. In certain individuals with very minimal skin excess, shorter scar lengths are possible, and these partial abdominoplasties are also termed “Mini-abdominoplasties”. The extent of the surgical intervention is tailored for the individual to minimize scars where possible, yet effecting a noticeable contour improvement with the addition of muscle tightening and liposuction. “Extended abdominoplasty” refers to extended excisions on to the hips and flanks, in patients where fat and skin excess carries over onto the lateral trunk. “Panniculectomy” refers to complete excision of a large overhang of skin and fat, typically in an overweight patient. In this case, the overhanging skin and fatty tissue is called a “pannus”
- Liposuction of the contiguous hips is part of the procedure in healthy individuals
- Liposuction of the mons pubis and/or mons pubis elevation may also be included as part of the procedure in patients with disproportionate fatty deposits in the area or if the mons is sagging
- Weak or separated abdominal muscles are sutured, narrowed, and tightened. Small incidental umbilical or abdominal wall hernias are repaired
- Excess skin is removed in an elliptical shape from the umbilicus to the suprapubic area. Old C-section scars are removed so that the final scar is as low as possible. Your preexisting umbilicus remains attached by its stalk to the underlying muscles. The upper abdominal skin and underlying fat are pulled down over your umbilical stalk and sutured to the inferior skin incision. A small oval of skin and underlying fat is excised at the location of your midline umbilical stalk. Your umbilicus is retrieved and a more youthful, oval-shaped belly button is made upon inset to the new surrounding abdominal skin, with care to hide the final scar deep within the shadows of the bellybutton
Postoperative Course:
- Patients usually spend one night in a nursing care facility. Walking is encouraged immediately in a slightly hips-flexed position to keep tension off the incision. Posture naturally improves to straight in 5-10 days, depending on the patient. Back discomfort from this “bent-over” posture is to be expected, and resolves once posture normalizes
- Pain will be controlled with a pain pump (involves constant and slow drip of numbing medication) for 3-5 days as well as oral pain medication and muscle relaxers. Drainage tubes are usually removed in one week
- An abdominal binder for light compression around the waistline is worn for 6 weeks to keep swelling to a minimum, and provide core support
- A recliner is recommended to sleep for the first week, to maintain a hips-flexed position, keeping tension off of the healing incision. It also facilitates ease with transferring to an ambulatory position. Frequent ambulation is required to speed recovery and decrease risks for complications. If you do not have a recliner at home, we can arrange drop off and pick up of a recliner to and from your home, so one is available as long as you need it.
- You will be uncomfortable for the first 2 weeks, most patients return to non-physical work 2-3 weeks after surgery
- A total of 6 weeks of no heavy lifting, fitness activities, aerobic exercise, or straining of abdominal muscles. Regular walking is encouraged
- The amount of swelling after abdominoplasty is variable and unpredictable from person to person. The majority of patients see significant improvements by 2 months after the procedure. Rarely, swelling can persist for much longer and may take 6-12 months to completely resolve. Scars take at least one full year to mature and fade to natural skin tone. Dr. Brown will follow your scars and advise scar therapies when indicated
- No tanning of the treated area until scars are mature (1 year is typical). Temporary numbness of the skin above the scar and below the umbilicus is normal.
- After 6 weeks, gradual resumption of fitness activities is advised, but only as tolerated, in addition to following a healthy diet. Weight gain after the procedure can negatively affect results.
Other Options:
- Breast procedures are commonly performed at the same time as abdominoplasty with no increase in the recovery process
- “Mommy Makeover” refers to abdominoplasty in conjunction with breast surgery after a woman is finished childbearing, to restore pre-pregnancy contours
- Small volume liposuction of non-contiguous areas such as the thighs or back may also be performed in select candidates
Abdominoplasty or “tummy tuck” is one of the most commonly performed aesthetic procedures. A flat and well-toned abdomen is something many of us strive for through exercise and weight control. Commonly, these methods cannot achieve our goals and frustration sets in. Many women of all sizes desire abdominoplasty to obtain a flat, tone, and attractively contoured abdomen. It is frustrating to regularly deal with excess skin and fat overhanging jeans and waistlines. It is equally distressing to “stuff-in” excess skin and fat into larger clothing sizes, and be unable to wear form fitting dresses and swimwear. Women after adominoplasty surgery experience life-changing improvements in quality of life, self-esteem, and confidence.
Tummy tuck surgery is a highly individualized procedure. “Mini-abdominoplasty”, while appealing, results in very minimal skin tightening so candidates are far and few between. Maximum skin tightening is usually desired after surgical intervention; so full abdominoplasty procedures are performed most commonly in patients of all sizes and weights. Residual skin excess or wrinkling in a bent-over position is much less tolerated than slightly longer scar lengths. Dr. Brown focuses on natural-looking results, with scars that are placed as low as possible so that regular bikini/brief styles conceal the scar. In addition, a natural-looking umbilicus is essential. Harmony with contiguous areas is also important in achieving an ideal well-proportioned silhouette. After having 4 pregnancies herself, Dr. Brown can identify with mothers who have worked hard to have and raise children, yet are powerless to improve the condition of their bodies on their own. Cosmetic surgery is an important adjunct to diet and exercise in restoring pre-pregnancy contours so that a youthful, fit, and healthy look is not only conveyed, but also felt within.
OUR BODY PROCEDURES INCLUDE:
www.projectbeauty.com, www.juvederm.com, www.realself.com, www.plasticsurgery.org, www.beautyforlife.com, www.botoxcosmetic.com and www.surgery.org.
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10001 S. Eastern, Ste. 406 Henderson, Nevada 89052 |