The term abdominoplasty also known as tummy tuck is very general, as it is an operation that varies greatly depending on the case. The abdominal wall and the skin of the abdomen are subject to serious and often irreversible changes when there is an extreme fluctuation of the abdominal fat or the abdominal volume in general. We notice that after a pregnancy, when it is not accompanied by a very large weight gain, the abdomen and abdominal wall can almost completely return to their original state. There is, however, a certain threshold of increasing the size of the abdomen, beyond which the connective tissue architecture of the subcutaneous is destroyed and also damage happens to the skin and abdominal wall. These changes translate respectively into sagging of the abdomen, stretch marks and hernias of the wall. How resistant a belly is to these changes depends on age, size and duration of fluctuation, anatomical and hereditary factors as well as hormonal, nutritional and other factors.
So, the deformities that an abdominoplasty comes to correct are the relaxation of the skin and fat of the abdomen, a part of the stretch marks, the relaxation of the abdominal wall such as diastasis of rectus abdominals, umbilical hernias. Abdominoplasty is very often combined with liposuction and liposculpture, firstly to significantly reduce the fat present in the abdomen and mainly to better shape the abdomen and the sides of the torso.
The most common indications for abdominal plastic surgery are after pregnancy, after weight loss and when the abdomen is disproportionately large and creates aesthetic and functional problems. For women who wish to correct their abdomen after pregnancy, it is preferable to have completed childbearing and to have passed a period of at least 6 months since the last birth. For people who have either lost enough weight, abdominoplasty is indicated when body weight has stabilized for a period of 6-12 months. Finally, when it comes to a large abdomen, the total body weight is taken into account and either a recommendation for weight loss is made first, or the operation is performed together with extensive liposuction.
Tummy tuck techniques
The techniques of tummy tucks, as mentioned, are varied and the operation is adapted each time to the needs and desires of each patient. We will refer to the basic plastic belly techniques and the possibilities and indications of each one
1. Mini tummy tuck
2. Classic tummy tuck
3. Extended or circular abdominoplasty
4. Abdominoplasty with incision in the midline
In the first technique, i.e. mini tummy tuck, a simple removal of part of the skin present below the navel is performed. This procedure mainly concerns cases of very small relaxation in the lower part of the abdomen and can be combined with liposuction / liposculpture to maximize the result throughout the abdomen and trunk. It is a relatively short operation with faster recovery and can even be performed and under local anaesthesia. The navel and abdominal walls are not affected in this case and the incision is placed as low as possible in the pubis so that it is not visible and is usually a little larger than the C-section.
The second technique is the classical tummy tuck. This procedure is usually performed under general anaesthesia and has a longer recovery time than mini abdominoplasty. The incision is again relatively low, below the line of underwear and usually extends from one iliac to another. There are three variations of this procedure, depending on how the navel is formed. In one case the navel simply detaches from the abdominal wall and moves 1-3 cm lower (floating tummy tuck), in the second case the navel remains attached to the abdominal wall in its original position and comes out of a new opening and in the third case a new navel is created. In all these cases we have the ability to correct any laxity of the abdominal wall, such as diastasis of rectus abdominals, hernias or muscle relaxation. Abdominoplasty can and usually is combined with small or large liposuction to better shape the sides of the trunk and the upper abdomen. It is the most common operation performed on women after pregnancy.
The third case, the extended abdominoplasty, is technically similar to classical abdominoplasty, however it differs in the extent of the incision which extends beyond the boundaries of the iliac pelvis, or it may be in the form of a circular abdominoplasty, i.e. the incision continues to the back of the trunk and has the form of a belt around the body. The main indication of this operation is after great weight loss.
Finally, abdominoplasty with an incision in the midline, known as Fluer de Lis, is a variant of extended abdominoplasty and is mainly indicated when there is great weight loss and intense relaxation on the sides of the abdomen. In this case, an inverted T incision is made, that is, a lack of skin is removed in the lower part of the abdomen and a triangle in the middle of the abdomen, which at the end are sewn in the shape of a T. This is more relevant when there is massive weight loss and the excess skin cannot get geometrically fully tucked with standard incision of the abdominoplasty.
In addition to the above abdominoplasty techniques, in some cases special manipulations are needed for the complete restoration of the abdomen and abdominal wall. So we see how multifaceted abdominal plastic surgery is and how important it is to examine each case to judge what exactly is necessary.
Tummy tuck recovery
Mini abdominoplasty can be performed either under general or local anaesthesia and sedation and is of lesser severity. The pain after surgery is not intense and subsides very quickly. Recovery is also relatively quick because the abdominal wall is not affected and this means that after 2-3 weeks one can return to physical activities and sports.
Classic abdominoplasty is performed under general anaesthesia and usually with an overnight stay in the clinic. The operation lasts less than two hours. After surgery, you need to abstain from physical exercise for 4-6 weeks and elastic bandage with a corset for 3-4 weeks. Apart from that, there is no need for any recovery. The main concern of most women is scarring. With the right design, the scar is placed low on the abdomen, like that of a caesarean section, lower than the height of the underwear, which means that the scar remains hidden even on the beach. It usually takes 5-6 months for the scar to thin and fade. Then a fine line remains.