Abdominoplasty is performed by making a transverse incision that extends from one hip, across the area just above the pubic region and then on to the contra lateral hip. The extent of each incision will vary with the patient's figure. As you are already aware, body shapes are widely varied. It is safe to assume that the heavier and more pendulous the abdomen, the longer the incision will need to be.
This incision allows the elevation and dissection of the entire abdominal skin and fat, from pubic region to the costal margin or rib cage, and breastbone. The umbilicus does not get removed or cut off. Dissection is carefully done around the umbilicus while the rest of the skin and fat are lifted. Our plastic surgeon Dr. Belman Galvis is then able to remove the entire portion of skin and fat that lies between the umbilicus and pubic area. Although this greatly improves the situation of the excess skin and fat it does not address the flaccidity of the underlying muscular abdominal wall.
Underneath the skin and fat of the abdominal wall lies the muscular layer of the abdomen. The main muscle of the abdomen is the rectus abdominis. This is a muscle consisting of two narrow and straight muscle strips that extend from the lower abdomen near the pubic region to the costal margin or rib cage. Usually these two strips of the muscle are very close together. As a result of pregnancy, weight gain and overall flaccidity, the muscle strips have separated. The resultant area is left very thinned out and weak. During this part of the abdominoplasty operation, Dr. Belman Galvis will suture these muscle together, side-to-side from the pubic region to the breastbone. This in effect creates a “corset” like effect, thereby tightening and strengthening the abdominal wall.
Next, the skin that was originally at the level of the umbilicus is now free to be pulled down to the pubic region. It is then sutured in place. Drains will be placed underneath the skin and brought out separately. These drains are usually removed during the first post-operative week depending on the amount of drainage. The patient has sterile dressings applied followed by an abdominal binder or some other type of compressive surgical garment.
Generally, this procedure is associated with liposculture.
SCAR:Discreet line, just a little bit visible at the level of the bikini line area.
PAIN:Moderate around 2 or 3 days, controlled by peridular analgesia.
RECOVERY:2 or 3 weeks to return to work and from 2 month to do exercises.
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