Abdominoplasty

Abdominal skin becomes loose and belly aesthetics deteriorate with aging. If a serious weight gain or pregnancy is experienced during this process, the abdominal wall loosens, curves forward, sags and stretch marks mar the skin.

The only solution is a mini or full abdominoplasty especially if there is sagging in the lower abdomen, or if there is a build-up of skin above the belly button. Patients who undergo abdominoplasty get rid of stretch marks as well as accumulated fat and sagging skin and gain a flat abdomen.

Due to the new techniques used, the complications in abdominoplasty (undesirable side effects) have been reduced and patient satisfaction has been increased with the attractive appearance.

What causes deformations during pregnancy?

Although each pregnancy deforms the abdominal region, the most deformation is caused by multiple births and multiple pregnancies (twins, triplets). Birth affects not only skin but also the abdominal muscles. There is an overall weight gain during pregnancy. Fat accumulates in the abdomen, waist, back, hips, inner thighs and stretch marks develop. There is a muscle pair in the midline of the abdominal wall called rectus. These muscles support and tighten the anterior abdominal wall. As the abdomen expands in pregnancy, this muscle pair shifts sideways. Although these muscles, which undergone change, almost regain their status after birth, they never regain their former state. Although the incumbents might not have excess abdominal fat, the internal organs push the loose abdominal anterior wall forward to manifest a swollen appearance. Severe stretch marks develop in people with weak elastic fibers. Fat deposits which are not easily eliminated also accumulate in the anterior abdominal wall and waist because of the weight gain during pregnancy.

Can cosmetic creams relieve sagging and stretch marks?

Many patients who apply for abdominoplasty indicate that they have exercised and used various creams to eliminate abdominal sagging and stretch marks however they have achieved no results. The problem involves the anterior abdomen  and skin and therefore the solution is the correction of the deteriorated muscle structure and the removal of sagging skin, in other words an abdominoplasty.

When to use which method

If the patient has only fat accumulation without skin sagging, severe stretch marks and muscle looseness, the best solution is achieved with 3D laser lipolysis on its own.

If the patient has mild skin sagging in the lower abdomen, a limited area with stretch marks and looseness only in the lower abdominal muscles and moderate fat accumulation, results can be achieved with 3D laser lipolysis accompanied with a Mini Abdominoplasty.

If the patient has excessive skin sagging in the lower abdomen, severe stretch marks reaching the belly button, loose upper and lower abdominal muscles accompanied with advanced or moderate fat accumulation, the best solution is achieved with simultaneous 3D laser lipolysis and LipoAbdominoplasty.

3D laser lipolysis is not necessary for patients without localized fat accumulation.

What kind of surgery is LipoAbdominoplasty?

Lipoabdominoplasty is carried out under general anesthesia and takes about 4 hours on average.

Initially, liquid is applied to the area to be treated and followed by the application of Vaserlipo (superultrasonic lipolysis) to both the upper and lower abdomen to emulsify the fat (mix the fat with water). The excess fat in the upper and lower abdomen is subsequently removed in liquid form without incisions. A skin incision is made by extending the edge of the caesarean section scar. The entire skin and subcutaneous tissue between the incision and the navel is removed with this incision. The loosened muscles are placed in their original place and sutured; the anterior abdominal wall is tightened. The skin remaining above the navel is brought downwards and sutured to the incision below. The navel is recreated. Patients in need of abdominoplasty usually have sagging in the groin and genital area; this sagging is also seriously improved with an abdominoplasty.

Most patients have fat accumulation in the waist and back areas that resembles a spare tire. 3D laser lipolysis can also be applied to these areas during the Lipoabdominoplasty. Thus the patient gets both a flat abdomen as well as a slim waist.

What is the Difference between LipoAbdominoplasty and Classical Abdominoplasty?

In LipoAbdominoplasty, excess fat in both the lower and upper abdomen is emulsified and extracted with 3D laser lipolysis. Thus, abdominal fat is reduced in the same session to shape the body. In a classical Abdominoplasty, fat is not extracted, fat in the lower abdomen is cut off and removed over the abdominal muscles, while no fat is removed from the upper abdomen. The fat in the upper abdomen appears to have thinned when the skin is stretched and pulled down like when thick elastic objects are stretched.

