Abdominoplasty or Tummy Tuck

Why abdominoplasty?

At the Centre de Chirurgie et de Médecine Esthétique Dr. Elise Bernier, we are aware that it can be unpleasant and uncomfortable to live with a flabby stomach. That’s why we suggest abdominoplasty, also known as a tummy tuck, a procedure that can be suitable for both men and women.

Due to weight gain and fat accumulation the stomach area can become loose. This also can occur after a rapid weight loss that can also cause sagging. A flabby or prominent abdomen can become embarrassing, cause low self-esteem, limit physical activity or clothing choices, and cause physical discomfort due to irritations, for example.

When physical activity and a balanced diet cannot help you achieve your goals, abdominoplasty (or tummy tuck) can be a solution. Through abdominoplasty, Dr. Bernier can redefine the abdomen and correct its imperfections: flaccid or excess skin, under umbilical stretch marks and muscle relaxation.

What is abdominoplasty?

This surgery tightens the abdominal area and then removes excess skin. Thereby abdominal muscles will be tightened, which restores to the stomach’s skin its initial shape.
This procedure can be combined with liposuction if the patient is looking to treat a fat layer.  This surgery will reduce abdominal fat and improve the definition of the abdomen.

How does a tummy tuck surgery work?

The procedure is performed under general anesthesia and lasts about three to four hours.

The incision is then made in the lower part of the abdomen.

  • Dr. Bernier can then lift all the skin to the ribs. To be able to pull the skin, it is necessary to release it from the belly button. The latter remains in its original location but is exposed through a new opening during the surgery.
  • Then, the relaxed muscles will be brought closer together with stitches that will tighten them and allow them to be functional once again.
  • Finally, Dr. Bernier will pull the skin from the abdomen down and remove excess skin and fat. Stretching the skin also makes stretch marks less visible. At the same time, it is also possible to perform liposuction of the lower abdomen.

The main scar will run horizontally along the lower abdomen so that a panty can hide it. There will also be a small scar around the belly button.

Is this surgery suitable for Me?

Abdominoplasty is for healthy people whose excess weight is not critical (not exceeding 15% of their normal healthy weight) or whose fat accumulation in the abdomen area is not the first source of a prominent abdomen. This procedure may also be contraindicated if the patient has already undergone surgery that has left scars in the upper abdomen area.

Contrary to popular belief, patients cannot undergo this procedure as soon as they start having sagging abdomen skin or a prominent belly. It is important to distinguish what the surgery can achieve from unrealistic expectations some patients may have.

The majority of women who undergo this procedure are those who have had one or more pregnancies and have flaccid skin on their abdomen (sometimes with stretch marks), excess fat and, on occasion, loose abdominal muscles.

In any case, only a proper medical evaluation by Dr. Bernier will allow us to conclude whether or not abdominoplasty is right for you. If this is not the case, Dr. Bernier will guide you to other options such as liposculpture, a weight loss diet or strength training program.

Convalescence

  • In the first few days, Dr. Bernier will prescribe the necessary medications to relieve the pain resulting from the procedure. Since this surgery tightens the abdominal muscles, you can expect more acute pain than when a simple adjustment of the excess skin is performed.
  • A work leave of two to three weeks as well as restricting physical activity are mandatory to allow tissues to settle properly. This will also prevent the accumulation of fluid under the skin.
  • For a few days, a semi-seated position will be recommended to reduce tension on the abdomen. Wearing abdominal support for about a month will be added to the measures to be taken.
  • Finally, the lower part of the abdominal wall may be hard and show signs of numbness for a few months. The duration of this side effect varies from one individual to another. Dr. Bernier will tell you when you can return to work and when you can resume physical activities.

Are there any precautions to take before abdominoplasty?

  • As a preventive measure, it is necessary to avoid taking aspirin, anti-inflammatory medicines and other coagulation-influencing medication for two weeks before and one week after the procedure to avoid bleeding during and after the procedure.
  • To maximize the chances of avoiding complications, Dr. Bernier will insist that the patient quit smoking at least two weeks before the procedure to promote better blood circulation. During the same period, alcohol will also be prohibited.

What are the possible complications?

