ABDOMINOPLASTY

Indicated for patients with excess abdominal skin or laxity, often accompanied by muscular weakness — a consequence of pregnancies and weight gain or loss.

This procedure consists of removing excess abdominal skin and performing a plication, repair, or reconstruction of the weakened abdominal muscles through a lower abdominal incision, achieving firmness and improved contour.

It can be combined with liposculpture on the flanks and posterior waist to obtain a more harmonious torso.

Although technically described, I do not recommend liposculpture or liposuction on the abdominal flap due to the increased risk of local and systemic complications.

Surgery time: 2 to 3 hours.

Surgical Technique

The amount of excess skin, abdominal laxity, and the presence of supra- or infraumbilical stretch marks are fundamental to the decision of which surgical technique to use. There are terms such as abdominoplasty, mini-abdominoplasty, and lateral tension abdominoplasty. Each has its own indications and technical variations, but all aim to remove the maximum amount of skin with abdominal muscular reconstruction.

A frequent concern is about limitations for future pregnancies after this surgery. The plication or repair of the abdominal musculature could alter the normal growth or development of the uterus, so it should not be performed on patients planning future pregnancies.

Since the concept of "circular torso management" is important for achieving a better aesthetic result, liposuction on the flanks and posterior waist is frequently necessary. However, if the excess adipose tissue is considerable, I recommend a second surgical stage to avoid violating safety standards and prevent complications.

This surgery generally achieves significant changes in body measurements and weight in my patients.

1 day of hospitalization required.

Pre-Surgical Examinations

It is necessary to evaluate the basic systems with a complete blood count, coagulation tests, and creatinine.

A cardiopulmonary examination and other specific tests would be necessary in special cases.

Post-Operative Care and Recovery

Analgesics and antibiotics.

Pharmacological prophylaxis for Pulmonary Thromboembolism and Venous Thrombosis.

Post-surgical massage, lymphatic drainage, and external ultrasound may in some cases assist the recovery process. The appropriate time to begin is defined according to each case.

Do not remain at absolute rest; early mobilization is indicated to reduce post-surgical risks.

10 days of incapacity are sufficient for most patients to resume work. Some may take a little longer depending on their response to pain, inflammation, or scarring.

Sports activities in 3 to 4 weeks.

Complications

Although uncommon, they must be listed:

1. Bleeding, hematomas, or seromas.
2. Infections.
3. Altered sensitivity in the surgical area.
4. Poor scarring.
5. Skin necrosis.
6. Deep Vein Thrombosis.

The incidence of the last two complications can be avoided by being prudent with surgical times, not performing multiple procedures, and using vascular compressors during and after surgery. Additionally, antithrombotic prophylaxis and early ambulation are equally important.

Smokers have a higher risk of any of these complications. For this reason, I never perform this procedure on heavy smokers.