Abdominoplasty

Examples

Introduction

The abdominoplasty is a surgery which aims to improve the global shape of the belly in treating globally the fat+the skin+the muscles. All the skin and the fat located between the navel and the pubes is removed.

The skin located below the navel is removed until the ribbing and the point located above the navel is moved down and is stitched up in the pubes level which allows to put straight again in tension all the abdominal skin (even the skin above the navel). The navel is then externalized at the same place than previously, but it is put vertical and therefore rejuvenated.

The scar is located under the knickers and the lateral branch are positioned at the desired place contingent on the swimsuit model or on the knickers generally worn. In case of transverse excess, it may be necessary to add a vertical branch linking the navel to the pubes in order to remove more skin amount. Very often, a muscle plastic surgery of the big righted muscles (the large muscles of the belly) is carried out in order to fix the muscles spreading and release.

Generally, after the old methods of non-endoscopic bariatric surgery, we can correct in setting a pre-peritoneal plate. If the patient would like to redraw the shape of her hips, a plastic surgery of the oblique muscles allows to "slim down" the waist.

Surgery

There are medications to avoid two weeks at least before the operation, specially aspirin and all the drugs containing acetylsalicylic acid: these drugs make bleed and can extend the surgery length. If necessary, dolprone or Dafalgan or any other medication on a paracetamol basis can be used. The day before the admission to the hospital, the patient may have a bath with isobetadine which helps sterilizing the operation area and reduce the risk of infection. The umbilicus must be cleaned with cotton buds and isobetadine. The day before, or two days before the operation, a long consultation will take place, it will set up the "specifications" of the surgery.
We will carry out a morphing and if necessary, we will provide a girdle. Only then, the admission will occur. The preoperative evaluation (blood test, radiography of the thorax and an EKG) in preparation for the anaesthesia, and the patient will be checked by an anaesthesist. The operation is always under general anaesthesia.
An epidural is normally carried out at the same time in order to reduce the postoperative pain. The operation lasts about one hour.
An urinary catheter is maintained on the first day after the operation in order to improve the patient comfort. The drip will remain in place until the biology has been verified. The epidural will remain in place for 48 hours allowing us to cancel the surgery pain. (With no epidural, the abdominoplasty is one of the most painful operations in the plastic surgery field).
The patient can then stand up and start to walk in a "bend forward" position in order not to pull up the sutures. The patient will receive a postoperative respiratory physiotherapy treatment and legs massages until she will be able to walk easily.
The hospitalization lasts about five days and depends on the moment the drains will be removed. The dressing made in the operating room will stay in place until the check out and the girdle must stay in place for five weeks.

The after effects of the surgery

When the patient leaves the hospital, the dressing must be changed everyday and the silicone dressing must stay in place, for it allows the scars to be improved.
Only the compresses soaked with isobetadine should be changed. The threads are resorbable, but for the patient comfort, the ends are removed between the second and third postoperative week. Then the first shower is allowed. Afterward, the scars should be disinfected with isobetadine. One week later, the patient must make a massage to her scar in order to soften it.
If the muscles tighten again , the patient must avoid any kind of effort during six weeks. It is common in this case that the patient feels a bit cramped. Back aches are common and are a consequence of the muscles compensation in the vertebral gutter against the anterior abdominal wall. The shape is definitive at the third postoperative month and the scars at one postoperative year. The scar will probably appear to be more visible, red and hypertrophic during the 3 first months. Only after this period of time, the scar will whiten and progressively vanish after one year. In addition, it is not recommended to expose it to the sun during the 6 first months. In case of exposure, one must apply a sunblock cream. It is worth noting that the belly and the anterior side of the tights will be temporarily senseless.

Refund

L'INAMI plans a refund in case of abdomen pendulum. Some patients won't pay anything as for example the extreme case of abdominoplasty of a woman whose weight was 250 kg and that couldn't walk anymore since her belly was literally dangling on the ground. However, abdomen full of stretch marks but with no skin excess is not refundable. Between those two extremes everything is possible.

To be read imperatively before any operation booking.

 

  

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