Abdominoplasty
( Tummy Tuck )

From Dr. Federico Macaya


Preparing for your surgery
The surgery
After your surgery
COMPLICATIONS

Abdominoplasty, known more commonly as a 'tummy tuck,' is a major surgical procedure to remove excess skin and fat from the middle and lower abdomen and to tighten the muscles of the abdominal wall. The procedure can dramatically reduce the appearance of a protruding abdomen.  But bear in mind, it does produce a permanent scar, which, depending on the extent of the original problem and the surgery required to correct it, can extend from hip to hip.

The best candidates for abdominoplasty are men or women who are in relatively good shape but are bothered by a large fat deposit or loose abdominal skin that won't respond to diet or exercise.  The surgery is particularly helpful to women who, through multiple pregnancies, have stretched their abdominal muscles and skin beyond the point where they can return to normal.  Loss of skin elasticity in older patients, which frequently occurs with slight obesity, can also be improved.

Patients who intend to lose a lot of weight should postpone the surgery.  Also, women who plan future pregnancies should wait, as vertical muscles in the abdomen that are tightened during surgery can separate again during pregnancy. 

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PREPARING FOR YOUR SURGERY

If you smoke, plan to quit at least one to two weeks before your surgery and not to resume for at least two weeks after your surgery.  Avoid overexposure to the sun before surgery, especially to your abdomen, and do not go on a stringent diet, as both can inhibit your ability to heal. If you develop a cold or infection of any kind, your surgery will probably be postponed.

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THE SURGERY

The surgery is performed in a hospital and the patient stays overnight, I prefer general anesthesia. Complete abdominoplasty usually takes two to five hours, depending on the extent of work required. Partial abdominoplasty may take an hour or two.

A  long incision  is made from hipbone to hipbone, just above the pubic area.  A second incision is made to free the navel from surrounding tissue. With partial abdominoplasty, the incision is much shorter and the navel may not be moved, although it may be pulled into an unnatural shape as the skin is tightened and stitched.

Next, the skin is separated  from the abdominal wall all the way up to your ribs and lifts a large skin flap to reveal the vertical muscles in your abdomen. These muscles are tightened by pulling them close together and stitching them into their new position. This provides a firmer abdominal wall and narrows the waistline.

The skin flap is then stretched down and the extra skin is removed.  A new hole is cut for your navel, which is then stitched in place. Finally, the incisions will be stitched, dressings will be applied, and a temporary tube may be inserted to drain excess fluid from the surgical site.

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AFTER YOUR SURGERY

For the first few days, your abdomen will probably be swollen and you're likely to feel some pain and discomfort which can be controlled by medication. Some people return to work after two weeks, while others take three or four weeks to rest and recuperate.

Your scars may actually appear to worsen during the first three to six months as they heal, but this is normal. Expect it to take nine months to a year before your scars flatten out and lighten in color.  While they'll never disappear completely, abdominal scars will not show under most clothing, even under a bathing suit.

You must stay 2 weeks after surgery in Costa Rica. I recommend the Las Cumbres Inn where you will receive personal attention, required medication and transportation to and from surgery. I visit my patients at Las Cumbres frequently following surgery to check on your recovery.

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COMPLICATIONS

Thousands of abdominoplasties are performed successfully each year. Nevertheless, there are always risks associated with surgery and specific complications associated with this procedure.

Postoperative complications such as infection and blood clots are rare, but can occur. Infection can be treated with drainage and antibiotics, but will prolong your hospital stay. You can minimize the risk of blood clots by moving around as soon after the surgery as possible.

Poor healing, which results in conspicuous scars, may necessitate a second operation. Smokers should be advised to stop, as smoking may increase the risk of complications and delay healing.

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