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Obesity and a great subsequent weight loss in men and women, as well as pregnancy, are the main causes for laxity of the muscle fascias of the abdominal walls, excess skin in the lower abdomen and stretch marks. Many significant aesthetic and functional problems arise, such as skin irritations if the tummy sags, pain in the vertebrae due to the excess weight, difficulty in bending, bad positioning of the urinary bladder and the uterus in women, and finally stress relating to dressing and going to the beach. Abdominoplasty is the only solution. During the first visit, the surgeon sometimes observes topical fat, especially in younger patients, which is solved simply with liposuction to the area. In this case, there is no laxity of the abdominal walls, but increased subcutaneous fat.

The abdominoplasty technique is simple and with excellent results if it is planned correctly. From a horizontal incision above the pubic area, so that it can be hidden inside underwear, the skin flap is prepared over the muscle fascia, up to the lateral arc, keeping the navel on the abdominal walls, but detaching it from the skin. The muscle fascias are folded and sutured together. The excess skin is removed and the new navel is sutured into place. Depending on the nature of the problem, the procedure may last 1-2 hours.

The abdominoplasty postoperative course is more severe compared to the other types of cosmetic surgeries. Patients need to remain hospitalized for at least one day. On the first days, they have to stay in bed, with their legs bent at the hips and two drainage catheters at the surgical wound. They will also have a urinary catheter and an IV. In the morning of the following day, the IV and urinary catheter are removed, and patients may carefully get out of bed, but have to wear an elastic compression garment. The drainage tubes will remain for four days. Most patients ask to be discharged when they feel better and return on the fourth day to have the drainage catheters removed. The sutures are removed on the seventh day. On that day, patients may also return to their normal activities, but are not allowed to lift any weights or exercise for a month. The abdominoplasty postoperative course is not completely painless and painkillers have to be taken. However, patients should be prepared for a routine surgery, with a guaranteed good result.

Measures are taken to prevent complications, and mainly thrombosis, especially in obese patients or those with varicose veins in the lower extremities. Topical complications that may arise during surgery are not major and can be treated. The most frequent is the development of seroma, a pocket of serous fluid under the skin. This can be treated successfully by inserting a new drainage catheter and keeping it for approximately ten days.

Small necrosis in the middle of the wound may be observed in smokers or in patients who have undergone surgery on the navel in the past. This delays healing and may cause discomfort to patients, as the area has to be redressed daily for a few days. A hypertrophic scar may appear on the lower incision in some patients, but this is easily corrected with local anesthesia. The incision is always hidden inside the underwear. Patients may experience a tingling sensation and mild pains on the skin for a while.

Useful Facts about Abdominoplasty (Tummy Tuck)

Length of surgery: 1 h- 2 h

Anesthesia: General

Duration of Hospitalization: 1 up to 4 days

Return to normal activities: 2 weeks

Postoperative care: Immobilization until the next day, when compression garment is worn. First dressing change on the second postoperative day. Drainage removed on the fourth postoperative day. Stitches removed on the seventh postoperative day. Avoid lifting weights for a month. Return to the gym a month postoperatively.