Abdominoplasty (Tummy Tuck)
The shape, tightness, contours of the abdomen and waist are important criteria for body beauty for both men and women. Regardless of how thin we are, a drooping, cracked, sagging abdomen disrupts the proportional lines that the body should have. no matter how much sports we do, the diet we follow the abdominal skin cannot be completely returned to its former state. deformities are caused by excess weight gain and loss, pregnancy, genetic predisposition, etc. affects people’s health and psyche; All these problems can be treated and the abdomen skin can restore its former shape by performing Tummy Tuck operation, which also called abdominoplasty.
Abdominoplasty is the operation of shaping the abdominal skin and subcutaneous tissue. this operation performed mostly to women, but the number of men who have undergone abdominoplasty has increased in recent years.
Anatomical Structure of The Abdominal Region
The abdomen is a structure that hosts many of the body organs. such as the liver, intestines, and organs.
Abdominal muscles are located in the abdomen. There is a membrane called fascia just above these muscles, fat tissue lay above these muscles and in the end the skin tissues that cover the whole body.
However, during tummy tuck surgery surgical interventions are made to muscles, fascia fat tissue, and skin.
Abdominal skin and fat tissue are greatly influenced by external and internal factors. One of the first places where fatty tissue accumulates is abdominal skin.
However, changes in the internal organs and increment of adipose tissue resulting from certain diseases lead to an expansion in the abdominal skin. Pregnancy in women is the most important reason for the abdomen skin expansion.
Why Does The Abdomen Expand During Pregnancy?
After 4 and 5 months of pregnancy, the main uterus grows out of the bone.
It continues to grow by pushing the internal organs upwards each day. Further expansion of the uterus continues with the expansion of the abdominal muscles and skin.
Finally, both the abdominal muscles and the abdominal skin keep expanding until birth. After birth, both the muscles and the abdominal skin return to their former state physiologically.
However, as the number of births increases, these expanded structures can not be fully returned to their former state. Even if doing sport allows to recover the flexibility and laxity of the abdominal muscles, this cannot be achieved in the skin. Excess weight gain and pregnancy have the same mechanism.
The growth of organs in the abdomen with weight gain has the same effect on the skin of the abdomen. Even if the expanded skin tissue shrank after losing some weight it can not return to its former state. Frequent weight gain and loss cause sagging in the abdominal skin for both men and women.
Evaluation Before Surgery
The most important thing to be considered in patients who are scheduled for abdominoplasty is the amount of abdominal skin sagging and the thickness of the fat tissue beneath. besides that, the structure of the abdominal muscles, whether they are loose ruptured or not, finally, hernia cases also should be evaluated. by evaluating all these conditions we can determine the number of tissues to be extracted and tightened and depending on the abdomen muscles we decide the type of Tummy tuck surgery that will be applied (Full or mini tummy tuck). These calculations also shed light on how much intervention is required in the muscle tissue during surgery.
The most important factor in abdominoplasty is the scars that may form after the operation. The larger the amount of tissue to be removed, the greater the size of the incisions. Since we have to tighten the tissues that will be sutured, the scars formed will be more obvious, Therefore the incision is made in a non-visible area. For this purpose, the abdominoplasty incision place is planned to be in the lower of the abdomen (bikini area). The length of this incision may extend to the waist according to the type of abdominoplasty performed (Full or mini tummy tuck).
Due to the different shapes of the bellybutton and depending on the culture and desire of the patients, the patient and doctor make a joint decision regarding the shape of the new bellybutton.
Before Tummy Tuck (Abdominoplasty)
Abdominoplasty is a relatively major operation. If the amount of blood loss and the amount of tissue removed is considered to be high, detailed preoperative preparation and preliminary examinations should be performed.
Hemoglobin level must be within its normal rate. Besides that, examinations that determine whether the person has systemic diseases (sugar heart blood pressure, etc.) or not must be made.
Systemic diseases that can be controlled do not impede the operation. However, the blood clotting and disorders, the use of blood thinners, painkillers and other drug use should be questioned before the operation and precautionary measures should be taken accordingly.
Patients with varicose veins should wear varicose socks because the operation may take a long time, knowing that losing some weight before undergoing a tummy tuck is not a condition but it increases the success rate of the operation.
Tummy Tuck Operation
The main purpose of Tummy tuck is to tighten the abdomen muscles and skin by extracting the sagging skin, abdominoplasty is combined with liposuction since there will be fat tissue in the upper abdomen and back.
Therefore, the fat tissue of the patient is taken out with liposuction before starting abdominoplasty surgery. liposuction is also important in terms of increasing the elasticity of the abdominal skin that will be tightened in addition to reducing fat tissue.
After liposuction, the abdominal skin is removed by surgical incision, the abdominal navel is removed and the abdominal skin is separated from the muscles underneath the abdominal area and up to the chest area.
