Abdominoplasty before – after, Dr Bellity
ABDOMINAL LIPOSUCTION THE BASICS
Abdominoplasty or a tummy tuck is reconstructive or aesthetic surgery carried out on the abdominal wall. The abdominal wall is made up of three main elements: skin, muscles and fat. Each of these elements has to be assessed separately and often all three will be treated in the same procedure. Through this procedure, abdominal fat that is difficult to shift – especially once we are over 40 – can be reduced. It is a procedure that can only be carried out in cases where there is no major skin distension or muscle collapse. Often liposuction of the waist is performed at the same time.
This is an ideal and spectacular intervention on the right patient; if the patient has a fold of skin while standing upright then a partial abdominoplasty is more advisable. If there is slight cutaneous sagging than we can employ a recent (Dr. Bellity) technique known as « alignment » which consists in placing an adhesive, rigid dressing on the skin above the navel to draw it upwards and spread the excess skin over a larger surface during healing. This dressing will have to stay in place for 10 days.
This surgery is carried out under local or general anaesthetic, or an epidural depending on how major the operation is. Hospitalisation: Overnight or as day-surgery if the procedure is minor. The scars measuring a few millimetres are generally invisible, hidden under the navel. The after-effects are simple: bruising for two to three weeks. You should wear a compression girdle for 15 days. You can shower from the following morning. The results are visible after two months. You can resume sports after two to three weeks. You will usually be given a precautionary course of anti-coagulants.
THE BODY LIFT
The body lift or circular lipectomy. This procedure consists of removing a band of skin of between 25 and 30 cm right around the waist to tighten stretch the excess skin of the stomach, the sides and the lower back. The scar runs right around the waistline.
The scar can be hidden under underwear. The effect on the figure is spectacular. The procedure, more complicated than a tummy tuck since the patient has to be turned and the separation of tissue and the scar are greater, is well established and carried out on risk-free patients: smokers have to quit and diabetes, hypertension and anaemia have to be correctly treated beforehand. The after-effects last longer and at least three weeks of rest are required.
My view on abdominoplasty :
Abdominoplasty is a wonderful procedure despite the bad reputation it has picked up. Professor Vilain used to refer to it jokingly as « abominableplasty ». In fact, it is a procedure that has excellent and often spectacular results on the quality of life of patients and on transforming the figure. The possible complications mean this major surgery is only for people in good health. Smoking and diabetes are its two enemies.
The basic rules are to remove the right amount of skin because if you stretch it too tight, the pubis will rise in a very unsightly way. If, however, too little skin is removed then there will still be a small roll above the scar and that, quite frankly, would be a real shame!
Liposuction should not be carried out as a fat removal procedure but as a real sculpture. Stomachs should not be amputated of their fat. We have to recreate a natural look with a flat stomach in the middle and a very slight bump at the bottom and around the navel. From a technical point of view, some complications are avoidable, thanks in particular to the new quilting trend. Quilting consists of inserting absorbable deep sutures which help the skin to bind immediately by reducing free space. This separation space encourages a build-up of lymphatic liquid which, should it occur, has to be drained off in the two or three weeks following surgery.