ABDOMINOPLASTY
Abdominoplasty is a surgical procedure in which excess fat and sagging skin in the middle and lower abdomen are removed and the abdominal muscles are tightened and strengthened. Abdominoplasty is not a treatment for obesity. Obese people should lose as much weight as they can before this surgical intervention. There are many techniques used by plastic surgeons for tummy tuck surgery. Abdominal stretching surgery can be performed together with other body contour correction surgeries. During the preoperative period, your surgeon will remind you of some points that must be followed. Especially if you smoke, you should stop smoking from 2 weeks before to two weeks after the surgery. You should not stay in the sun for too long during this period. If you are using vitamin E and aspirin, you should take a break during this period and avoid heavy diet regimes before surgery. A cold or another infection may cause the surgery to be postponed. A drawing will be made before the surgery to plan the details of the procedure to be performed. Following this, the necessary photographs will be taken to compare the before and after surgery.
Abdominoplasty SURGERY
Surgery, depending on the procedure2–5 hours It may last. An incision line is made, which can often be hidden under underwear and remains 8–10 cm below the navel and above the genital area. A second incision is made around the navel, according to the surgeon's preference. After the surgery is completed, the incision line is closed with either metal staples, individual stitches on the skin, or subcutaneous hidden stitches, and covered with dressings. One or more tubes called drains may be placed to remove excess fluid collected in the area. During the surgery, a urinary catheter is usually used on the first day. After you stand up, the urinary catheter will be removed.
AFTER SURGERY
In the postoperative period, you will be asked to lie in a position we call the V position, thus trying to reduce the tension in your surgery area. This position is where your body is elevated 45 degrees from your waist. From time to time, you are allowed to bend your legs and bring them closer to your body, and at the same time, make your body lie down from the waist. You will be asked to move your legs frequently from the first hours after surgery. After the surgery, an abdominal corset will be applied to your abdomen. This pressure-adjustable corset is used to help keep your surgical area immobile and prevent swelling. You are not allowed to eat anything in the first hours after surgery. Usually the first feeding is with liquid foods. Once you can pass gas easily, you can start eating soft foods. In the first weeks after surgery, you generally need to increase the number of meals and limit the amount and avoid gas-causing foods. The first day after surgery is the most troublesome period. Painkillers and occasionally sleep-inducing drugs are used to make this period more comfortable. There may be swelling and pain in the abdominal area for the first few days. But this pain can be controlled with painkillers. Drains are average1–5 days, non-dissolvable stitches on the skin1–3 weeks is taken later. Dissolvable stitches applied subcutaneously as hidden stitches do not need to be removed. The first two days after the surgery are the period when the body is edematous. During this period, the body collects water and movements become difficult. Generally, from the third day onwards, edema begins to decrease and movements become easier. Average length of stay in hospital after surgeryIt is 1-5 nights. After you are allowed to go home, you are expected to spend the first week on home rest.
EXPECTED BENEFITS FROM THE TRANSACTION
Tummy tuck surgery aims to achieve a more aesthetic appearance in the abdominal area. Stretch marks, sagging skin and wrinkles occurring in the skin below the navel are partially reduced.
CONSEQUENCES THAT MAY BE ENCOUNTERED IF THE PROCEDURE IS NOT IMPLEMENTED
Although the sagging and stretch marks in the abdominal areas of patients who have not undergone abdominoplasty cannot be reduced, they may be disturbing in appearance. Patients are affected psychosocially.
ALTERNATIVES TO THE PROCEDURE
Vacuum-assisted fat removal (liposuction) can be considered as an alternative for people of normal weight if there is good quality taut skin and limited fat accumulation and the abdominal wall is intact. Diet and exercise programs can also be effective in reducing whole body fat, but they are not effective in sagging skin. If there is excess skin and sagging, liposuction method alone is not a solution.
RISKS AND COMPLICATIONS OF THE PROCEDURE
Every surgical procedure has a certain amount of risk, and it is important that you understand what is involved with tummy tuck surgery. It is essential to compare the risks and benefits of the procedure before a person accepts the surgical procedure. Even though many women or men do not experience the following complications; Discuss the risks, potential complications, and consequences with your plastic surgeon until you are sure you understand them.
Bleeding: Although it is not common, it is possible to encounter it during or after the operation. When postoperative bleeding occurs, urgent drainage of accumulated blood and blood transfusion may be required. Starting ten days before the surgery, do not take aspirin or anti-inflammatory, pain-relieving treatments, as this may increase the risk of bleeding.
Infection: Infection is not uncommon after this type of surgery. If infection develops following surgery, treatment including antibiotics or additional surgery may be required.
Change in skin sensation: It is natural for numbness, numbness and edema to occur in the areas above the incision line. This is usually a temporary condition and may take up to 6-12 months to resolve. Numbness is rarely permanent. By the way, in areas where the muscle membranes are folded, it may be possible to feel the stitches manually after surgery.
Irregularities in body lines: Irregularities may develop in body lines after abdominoplasty. Additionally, visible or palpable skin folds may form. Folds and ripples may occur on the skin.