Then, the separation in the abdominal muscles is fixed and tightened by performing a procedure we call Plication. also, at this stage, abdominal hernias can be repaired “if found”. after that we tighten the abdominal skin by extracting the excess skin with creating a new belly button, in the end, we adapt the skin to its new location.
A surgical drain is placed to prevent leaks after surgery, generally, the sutures used in surgery will be absorbable so there will not need to remove the sutures after surgery.
Period After Surgery
The period after abdominal surgery changes depending on the interventions made and technique used in surgery.
This painful period is shorter in case we didn’t perform a Plication procedure or if the interventions made over muscles were simple. it is recommended for the patient to rest in bed for one day after surgery, but the patient must get out of bed and start walking in the hospital or home on the day after surgery. This helps the patient to get rid of edema faster and to prevent coagulation problems.
After surgery, the patient must wear a corset for a period of 3 to 6 months, and he/she will be able to return to his/her daily life, work and drive a car after 5-10 days depending on the interventions made in surgery.
Besides the interventions made, the postoperative period also changes depending on the patient’s pain threshold, wound healing status and genetic characteristics. in case tummy tuck and liposuction are performed it takes at least 6 months for edema to go away, a scar to form and to get the last shape of the abdomen.
The patient can do long walks and swim after 2-3 weeks of the abdominoplasty operation but he/she needs 6 weeks to be able to do exercises that force the abdomen muscles.
It is a cosmetic surgery performed by cosmetic surgeons to correct the deformities or remove the sagging in the abdominal skin caused by pregnancy, childbirth or significant weight gain or loss.
A tummy tuck takes between 2 – 4 hours depending on the procedures that will be performed in the operation.
The duration of stay in the hospital after tummy tuck is determined according to the technique used and the procedures performed during the surgery. The patient may be discharged on the same day or may need to stay for one night in the hospital.
Due to the technique used in stitching after Tummy Tuck, there will be small scars, these scars are barely seen and can be easily hidden because they are located in the area below the abdomen.
It is not recommended to undergo tummy tuck at an early age. All people can undergo tummy tuck after their body is fully grown, on condition that no health problems are preventing them from performing the procedure.
The only relationship between a tummy tuck and pregnancy is the abdominal looseness again after pregnancy. Otherwise, tummy tuck surgery does not prevent pregnancy and does not cause any problems during pregnancy.
The skin of the abdomen sag in certain proportions after giving birth, this sagging skin gathers in certain proportions after about 6 months but does not return to its previous state. If this state still disturbing the woman, she can undergo a tummy tuck surgery.
Gaining weight is a normal way that does not cause the skin to sag again, but if the weight gaining can lead to skin sagging and surgical intervention can be performed again to tighten the skin at the request of the patient.
Scars appear after performing any surgical operation. The shape and size of the scars vary according to the surgical operation and the size of the area where the intervention was performed. Some creams help to reduce these scars but they cannot be removed using a laser.
A second tummy tuck can be performed after a certain period of the first operation, but we must know that the second operation will be more difficult than the first for both the doctor and the patient.
In case of severe sagging, or if the abdominal muscles will be tightened, the surgery is performed under general anesthesia. Otherwise, the surgery is performed under the spinal anesthesia or epidural anesthesia according to the patient’s condition.
Hernia and muscle tissue laxity resulting from aging, giving birth or heavy working can be repaired during tummy tuck surgery.
Most of the tummy tuck surgeries are performed combined with liposuction which provides better results, besides that other body lifting surgeries can be performed on other areas of the body at the same time.
Some chemical products are used to tighten the abdomen but because of the allergic reactions caused by these products it is considered more harmful than to be useful, some exercises help in tightening the abdomen but it is useless in cases of severe sagging. The only solution to tighten the abdomen in cases of severe sagging is the tummy tuck surgery.
There are two types of Tummy tuck, the first one is the mini tummy tuck, the second one is the full tummy tuck.
The mini tummy tuck is performed for people who have slight sagging and no interventions are made on the navel. There will be few scars after the mini-tummy tuck due to the small size of the surgical incision.
The full tummy tuck is performed to people who have severe sagging. Intervention is also performed on the navel and the surgical incisions can be longer than the incisions made in the mini tummy tuck.
The corset recommended by the doctor should be worn for 6 weeks after the operation, and there is no harm from taking off the corset for one hour each day, the corset can also be taken off for bathing after two days of surgery.
The patient should stay away from the sea, swimming pools and sauna for 3 weeks after tummy tuck until the wounds heal and to avoid microbes.
Routine tests and examinations should be performed to determine the patient’s suitability to surgery. Keeping blood thinner medications taking under the supervision of the doctor. following the doctor’s instructions strictly before and after surgery. Avoid heavy movements and exercises for the first month after surgery and do short walking, paying attention to the wound dressings and keeping the wounds dry.