Abdominoplasty is a surgical procedure performed to improve the appearance of the abdomen. Pregnancies can cause the abdominal skin and muscles to become loose and flabby. Excessive weight gain followed by weight reduction often leaves a layer of loose excess skin and stretched-out, thin musculature in both men and women. Abdominoplasty is designed to correct these conditions. This can be done by removing excess skin and fat and tightening the muscles. It can also be done to eliminate or improve existing scars and to correct hernias.
Patients who undergo breast reduction surgery frequently are seeking relief from physical symptoms caused by the excessive weight of large breasts. Breast reduction usually can solve these problems as well as improve the size and shape of your breasts. Following breast reduction, your breasts will be more proportional to the rest of your body, and clothes will fit you better.
It is important to note that No guarantee of the results is implied ot projected hereby. Each and every patient has a unique shape and body funtion that could yield different results with different procedures. With some the results are radical and very different - yet with others the changes are quite subtle.
Abdominoplasty – Tummy Tuck
Abdominoplasty, often known as a 'tummy tuck', is a not weight-loss technique. Although the procedure removes some fat, it is not a substitute for a healthy diet or sensible exercise. Patients should be at normal or near-normal weight before surgery.
Two kinds of abdominoplasty can be performed - a complete abdominoplasty and a mini-abdominoplasty. The complete abdominoplasty is performed for patients who need maximum correction. In this operation a horizontal incision is made low on the abdomen at the level of the pubic hair. The abdominal musculature is tightened with stitches and any hernias or weaknesses are repaired. The umbilicus (belly button) is usually circumscribed during the operation. It remains in the same position on the abdominal wall, but is brought out through a new skin opening.
A mini or modified abdominoplasty is performed for patients who require less correction. In this case there is no scar around the umbilicus and the horizontal scar is shorter. In a full abdominoplasty the scar extends from hip to hip.
It is possible to perform an abdominoplasty at the same time as another intra-abdominal procedure such as a tubal ligation, although I prefer to perform an abdominoplasty as a separate procedure. It can also be performed at the same time as other cosmetic procedures such as breast or facial surgery. Liposuction of the hips and other areas is commonly performed with an abdominoplasty.
At the time of your consultation, we will assess whether you are a candidate for a complete or mini-abdominoplasty. We will take clinical photographs, before and after surgery, as these are an important aid in planning and performing the surgery. They become a permanent part of your patient record. These photographs are of the abdominal region only and do not include your face.
Here are some questions frequently asked about abdominoplasty:
Will I have to have a general anaesthetic and how long will the operation last?
If you have a complete abdominoplasty you will be given an epidural or general anaesthetic. A mini-abdominoplasty can be performed under a local anaesthetic. The procedure takes between one to three hours, depending on the area involved.
Will I have to stay in hospital?
If you have a complete abdominoplasty you will need to stay in hospital for 2 days after surgery. For a mini-abdominoplasty you will be discharged after 1 day.
What care is necessary after the operation?
Patients who have a complete abdominoplasty remain in bed until the next morning. A urinary catheter will be placed during your operation while you are asleep and remain for one day after surgery. Patients who have a limited abdominoplasty do not need a urinary catheter. You will experience some pain but this gradually subsides as you begin to walk. A narrow bandage is removed two days after surgery, and you may shower. All stitches are internal and self-dissolving. You will be given medication for pain.
When can I return to work and what sort of physical activity will I be able to do?
Most people return to their usual activities and to work two weeks after the operation. Strenuous sport, however, is prohibited for two months.
Will I have scars?
Following both a complete and a mini-abdominoplasty, you will have a horizontal scar low on the abdomen. After the complete abdominoplasty you will have a circular scar within the umbilicus. A different type or location of scar may sometimes be necessary because of individual anatomic variations but this would be decided upon beforehand. Although occasional findings during the operation dictate that the scar be somewhat longer or in a different position than planned before surgery, I will make every effort to keep the scar as short and inconspicuous as possible.
