Abdominoplasty

The motivation that drives a patient to undergo this operation arises from the aesthetic need to make his abdomen more toned and to proportion it to his body structure. This operation can be useful if any cause, such as significant weight loss (diet and/or bariatric surgery) or pregnancy, causes relaxation of the abdominal wall with a decrease in skin elasticity. Skin resection of the lower abdominal region also allows for the improvement of skin blemishes that are very frequent in this type of patient, such as scars and stretch marks.

This operation has the aim of eliminating excess fat and skin, as well as strengthening the abdominal wall through particular muscle suturing techniques, giving tone to the muscles. However, the purpose of the surgery is not weight loss and is not a substitute for a healthy lifestyle.

The operation takes place under general anesthesia and can last two or three hours. The standard abdominoplasty surgical technique involves a transverse incision above the pubis between the two iliac crests. We proceed with the suprafascial dissection of the abdominal wall up to the xiphoid process of the sternum and periumbilical incision with isolation of the navel. If necessary, in the case of diastasis of the rectus abdominis muscles, the muscular margins are brought together along the midline by means of sutures. The operation proceeds with downward traction of the abdominal wall, with the resection of the excess tissue and the suturing of the margins. The operation ends with the repositioning of the navel and the positioning of suction drains. Compared to the standard procedure, the mini-abdominoplasty requires less dissection of the abdominal wall and does not require umbilical repositioning. At the end of the operation, a compressive bandage is applied, which, once removed, is replaced by an elastic support girdle. In some cases it is also possible to combine liposuction of excess adipose tissue in specific areas.

One or two days of hospitalization is normally required. After approximately 48 hours, the wound is dressed, the compression bandage is removed and the drains are removed. At this point the patient must wear a support girdle for a period of 25-30 days. The sutures are removed approximately 15 days after surgery. In the days following the operation, absolute rest and limitation of movements are recommended. It is preferable to sleep in a semi-sitting position for at least two weeks. After 7-10 days, work activity can be resumed, and, after approximately 40 days, sports activity. Mini-abdominoplasty allows for faster recovery, thanks to the less invasive nature of the operation and the reduced extension of the sutures.

In the first post-operative days, the presence of pain, swelling, redness and bruising in the treated area will be normal. Post-operative discomfort can be controlled with normal painkillers, antiemetics and anti-inflammatories.

There will be two residual scars: a long, transverse "gull wing" scar, suprapubic, easily concealable with normal underwear and a periumbilical scar. In more severe cases, a third vertical suture, subumbilically, perpendicular to the transverse incision may be necessary.

The success of the surgical operation depends on several factors: the initial clinical condition of the patient, the patient's ability to heal, adequate tissue resection and the patient's compliance with the doctor's post-operative instructions (avoid inappropriate movements/exposure in the sun). The abdominal profile desired by the patient will also be achieved with the help of a correct diet and suitable physical exercise.

Complications of the operation may consist of: hematomas and bleeding, infection and delayed healing of the surgical wound, seromas, poor healing, modification of skin sensitivity, skin necrosis, persistent pain, venous thrombophlebitis and abdominal asymmetry.