Any surgical procedure involves risks. However infrequent they may be, they do exist, hence the importance of drawing up a non-exhaustive list here. It should also be noted that the presence of a seroma (accumulation of a liquid under the skin) is both the most frequent and the most common complication.

Early complications

  • Seroma: Fluid can accumulate under the skin. In this case, several visits to the doctor may be required to vacuum this liquid by a puncture in a non-sensitive area. Drainage is necessary to allow the different layers of tissue to remain in contact and thus better merge.
  • Bleeding: It is normal for the dressing to be soiled during the first few days. If the bleeding remains severe after some time, surgical treatment may be necessary.
  • Infection: It is uncommon. Drainage, dressings or antibiotics may then be necessary.
  • Skin necrosis: This poor skin circulation is rather rare. Smokers and people with abdominal scars are at higher risk of this type of complication.
  • Fat necrosis: Sometimes fat lobules liquefy and a yellowish discharge may persist for several weeks. Smokers and obese people are more likely to experience this type of side effect.
  • Wound dehiscence: It is quite rare that the wound does not heal properly and opens up on its own. In this case, it may be necessary to perform a second procedure to close the wound.
  • Phlebitis: This inflammation of the veins in the lower limbs is very rare. It is important to move the legs and calves after the operation to avoid this problem.
  • Pulmonary embolism: This is an extremely rare complication. To avoid it, it is important to move your legs and calves after the procedure.
  • Bad scar or vicious scar
  • Painful scar
  • Belly button deformation
  • Persistent numbness in the lower abdomen
  • Persistent edema (swelling) in the lower abdomen.

Frequently Asked Questions about Abdominoplasty

Will I have scars?

Incisions are necessary to access and tighten the abdominal muscles, as well as to remove excess skin. Scars are therefore inevitable. The scars will be located around the belly button and all over the lower abdomen. Long scars are however well hidden under Bikini panties.
Scar healing is an individual physiological process that takes place in depth over several months, even a year or more. The scar can be fine, enlarged, pigmented or not.

The scar final appearance has little to do with the surgeon. However, certain factors such as smoking, alcohol, bleeding and diet can affect the quality of a scar.

Should I lose weight before the procedure?

Prior weight loss is preferable. Since this technique aims to modify the external appearance of the abdomen, it is in the best interest of the patient to reduce the internal content (fatty tissue under the skin and in the abdominal cavity), to remove as much excess skin as possible and to stretch the tissues optimally.

Are the results permanent?

No one can counter the effects of time and ageing, which are the main causes of tissue sagging. Nevertheless, good weight control, a healthy lifestyle and regular physical exercise remain your best guarantees of success to maintain and preserve the results achieved b a tummy tuck.

Is sunbathing beneficial to the scarring process?

No, because sunbathing does not heal a wound any faster. Sun exposure of scars that are less than three to four months old can even alter these scars, which would then become redder or darker. Dr. Bernier will tell you when it will be possible to expose yourself to the sun without any consequences.

Before the surgery, can we see “before/after” photos?

During the first consultation, some patients ask to see photographs to see in advance “how it will turn out”. Dr. Bernier agreed to show some, but she makes sure to imply the limits of this method. This may lead to patients having false expectations about their outcome.

One has to note that another person’s results on a photograph and what is possible to achieve on one’s own body are two completely different things. Indeed, morphologies and healing processes can vary from one person to another. However, Dr. Bernier will take pictures of the patient before surgery. This will allow her to prepare the case and refer to the photographs, if necessary, during the procedure.

To sum up

Abdominoplasty or tummy tuck is commonly performed and, generally, the results are satisfactory for patients. Restoring the skin and tightening the abdominal muscles improves the shape and contour of the abdomen. They also allow patients to wear more fitted clothing and feel more comfortable when playing some sports.

DO YOU WANT TO KNOW MORE ABOUT Abdominoplasty?

At the Centre de Chirurgie et de médecine esthétique Dr. Elise Bernier, we will be honoured to answer your questions. Feel free to contact us here for more information.

To ensure that these treatments are perfectly suited to you, we will first offer you a medical evaluation at our offices in Sherbrooke, Montreal or Val-d’Or.

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