Will I be able to have more children?
Yes, you will be able to have more children but you should not have an abdominoplasty until your family is complete as pregnancy will stretch the entire abdomen considerably.
What will I feel like after the operation?
As with any surgical procedure, small nerves to the skin are interrupted during an abdominoplasty. Parts of your abdomen will feel numb or have less than full feeling. Sensibility returns over several months but some diminished feeling may last indefinitely.
Swelling of the abdomen is normal following surgery. During the first week your clothes may fit more tightly and you may weigh more than before. This swelling will subside from the second week after surgery but some lower abdominal fullness persists. You may expect to see about 50% of your total contour improvement at two weeks and about 75% at one month. It usually takes an additional two months for the last of the swelling to recede. Occasional patients may see continued improvement up to six months after surgery but changes beyond three months are subtle. It is important to understand that it will take between six months to a year for the scars to mature fully. Tissue oil massage helps immensely.
Are there likely to be any complications?
As with all surgery, it is important to be aware of possible side effects and undesirable or serious complications no matter how remote their possibility. All surgery carries potential risks which could be fatal. It is important to be aware of these possible complications so that your decisions are made with an understanding of them. I would discuss these risks with you pre-operatively and they include infection; blood collection under the skin (haematoma); serious fluid collection under the abdominal skin (this fluid can be aspirated with a syringe if it collects post-operatively); wound healing problems; deep vein thrombosis - this is a blood clot in the leg which rarely travels to the lungs.
Summary on Abdominoplasty
Abdominoplasty is a surgical means of correcting flabbiness and improving muscle tone in the lower abdomen. Although not a procedure performed for weight loss it flattens the tummy area and improves contour.
You may be a good candidate for breast reduction if you have one or more of the following conditions:
- breasts that are too large in proportion to your body frame
- heavy, pendulous breasts with nipples and areolas that point downward
- one breast is much larger than the other
- back, neck or shoulder pain caused by the weight of your breasts
- skin irritation beneath your breasts
- indentations in your shoulders from tight bra straps
- restriction of physical activity due to the size and weight of your breasts
- dissatisfaction or self-consciousness about the largeness of your breasts
Breast reduction can be performed at any age, but plastic surgeons usually recommend waiting until breast development has stopped. Childbirth and breast-feeding may have significant and unpredictable effects on the size and shape of your breasts. Nevertheless, many women decide to undergo breast reduction before having children and feel that they can address any subsequent changes later. If you plan to breast-feed in the future, you should discuss this with your plastic surgeon.
During the consultation, you will be asked about your desired breast size as well as anything else about your breasts that you would like to see improved. This will help your plastic surgeon to understand your expectations and determine whether they realistically can be achieved.
The following questions are often asked about breast reduction.
How Breast Reduction is Performed
Individual factors and personal preferences will determine the specific technique selected to reduce the size of your breasts.
Where are the incisions placed?
The most common method of reducing the breasts involves three incisions. One incision is made around the areola. Another runs vertically from the bottom edge of the areola to the crease underneath the breast. The third incision follows the natural curve of the breast crease.
After the surgeon has removed excess breast tissue, fat and skin, the nipple and areola are shifted to a higher position. The areola, which in large breasts usually has been stretched, also is reduced in size. Skin that was formerly located above the nipple is brought down and together to reshape the breast. Liposuction may be used to improve the contour under the arm.
One common breast reduction technique removes excess breast tissue, fat and skin through the incisions shown. The nipple and areola remain attached to the underlying tissue but are shifted to a higher position. The size of the areola is often reduced at the same time.
Usually, the nipples and areolas remain attached to underlying mounds of tissue, and this allows for the preservation of sensation. The ability to breast-feed may also be preserved by this method, although this cannot be guaranteed.
Skin that formerly was located above the nipple is brought down and together to reshape the breast.
