Aesthetic concerns relating to the abdomen are frequently seen in our specialty. The severity of the problem varies according to the degree of 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, improving posture and helping the patient fit better in clothing.

Candidates. Most patients have experienced changes to the shape or form of their abdomen resulting from pregnancy or weight gain (obesity); in cases where both of these factors occur, the problem may be more acute. The condition ranges from a minimal accumulation of fat in the infraumbilical region, with or without tissue flaccidity, to large accumulations of fat, sagging skin and laxity of the deep muscular aponeurotic tissue. Abdominoplasty is generally not indicated for women who plan to have more children since a subsequent pregnancy would probably alter the results. In addition, the primary goal of this surgery is not so much to lose weight as to provide a noticeable improvement in body contour.

Surgery. The decision regarding which surgical technique will be employed depends on the individual patient, seeking in all cases to: (1) obtain the maximum reduction of loose skin; (2) correct the separation in the deep muscular aponeurotic system; (3) and leave as short of a scar as possible. Surgery is performed in the operating room and generally lasts 2 to 3 hours under general anesthetic or spinal block. The technique used most frequently involves a transversal incision of the skin directly above the pubis, extending laterally toward the hips, the lifting and repositioning of abdominal skin, tightening of internal muscles and removal of excess loose skin. The resulting scar may be covered with 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 their 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 the strain on the tissues that have just been operated. Generally, drainage tubes are left to prevent an 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 return to his or her regular activities. A special lycra garment is worn for 8 weeks to help maintain the body contour obtained in surgery.

Actual photos before and 3 months after surgery