With a LipoAbdominoplasty only skin tissue is removed because the fat is removed from the lower abdomen by extraction. The Scarpa fascia between  the superficial and deep fat layer and the underlying lymphatic circulatory system is not touched. Therefore, the problem of circulatory and fluid accumulation in the skin after this type of tummy tuck is less common. In classical abdomen, fluid accumulation and circulation problems are more likely because the scarpa fascia and the underlying lymphatic circulation are not protected.

In LipoAbdominoplasty the excess fat is removed from the upper abdomen by emulsifying and therefore excessive tightening of the skin is not necessary. However, since no fat is removed from the upper abdomen in classical abdominoplasty, a maximal amount of skin is removed and the waist is tightly bent and sutured near the groin. The idea is to prevent the skin from loosening if the patient’s excess abdominal fat decreases in the future.

 

Will a recurring pregnancy be problematic for a person who has undergone LipoAbdominoplasty?

After 1 year there is no problem, but I advise my patients to complete their reproduction before the procedure. If a birth event occurs again after the operation, the image will be marred, the aesthetic image will be somewhat impaired.

Is it not possible to have a shorter incision for abdominoplasty?

The length of the incision during abdominoplasty is not dependent on the surgeon alone. In fact, the length of the incision is determined by the amount of sagging in the patient’s abdomen. The patient should be aware that the surgeon will always try to make the shortest possible incision; however, trying to keep the incision shorter than necessary causes poor results; pockets form at the edges and excess remains.

When is mini abdominoplasty (mini tummy tuck surgery) appropriate?

Mini Abdominoplasty is an operation to correct the deformations in the area below the navel. However, at the same time 3D laser lipolysis can also be applied to accumulated fat in the upper abdomen and waist area. No procedure is carried out for the navel.

In mini abdominoplasty first 3D laser lipolysis is applied to the upper abdomen, waist and lower abdomen to reduce the amount of fat. Subsequently, the sagging and stretch marked skin in the lower abdomen is removed in such a way that it does not pull at the navel very much. Muscle laxity in the lower abdomen is restored and the remaining skin is sutured in place. A mini abdominoplasty takes around 2-3 hours.

 

What patients should take into consideration before the operation

As with all body shaping surgeries, post-operative exercise and proper nutrition will contribute to better results in LipoAbdominoplasty.

If you smoke, you must quit smoking 1 week before surgery to reduce possible risks. Furthermore, patients who are scheduled to have abdominoplasty must start using liquid food 2 days before the operation.

How is the period after lipoAbdominoplasty?

After lipoAbdominoplasty, the patient usually stays in the hospital for one night, rarely for two nights. Then there is no serious pain. It can be easily controlled with painkillers. Immediately after the surgery the patient is fitted with a corset and asked to wear it for one month on average. The corset not only contributes to the success of the operation but also supports the abdomen and provides confidence to the patient during movement and helps the patient to recover comfortably.

We will ask you to stand up and walk 3-4 hours after abdominoplasty, at first you may be hesitant and tend to bend over because of the feeling of tightness which will be reduced shortly.

After 3 days, the patient can take a shower after removing the corset and dressings. The patient can return to work after 7-10 days

15 to 20 days after abdominoplasty the patient can comfortably go swimming. The patient can start doing sports in one month.

As with all cosmetic surgeries, it will take 3-6 months after abdominoplasty to reach the expected body form.

What are the common negative aspects of abdominoplasty in general?

Albeit below the bikini line, an incision scar will remain following abdominoplasty; the patient must accept this. Furthermore, the navel will also be recreated. One thing that abdominoplasty cannot correct are stretch marks over the navel line.

What are the complications after lipoAbdominoplasty?

Infection or blood accumulation (hematoma) can incur after Classical Abdominoplasty. Another possible problem after Abdominoplasty is the development of skin loss around the wound due to insufficient blood supply to the skin. All complications that may be encountered after classical abdominoplasty are significantly less likely to incur after lipoAbdominoplasty.

 

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