By the term abdominoplasty, or the so-called "tummy tuck" in English, we mean a surgical procedure that aims to reduce skin and excess fat around the abdomen as well as increase the strength of the abdominal muscles. The goal of this intervention is to achieve an aesthetically pleasing abdomen for the patient. With the increase in bariatric procedures, abdominoplasty is a very good option to remove excess tissue, as these patients have experienced significant weight loss.

 

Indications

 

The reasons for which an abdominoplasty can be performed are numerous and include:

 

· Women and men who want to improve the aesthetic appearance of the abdomen

 

· Women with skin and excessive laxity after pregnancy

 

· Bariatric patients who have excess skin as a result of large weight losses

 

 

 

In many cases, diet and physical activity are sufficient to lose excess weight and strengthen the abdominal muscles. However, in some patients such results cannot be achieved and the condition continues and persists.

 

Patients with minimal subcutaneous tissue in the lower abdomen or with moderate skin laxity in this area are candidates for a mini abdominoplasty. Conversely, patients with excessive skin laxity, fat and abdominal wall weakness are ideal candidates for total abdominoplasty.

 

 

 

Contraindications

 

Patients with various diseases such as cardiopulmonary problems, liver cirrhosis or uncontrolled diabetes are the least preferred candidates for intervention. Smoking is an important determining factor, since it plays a role in blood circulation and correspondingly increases the possibility of wound complications. The surgeon may ask you to stop smoking for several weeks before the procedure.

 

For female patients who desire further pregnancies, it is recommended that the intervention be postponed and carried out after the end of the pregnancy.

 

 

 

Preparation for intervention

 

When determining patients to undergo such a procedure, it is important to take a detailed history. Since wound healing is very important, patients should have optimal general medical conditions as well as good nutritional status. Thus, patients with a lower BMI have better results, while patients with Diabetes Mellitus are more prone to complications.

 

Before the intervention, the shape and size of the abdomen, the location of excess fatty tissue, the elasticity of the skin and the medications used by the patient are also evaluated.

 

 

 

 

 

 

 

interference

 

It is performed under general anesthesia. Two incisions are made: one from the iliac crest of one side to that of the other side, near the pubic area. This incision, due to its location, is easily covered by clothing. The other incision is made around the umbilicus. The skin is separated from the abdominal muscles. Muscles tighten and contract to create a tighter waist as well as a firmer abdomen. The skin separated from the muscles is then pulled back and the excess is removed. The umbilicus is repositioned in a normal position. Then the wound is sutured, two drainage tubes are placed under the skin, in order to prevent the accumulation of fluids in the operative area. The wound will be covered with sterile gauze. The intervention lasts from two to five hours.

 

 

 

After the intervention

 

The patient can stay one night in the hospital or can leave after a stay of several hours. Before leaving, relevant advice will be given for the post-operative phase.

 

· It is important that the patient stays in a flexed position for 2 weeks. This position reduces the traction forces at the level of the wound as well as reduces the possibility of hypertrophic tissue formation.

 

· The patient should walk as soon as possible after the intervention to speed up recovery.

 

· The patient should not shower until the drainage tubes are removed.

 

· Compression bandages are worn throughout the recovery period. This phase varies from two weeks to two months. During this period, patients should not lift heavy weights or do strenuous physical activity.

 

· Patients can return to work after 2-4 weeks.

 

 

 

Drainage tubes are usually removed one week, and sutures two weeks after the intervention.

 

Swelling, pain and hematomas in the abdominal area are normal and can last from two to six weeks. Recovery is quick for healthy people. The incisions will remain red for a few months, but will then gradually fade.

 

 

 

Results

 

In most cases, surgical intervention is successful when performed by experienced surgeons. However, it is very important that patients are educated and change their lifestyle in order to prevent a relapse. If the patient maintains a constant weight, has a healthy lifestyle and performs physical activity, the results will be long-term.

 

Dr. Gentian Zikaj

 

Plastic Surgeon