Abdominoplasty is particularly helpful for women who have stretched out abdominal musculature and skin following multiple pregnancies. The redundancy that often occurs with additional fat during aging can also be improved by the operation. Patients who are planning future pregnancies or additional weight loss should wait before having the operation. Although the majority of patients undergoing abdominoplasty are women, more men are now having the operation every year.
There are several variations on the types of operations that can be done to improve abdominal contour. These range from liposuction to complete abdominoplasty. Liposuction alone can be helpful for patients with an isolated area of additional fat with good skin elasticity and without muscular laxity. Patients with mild laxity of the lower abdomen may undergo a partial abdominoplasty (mini-tummy tuck). More extensive laxity requires a complete abdominoplasty that usually involves removal of skin and fat and tightening of the abdominal wall.
The facility and the anesthesia used for the operation will depend on the type of procedure done, as well as the recommendations of the surgeon. These decisions will also affect the cost of the operation. Some of the more limited procedures may be done in the outpatient setting, whereas most patients undergoing a complete abdominoplasty are hospitalized postoperatively.
The surgery starts with a lower abdominal incision. The exact location and shape may vary among surgeons and different abdominal contours but usually runs from each hip down to a point just above the pubic area in the midline. A second incision is made around the navel. The skin and fat are then separated from the underlying muscle up to the level of the ribs. Portions of the "fascia" lining the abdominal musculature are then brought together and stitched in order to narrow the waist and tighten the abdominal wall. The previously lifted abdominal skin and fat is then pulled down, the redundant section is removed, and the incisions are closed. Drains are usually left in place postoperatively and are usually removed easily within the first postoperative week.
Swelling occurs during the first few postoperative days, and patients feel some pain and discomfort that require medication. The duration of hospitalization varies but is usually not more than a few days. A support garment may be placed around the abdomen and worn for the first few weeks. Return to work varies among patients and job types, but usually ranges from two to six weeks. Full recovery may take several weeks to a few months.
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