The abdominoplasty is performed to eliminate the surplus of integument (skin and subcutaneous adipose tissue) which can produce some obvious imperfections, such as folds and undulations of the skin, and/or, in the most accentuated cases, a real apron that covers the pubic region. 

Abdominoplasty consists in the removal of excess skin and gives the abdomen a more pleasant and natural appearance. 

The disorders present in the most pronounced cases, such as dermatitis, which often occurs at the level of the skin and inguinal folds, and difficulty in movement or in the choice of clothing can be eliminated. The removal of the skin can be associated, when appropriate, with the removal of excess adipose tissue, using a liposuction technique. If there are hernias caused by sagging of the abdominal wall or diastasis of the rectus abdominals, they must be repaired during the abdominoplasty surgery. In some cases, it may be necessary to implant a restraint net that reconstitutes the continuity of the abdominal wall.

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The following can contribute to the prominence of the abdomen:

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- a poor muscle tone that cannot be corrected surgically but, in case, at least partially recovered with a specific physical activity. For the purposes of defining the possible results that can be obtained, the planning of the intervention must take this factor into account. In other words, the presence of poor muscle tone prevents a "flat abdomen" from being guaranteed with the surgery;

- Excessive adiposity and / or distension of the viscera that can only be improved with diet.

It must also be remembered that in some cases the prominence of the abdomen is due to the presence of an accumulation of adipose tissue, with discrete or good elasticity tissues; in these cases it is preferable to proceed with a simple liposuction which in itself can give, in the correct indications, a good aesthetic result. If at least 4-6 months after liposuction, tissue sagging becomes evident, an abdominoplasty surgery may be considered.

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Preparation for surgery: 

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If there is an overweight condition, it is preferable, before planning the intervention, to pursue an appropriate weight loss through a diet and motor activity indicated by the specialist.

Before the surgery, the reports of the prescribed pre-operative analysis and examinations must be delivered, which may also include an ultrasound and / or abdominal CT scan and respiratory function tests. A possible ultrasound doppler of the lower limbs may be requested in the presence of risk factors for thromboembolism. In some cases, about three weeks before surgery it may be appropriate to make one or two blood donations to be made at a blood transfusion center. Any pharmacological therapies in progress (cortisone, contraceptives, antihypertensive, cardioactive, anticoagulants, hypoglycemic agents, antibiotics, tranquilizers, sleeping pills, stimulants), homeopathic and phytotherapy therapies and possible allergies to antibiotics and drugs in general must be reported.

Estroprogestin hormone therapy ("pill") must be suspended one month before surgery, in order to have a regular cycle without hormone intake for a month, to reduce the risk of thromboembolism.

At least two weeks before surgery, the intake of medicines containing acetylsalicylic acid (such as aspirin) is avoided and the simultaneous intake of oral anticoagulants must be avoided and, in any case, the continuation of these therapies must be agreed with the treating physician.

At least one month before, it is recommended to stop smoking, which has decidedly negative influences on the skin and fat vascularization.   

 

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The day before the surgery:

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A thorough cleansing bath must be performed, nail polish removed from the fingernails and toenails and the groin-pubic region shaved. Before surgery, a fast of at least 8 hours from solid foods and drinks must be observed.

 

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On the day of the surgery:

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It is recommended to wear clothing with comfortable sleeves that open completely at the front and shoes without heels. An elastic girdle or girdle will be prescribed to wear after the surgery.

 

 

Anesthesia:

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The surgery is performed under general anesthesia.

 

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Postoperative:

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In the post-operative period, a certain tension may be felt in the abdominal region, which will spontaneously regress within a few days or a few weeks; it is good to avoid efforts and extensions of the trunk in the first days. For the first 4 weeks you should generally avoid making large movements with the trunk; you will also have to refrain from sexual activity, which can be resumed after this period.

- Drains are generally removed after a few days after surgery; dressings can be left in place for a few days. This dressing should neither be removed nor wet.

- It is advisable to keep the thighs flexed on the hips during bed rest with a pillow under the knees, and to walk with the torso slightly bent forward in the first days after surgery. In order to minimize the risk of thromboembolism, mobilization of the lower limbs immediately after surgery is very important.

- It is absolutely recommended to abstain from smoking for at least a week.

- For the first 4-5 post-operative days, you will have to continue taking antibiotics, if this is deemed appropriate. The presence of a fever is common and does not strictly indicate infection.

- For the first 2 weeks you may not drive vehicles.

- The external sutures will be removed 7-15 days after the surgery. The first complete cleansing shower can only be practiced after this period.

- Swelling and bruising are normally present for at least 2 weeks and can often extend to the pubic, genital and thigh region.

 

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Results:

The improved effect of abdominoplasty is immediately visible to the surgeon already during the surgery, the final result is fully appreciable about six months later.

In some cases, after this period, a surgical correction may be necessary to eliminate any residual imperfections. The result of the intervention is permanent, in the sense that the removed tissue does not reform. Moreover, over the years the normal processes of skin aging, pregnancy, significant weight gain and loss and unhealthy lifestyles, can lead to an alteration of the shape of the abdominal wall.

Inevitably, the operation produces skin scars, to the extent and position of which depends on the original size of the abdominal wall, the amount of tissue removed and the surgical technique used.