Aesthetic concerns related to the abdominal wall are frequently seen in our specialty. The degree of severity varies in relation to the distension or thickening of the abdominal wall suffered by the patient. Given that the abdomen is an extremely visible part of the body, the objective of this surgery is to restore the natural contours of the figure to improve posture and to be able to fit well in clothes.

Candidates. Most patients experience abdominal alterations caused by pregnancy or weight gain (obesity), when both of these factors are present, the problem may be more severe. These may range from a minimal accumulation of fat in the infraumbilical region, with or without tissue flaccidity, to large accumulations of fat with flaccidity of the skin and significant aponeurotic muscle laxity. This surgery is generally indicated for women who do not plan to have additional children since a subsequent pregnancy would probably alter the results obtained. Most of these techniques are not designed for patients seeking to lose weight, but to offer a notable improvement in the body contour.

Surgery. The selection of which surgical technique to use depends on the individual patient, but is always designed to (1) obtain the maximum reduction of loose skin; (2) correct the separation in the deep aponeurotic muscular system; (3) leave the least extended scar possible. Surgery is performed in the operating room with a duration of 2 to 3 hours under general anesthetic or spinal block. The most frequently used techniques involve a transversal cut in the skin directly above the pubis, which is extended to the hips, the lifting all the skin of the abdomen, adjustment of the internal muscles and removal of excess flaccid skin. The resulting scar may be concealed by a bathing suit or lingerie. In most cases patients also have liposuction of fat performed in certain localized zones of the hips or waistline to improve the results.

Postoperative care. The patient remains in a reclined position for 24 hours with a cushioned abdominal dressing and with the legs flexed, to reduce tension on the tissues that have just been operated. Generally drainage tubes are left to avoid the accumulation of blood in the abdomen, which are removed the day following surgery, and the patient sent home. Analgesics, antibiotics and anti-inflammatories are prescribed, as is home rest and walking with the waist slightly bent the first week. The stitches are removed in 12 days, and 12 days after that the patient may gradually resume activities. A special lycra garment is used for 8 weeks to help maintain the body contour obtained in surgery.

Actual photos before and 3 months after surgery