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FAQ
Tummy Tuck (Abdominoplasty)
Abdominoplasty: This procedure is sometimes called the "Tummy Tuck"
and while it's mostly done to neutralize the ravages left from pregnancy, it also
helps both men and women to regain their youthful figures.
The surgeon begins by making a long, shallow, horizontal incision across the
patient's lower abdomen. Starting at one of the hips, he continues it to just
above the groin crease. Then crossing over the upper level of the pubic hair,
he brings it over to the opposite hip, where it ends.
At the same time he makes a small, circular incision around the navel without
detaching it from its underlying blood supply. Then, with the patient's navel
still in place, he lifts the loosened abdominal skin over the entire front of
the trunk and all the way up to the lower border of the ribs. Now any of the
possible problems are ready to be corrected.
Lax muscles are fixed by putting permanent sutures in the tough material that
covers them, and then folding the muscles back upon themselves. This process
also narrows the waist and flattens out that lower bulge.
Then all of the excess skin and fat between the umbilicus and the line above
the pubic hair is pulled down and cut away. This also removes offending stretch
marks and even some old scars, such as those that develop from an appendectomy
or cesarean section.
Afterward, the remaining skin is drawn downward until it reaches the line of
the long incision from the pubis to t he hips. When this incision is closed,
the skin is fastened with sutures.
As the navel was never moved, it is now covered with skin; by cutting a new
hole directly above it, it can be pulled through the surface and sutured in
place. So the umbilicus ends up in exactly the same position as before.
There will be a small and acceptable scar that encircles the navel, and a lower
major scar that runs across the long incision. This one may thicken into high
visibility, but it is easily hidden by underwear or a bathing suit.
Occasionally the abdominoplasty is done with an extensive up-and-down incision
that runs from between the ribs to above the pubis. But the vertical cut is
not in a favorable position for healing, so the scar will probably be very this,
and there's no way to hide it.
Of course, if the abdominal region already has a vertical scar, then this is
not likely to be a consideration. But in some cases the patient will not have
a choice. If the deterioration is unusually bad, the surgeon may have to make
the vertical incision as well as the horizontal incision in order to repair
it.
Besides the scarring, the results of the abdominoplasty are generally excellent,
although they may not be entirely permanent. For example, another pregnancy
or further aging might bring back some of the original problems, as will overeating.
But excised fat cells never return, so the patient will still be better off
having had the operation.
The cost of the abdominoplasty should be $7,500 to $10,000. The recovery period
can extend for up to six weeks.
A day or two of bed rest is normally required after the surgery, and there
is bound to be some post-operative pain. This is usually nothing more than a
dull ache that disappears with bed rest, but once in a while it will be more
severe. Also, some patients feel a pulling in the abdominal region that may
persist for several weeks.
You can start to engage in light activity almost immediately following the
period of bed rest; after four to six weeks you should be completely back in
your regular routine, including hard work and even strenuous exercise.
However, during the first one or two weeks of convalescence walking will probably
have to be done in a slightly bent-over position due to the unnatural tightness
across your stomach.
Complications like infection and postoperative bleeding are not too common.
There may be some skin loss above the pubic hair, resulting in a wider and more
visible scar, but this is never serious, and it can normally be revised later
on.
FOR HANGING SKIN (VARIATION 1)
When people gain and then lose a great deal of weight, they can develop the
same problems that often result from pregnancy or aging. If so, the basic abdominoplasty
will be enough to help them. But if the weight gain was really massive, they
may be left with an additional condition that requires a special procedure.
The skin can stretch out to such an extent that it never shrinks back. Instead,
it hangs from the stomach like a flabby apron, interfering with cleanliness
and making it difficult to wear clothes. This is humiliating and unhealthy,
and it should be corrected as soon as possible.
The surgeon starts out by making the same lengthy incision as before. Then
he gathers all of the hanging skin, pulls it tight, cuts if off, and sutures
the wound. This leaves a visible scar over the incision.
If the patient also has torn skin, damaged muscles, stretch marks, or a lower
bulge, the entire abdominoplasty can be performed at the same time.
FOR OBESITY (VARIATION 2)
As a general rule, obese people should not be made thinner through cosmetic
surgery. Surely a combined program of exercise and diet will lead to a more
sensible and satisfactory solution. Nevertheless, it is possible to thin out
the stomach area, and it may even be necessary for the patient's health.
The surgery begins just like the abdominoplasty, with the lengthy incision
from hip to hip and circular cut around the navel. But this time when the skin
is lifted off the muscle, the large layer of exposed fat is carefully removed.
This is done from the pubis up to the lower border of the ribs, and around to
each side as far as possible.
Unfortunately, the results of this correction are not always acceptable, because
it's extremely difficult to taper the fat removal to blend in naturally wit
the rest of the torso. Also, the risk of skin loss is greatly increased, so
the long scar is apt to be thick and upsetting. Thus the operation is usually
discouraged.
FOR LOCALIZED FAT DEPOSITS (VARIATION 3)
This correction is for truly huge people who have uncomfortable rolls of fat
that fill up their middles. Once again, the preferred treatment is diet and
exercise, but this time the surgery is more feasible because a major operation
can be avoided. A local incision is made in the most prominent area, and the
unsightly rolls are simply removed. The patient will still have to check into
a hospital, and there will be a long and visible scar over the site of the wound.
FOR THE EXAGGERATED POTBELLY (VARIATION 4)
Prolonged obesity causes fat to accumulate not only under the skin, but in
an internal structure called the omentum. This structure is attached to the
stomach and covers the intestines like an internal apron. It has the capacity
to store tremendous amounts of fat; as it spreads out, it swells the abdomen
totally out of proportion with the rest of the body. The most vivid examples
are men with beer bellies, but woman can be affected too.
The problem is corrected by removing the omentum during the conventional abdominoplasty.
But this means that the abdomen itself must be opened up, and this is rarely
advisable. Also, the omentum acts as a guardian against intra-abdominal infection
if the appendix or intestines should ever happen to rupture. So the procedure
is almost never recommended, even though the result can be a startling change
in appearance.
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