Fortunately, significant complications from breast reduction are infrequent. Every year, many thousands of women undergo successful breast reduction surgery, experience no major problems and are pleased with the results. Anyone considering surgery, however, should be aware of both the benefits and the risks.
I understand that every surgical procedure has risks, but how will I learn more so that I can make an informed decision?
The subject of risks and potential complications of surgery is best discussed on a personal basis between you and your plastic surgeon, or with a staff member in your surgeon's office.
Some of the potential complications that may be discussed with you include bleeding, infection and reactions to anesthesia. Rarely, a patient may require a blood transfusion during the operation. This usually can be anticipated in advance, and your plastic surgeon may, under certain circumstances, advise you to donate your own blood in preparation for surgery.
Following reduction, sometimes the breasts may not be perfectly symmetrical or the nipple height may vary slightly. If desired, minor adjustments can be made at a later time. Permanent loss of sensation in the nipples or breasts may occur rarely. Revisionary surgery is sometimes helpful in certain instances where incisions may have healed poorly. In the unlikely event of injury to or loss of the nipple and areola, they usually can be satisfactorily reconstructed using skin grafts.
You can help to lessen certain risks by following the advice and instructions of your plastic surgeon, both before and after surgery.
How will I look and feel initially?
The day after surgery, you will be encouraged to get out of bed for short periods of time. After several days, you will be able to move about more comfortably.
Straining, bending and lifting must be avoided, however, since these activities might cause increased swelling or even bleeding. You may be instructed to sleep on your back to avoid pressure on your breasts.
Any surgical drains will be removed a day or two after surgery, at which time your dressings may also be changed or removed. You will be instructed to wear a support bra for a few weeks, until the swelling and discoloration of your breasts diminishes. Generally, stitches will be removed in stages over a period of approximately three weeks, beginning about one week after surgery.
You may notice that you feel less sensation in the nipple and areola areas. This usually is temporary. It may, however, take weeks, months or even more than a year before sensation returns to normal. Your breasts may also require some time to assume a more natural shape. Incisions will initially be red or pink in color. They will remain this way for many months following surgery.
When can I resume my normal activities?
After breast reduction surgery, it is often possible to return to work within just a couple of weeks, depending on your job. In many instances, you can resume most of your normal activities, including some form of mild exercise, after several weeks. You may continue to experience some mild, periodic discomfort during this time, but such feelings are normal. Severe pain should be reported to your doctor. Any sexual activity should be avoided for a minimum of one week, and your plastic surgeon may advise you to wait longer. After that, care must be taken to be extremely gentle with your breasts for at least the next six weeks.
How long will the results last?
Unless you gain or lose a significant amount of weight or become pregnant, your breast size should remain fairly constant. However, gravity and the effects of aging will eventually alter the size and shape of virtually every woman's breasts. If, after a period of years, you become dissatisfied with the appearance of your breasts, you may choose to undergo a breast "lifting" procedure to restore their more youthful contour.
Results of Breast Reduction
Breast reduction surgery will make your breasts smaller and firmer. Without the excessive weight of large breasts, you may find greater enjoyment in playing sports and engaging in physical activity.
The incisions from your breast reduction surgery will heal and fade over time. It is important to realize, however, that the incision lines will be permanently visible, more so in some individuals than others. Fortunately, the incisions for breast reduction are in locations easily concealed by clothing, even low-cut necklines. Breast reduction often makes a dramatic change in your appearance. For this reason, it may take some time to adjust to your new body image. Most women, however, eventually become comfortable with their smaller breasts and feel very pleased with the results of surgery. In fact, the level of patient satisfaction resulting from breast reduction is among the highest of any plastic surgery procedure.
General breast care
You should regularly examine your breasts, whether or not they have been augmented. Any suspicious lumps should be examined immediately. Ask your doctor to examine your breasts when you have your routine pap smear.
Breast augmentation is one of the most frequently requested cosmetic operations. It is a simple procedure used to enhance breast size or to correct symmetry. Modern and improved prostheses ensure that associated health risks are minimal.