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Due to extreme weight loss, pregnancies, aging or surgery, your abdomen can creating a hanging belly. This excess skin can obstruct your daily life and physical activities. There may also be irritations and infections in the folds of your skin. We can remedy this by performing an abdominoplasty surgery for you. Your skin, fat and your rectus muscles are then corrected with plastic surgery to make sure you have a tight stomach again.
An abdominoplasty is performed under general anesthesia and lasts for about two hours. You must stay overnight after the operation. You can return home after two to four days.
If you are considering a abdominoplasty, the surgeon will look at your excess skin, the amount of fat and the position of the rectus muscles. An abdominoplasty does not change anything on the flanks and “love handles”. These can be removed with liposuction during this operation. We find it important to tell you during the consultation about the possibilities, but also about the risks of the operation, so that you have a realistic expectation of the end result.
Facts on Treatment
Anesthesia: General anesthetics
Operating time: 90 – 120 minutes
Operating time: 4 – 6 weeks
More information about the treatment
During the first consultation, the excess skin, subcutaneous and intra-abdominal fat is judged. Also, the presence and extent of separation of the recti muscles is determined. It is of great importance that your weight and general health is acceptable. If you are too heavy it is advisable to lose some weight prior to surgery. The result of your surgery will be better and the operative risks reduced. Smoking gives spasms of vessels which causes wound healing problems and should therefore be completely terminated at least 4 weeks prior to and 4 weeks after surgery.
An abdominoplasty does nothing for the flanks and “love handles”. Liposuction can be effective in improving the waistline further and can be performed at the same time. An abdominoplasty will result in a lower abdominal scar from left to right that will be located under the bathing trunks, in the bikini line. There will also be a scar around the belly button that is pulled and stitched inward.
An abdominoplasty is normally performed under general anesthetic. The procedure takes about 2 hours. The abdominal skin is elevated from the lower abdomen upwards up to the ribs and sternum. The base of the belly button is mobilized from the skin and the stalk remains attached to the underlying abdominal wall. If the recti muscles have separated from each other, they are sutured back together in the midline.
Subsequently, the lower excess skin is removed and the upper abdominal skin pulled downward and sutured. A small hole is made to suture the belly button back into the abdominal skin. Most of the time 2 drains will be placed under the skin through the pubis to evacuate any wound fluid. These drains will remain in place for a couple of days until there is minimal drainage.
If the recti muscles needed to be sutured toward each other, you will feel discomfort from getting out of bed or a chair and whilst walking. You will receive an abdominal binder for support when you start moving the next day. This binder needs to be worn as much as possible for the first 6 weeks and you are not allowed to do any heavy lifting. In the case the recti muscles do not need to be sutured you can move the same day. After the drain removal (normally 2 to 4 days after surgery) you can go home.
Sometimes the patient can go home with drains that are subsequently removed in the consulting rooms. The first follow up appointment is about one week later. The skin stitches in the lower abdomen are dissolvable and the stitches in the belly button are removed after 2 weeks. Most people have recovered well after 4 to 6 weeks, however, complete return to all physical activities and sports will be after 2 to 3 months.
An abdominoplasty can provide a functional and esthetic improvement to the abdomen. Irritations and infections due to the apron are resolved and the abdominal muscle strength is improved due to the plication of the recti muscles. The abdomen becomes flatter and the waistline greatly improves. Stretch marks and scars under the level of the belly button are removed, but the ones above it will be pulled down and are still visible.
The pubis will be pulled upward, which will have a rejuvenating effect. There will however be a long scar in the lower abdomen, but this will be in the bikini line area. The scar of the belly button is small and is often not very noticeable.
An abdominoplasty has the same risks as other surgical procedures. Thrombosis and pulmonary embolus is an important complication in abdominoplasty that needs to be prevented with injections of a blood thinner into the skin. Furthermore, early mobilization must improve the circulation in the legs. Bleeding and infections are uncommon. A seroma is an accumulation of wound fluid under the skin that can develop after a drain is removed. This needs to be aspirated regularly in the consulting rooms.
Healing problems can always occur and can be treated as an outpatient. The lower abdominal scar will always be visible and some people scar better than others. Occasionally, some excess skin remains on the sides. Normally this settles down, but sometimes this needs to be excised. This can take place under local anesthetic as an outpatient.
Another consequence of an abdominoplasty is that the skin below the belly button becomes temporarily numb but sometimes it can remain numb. This has no consequences and in time the area of numbness should become smaller.
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Rosa van Dijk (Nederland)
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