Abdominoplasty is performed through a horizontal incision placed low on the abdomen, often similar in location to a C-section scar. (Figure 2) The exact location of the scar can be variable from patient to patient, and Dr. Chang takes care to customize this position according to each person’s desires. Through this incision, the skin and fat on the abdominal wall above the muscle layer is lifted. The belly button is separated from the lifted skin and fat and left intact on the abdominal wall in its exact original location and configuration.
Just beneath the skin and fat lies the muscle layer. Most patients have a separation between the two large vertical muscles in the center of the abdomen (called the rectus abdominus muscles). This separation is called a rectus diastasis. (Figure 3) Rectus diastasis is the cause of the abdominal wall laxity that is especially noticeable in some women after pregnancies. The diastasis is then repaired in order to restore integrity and firmness to the abdominal wall. (Figure 4) This procedure does not in any way detract from muscle stability and strength. It may actually improve it to some degree, and does not interfere with one’s ability to gain weight in the area or have another pregnancy.
Once the abdominal wall is tightened, the skin and fat that was formerly lifted is pulled back down over the area. The excess is removed, and a new hole is made for the original belly button. Patients notice a rejuvenated, flatter, and tighter abdominal area as a result. (Figure 5) Liposuction is sometimes simultaneously performed in the back flank area, or “love handle” area, for select patients in order to achieve the optimal circumferential slimming effect.
A small percentage of patients may be candidates for a shorter scar mini abdominoplasty. In this procedure, the skin and fat is only lifted to the level of the belly button. The belly button is not separated from the lifted skin, and the diastasis tightening is only performed from the belly button to the pelvic area. The upper abdominal area is essentially untouched in this procedure, and for that reason, only select patients will have a satisfactory result with this technique.
Dr. Chang performs abdominoplasties in a fully accredited San Francisco hospital with board certified anesthesiologists. The procedure generally lasts from three to four hours. Patients spend one night in the hospital and can go home the next day with supervision. The initial recovery is from one and a half to two weeks, and patients are encouraged to take this time off work. Mothers should arrange consistent child care for at least a week to a week and a half after the procedure. During the postoperative period, patients will be asked to wear an abdominal binder to support the area. This helps to decrease drainage and swelling. After a few weeks, many patients convert to a girdle type of compression for support. Dr. Chang recommends that some type of support be worn for at least six weeks postoperatively. Strenuous activity and exercise should be avoided for four to six weeks after surgery.
Abdominoplasty as it has the unfortunate reputation of being difficult to recover from. This is not so. Dr. Chang uses gentle techniques in order to minimize pain and swelling in her patients. She offers a postoperative “pain pump” that delivers a local analgesic to the area for the first 48 hours to further minimize discomfort. Many patients find abdominoplasty much easier to recover from than they had anticipated.
As with any surgical procedure, there are risks associated with abdominoplasty. These risks include fluid collections (or seromas) after surgery, persistent numbness of in the operated area, contour irregularities, and loss of circulation to the skin or umbilicus. Other risks can include unfavorable scarring, bleeding, infection, blood clots, and anesthetic complications. Fortunately, most abdominoplasty procedures are completely problem free, and any complications which may occur are often temporary.
Abdominoplasty has the ability to provide “instant” gratification for most patients. In a single procedure, one is able to achieve what years of diet and exercise were not able to do. In that sense abdominoplasty patients are thrilled, particularly when they look in the mirror and see a new slimmer self.
Abdominoplasty and breast reduction
Abdominoplasty and hernia repair and mastopexy and augmentation
Abdominoplasty and corrective secondary augmentation with mastopexy
Combination surgery, abdominoplasty and hysterectomy
Abdominoplasty and mastopexy
Abdominoplasty and mastopexy