Tummy Tuck Operation (Abdominoplasty)

Rapid weight loss in a short period in cases such as pregnancy, repetitive weight gain-loss, after obesity surgery, causes deformities in various anatomical regions of the body together with the abdomen. Especially after multiple pregnancies and excessive weight loss, the skin in the abdomen sags and there is laxation in the anterior abdominal wall muscles. In these people, the sagged abdomen cannot be recovered only by removing fat, because both the excess of the skin and the relaxation of the abdominal muscles do not improve with the removal of fat. Moreover, fat removal from a sagged abdomen with liposuction will decrease the volume in the inside of the skin and cause further sagging. Abdominoplasty can be a solution to all these deformities.

Who can undergo abdominoplasty?

Abdominal stretching is often performed in two main groups of patients, women with multiple pregnancies and people who lose weight in a short time (with diet, exercise, or after obesity surgery). In these patients, overgrown abdomen area loses elasticity due to stretching due to a loss of elasticity, cannot recover following weight loss and sags. Women with plans of getting pregnant again may also have an abdominal stretching operation, but there is a risk of losing the gains that the operation has provided.

Can stretch marks in my abdomen be corrected by abdominoplasty?

The answer to this question is both yes and no. It can be explained as follows:

The fact, which arises after all of the treatment methods that have already been tried, is that; no effective remedy for stretch marks has yet been found. In abdominoplasty operation, excess skin, containing stretch marks in the abdomen, is removed, as well. In the operation, which we call full abdominal stretching, the skin between the incision similar to a caesarean section (but longer than a caesarean section) and the incision above the belly button is removed. For this reason, even if the patient gets rid of the stretch marks on the skin, the stretch marks outside this area still exist after the operation. In fact, since the remaining abdomen skin is pulled downwards, the remaining stretch marks may be slightly elongated.

How are abdominoplasty operations performed?

Various surgical techniques are used for abdominoplasty operation. In some people, there are sagging and muscle decomposition in the lower part of the belly, and in some patients, especially in women, who had multiple deliveries, there is relaxation due to the disintegration of all abdominal wall muscles and sagging in the skin.

Full abdomen stretching and mini-abdominal stretching operations are planned in such a way that an intra-incision longer than the caesarean section remains under the underwear. In full abdominal stretching, the surgeon enters through this incision and separates the abdomen together with the subcutaneous adipose tissue on the anterior abdominal wall from the top of the abdominal muscles and pulls it downwards. Excessive skin area to be removed in full abdomen stretching is determined by combining the incision in the underwear area with the incision above the belly button. Muscles of the anterior abdominal wall are tightened with surgical stitches starting from the bottom of the breast area and continuing to the lower incision area, and then the abdomen skin is pulled down, stretched, and fixed by temporary stitches. At this stage, the new belly button is formed and the operation is completed with the placement of permanent stitches.

Mini abdominal stretching is ideal for patients with less abdominal distortion. In this operation, the upper limit of the incision is different from the full abdomen stretching and passes from below the belly button not above it, and there is no need to create a new belly button. The duration of the operation and the post-operative recovery period are shorter.

In people, who lose a significant amount of weight following morbid obesity surgery, the skin in both the abdomen and the back area becomes sagged and the skin is removed from both the back and the abdomen. This technique is called belt lipectomy and it means that more tissue, in the form of a belt, is removed from the patient during the operation. In some patients, there may be an excess mid-line tissue, which requires removal of vertical skin down between the breasts.

Is liposuction performed together with abdominoplasty?

Nowadays, surgeons perform the combination of abdominoplasty and liposuction to achieve a more aesthetic abdomen. Not in the past but years ago, it was thought that performing liposuction with abdominoplasty would impair the blood supply to the skin. Successful surgery results of leading plastic surgeons in body shaping have led to combined abdominoplasty and fat removal procedure to become widespread. In abdominal stretching, liposuction from the areas outside of the skin to be removed yield more successful results than sole abdominoplasty.

How is the post-operative process?

After abdominoplasty, a drain is inserted to discharge the internally collected blood with leakage and it is usually removed on the following day, depending on the volume of blood. Resting on the first few days after the operation will reduce the pain, which arises with movement. The patients’ leaning slightly forwards while walking in the first week after full abdominal stretching is very important not to strain the stitches.

Unless otherwise indicated by your doctor, you should use the corset, worn after the operation, for at least 1-1,5 months. Although the scars in the operation area are markedly red in a way to demoralize you in the first few weeks, they will become less visible over time. At the second week of the operation, silicone-containing scar reduction creams are started to be used and they are recommended to be used for 6 months. These creams are quite useful in terms of fewer scars to remain.

Does sagging occur following abdominoplasty operation?

After the surgical procedure, the weight gain in the normal range, which can be 5 to 8 kilograms, no sagging in the abdomen will occur. However, in cases of significant and frequent weight gain-loss or pregnancy, deformation in the abdomen may reoccur.

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