Scar on the Skin: There will be scars on the incision line of the surgery and around the navel, which are initially red in color and turn pink and fade over time (at least after 6 months). These scars are permanent. If the patient has or develops abnormal wound healing, significant scar tissue may form (hypertrophic scar/keloid). Excessive scarring is not usual. In rare cases, abnormal scars may occur. The scars may be ugly, have a different color than the surrounding skin, be swollen, and extend beyond the wound lips. Additional treatment, including surgery, may be required for abnormal scarring. However, as a result of these treatments, scar reduction treatment may fail or even become worse than the initial condition.
Anesthesia: Both local and general anesthesia carry risks. In all surgical anesthesia and sedation procedures, there is a possibility of complications ranging from the simplest to very rare, even leading to death.
Asymmetry: Symmetrical body image may not be achieved after abdominoplasty. An asymmetry in the body may already exist due to factors such as skin tension, fat accumulation, and body protrusions. After surgery, differences may occur between the right and left parts of the body, and between the lower and upper parts. Additionally, the scars may be asymmetrical. Traces of different sizes may remain between regions.
Delayed Healing: Opening of the wound or delayed healing is possible. Certain areas of the abdomen may not heal normally and may take a long time to heal. There may be partial or complete tissue loss in the area above the incision line or in the belly. Your navel may partially or completely die. This situation occurs especially as a result of smokers, people with comorbidities, and those who do not pay attention to the recommended lying and walking positions in the postoperative period. In case of losses occurring after wound healing problems, repeat surgery may be required. When necessary, it may be necessary to bring a skin patch from other body parts. In such cases, bad and asymmetrical scars remain and an asymmetrical appearance can be created, which can create an unaesthetic appearance for the patients.
Allergic Reactions: Rarely, allergies to the tapes, suture materials or creams used have been reported. More serious systemic reactions may occur with medications used during or prescribed after the surgical procedure. Allergic reactions may require additional treatment. Sometimes allergic conditions can result in death. If you are allergic to any food, medicine or object (blanket, wool, soap, etc.) before the surgery, be sure to inform your doctor.
Lung Complications: Lung complications may develop due to both blood clot (pulmonary embolism) and collapse of the lungs after general anesthesia. Closure may occur in small areas of your lungs. This increases the risk of lung infection. Antibiotic use and respiratory physiotherapy may be required. Treatment for both complications may require hospitalization and additional treatments. Pulmonary embolism can cause life-threatening and fatal consequences in some cases. The most feared complication of abdominoplasty is embolism. To prevent this, blood thinners are given when necessary and compression stockings are applied to the legs. Despite all this, embolism may develop. If you or your family has a history of embolism, it should be noted. The most important mechanism that causes embolism is long periods of inactivity. For this reason, it would be appropriate to move your legs in bed, move your hips frequently, and not lie in the same position until you are allowed to get up. It is useful to massage your legs and calves from time to time. You will be helped the first time you are allowed to get up. It is not uncommon to feel dizzy and faint when getting up for the first time. To prevent this, it would be relaxing for you to sit on the edge of the bed for a long time and look ahead when you first get up. Likewise, when you stand up in the first days, it would not be right to walk upright and stretch. It is helpful to bend slightly because of the tension in your abdomen.
Seroma: Fluid accumulation between the abdominal wall and skin may rarely occur. When it develops, additional treatment may be required for drainage. It is sometimes resistant and may require multiple hospital visits. It increases the possibility of infection. It requires long-term use of antibiotics.
Pain: Chronic pain may rarely develop after abdominoplasty due to nerve endings trapped in the scar tissue. Sometimes these pains are resistant and may not go away.
Belly Button: Poor placement, scarring, unacceptable appearance or loss of the belly button may occur. In other words, the final appearance of the navel may not satisfy you aesthetically. When you lose your belly button, only scar tissue remains in the belly area.
Unsatisfactory Results: You may rarely be disappointed with the results of your surgical procedure. There may be asymmetry in the surgical scar, incorrect location of the navel, and contour differences that cause asymmetry in the tissues above the incision line. In addition, pubic hair may be pulled upwards. Such images may not be satisfactory at all. Additional surgery may be required to correct such results.
Long Term Effects:Changes in body lines may occur outside the surgery area due to aging, pregnancy, and weight gain or loss. In addition, if breast cancer develops in the future and breast reconstruction is required, it will not be possible to use the abdominal skin after abdominoplasty (tummy tuck) surgery.
ESTIMATED DURATION OF THE PROCESS
Surgery, depending on the procedure2–5 hour It may last.
WHAT ARE THE CRITICAL LIFESTYLE RECOMMENDATIONS?
One should be careful about smoking in the first week after surgery. It should not be forgotten that smoking has a negative effect on the wound healing process. You will be allowed to slowly return to your social life starting from the second week after the surgery. However, you are expected to avoid heavy work for six weeks.
Usually, in the first week, you are allowed to take half showers without getting your surgery area wet. A full shower can be taken starting from the second week. You are not allowed to swim in the pool or the sea before the fourth week. Sauna, solarium, steam bath, sunbathing and heavy sports are prohibited for six weeks after the surgery. The surgical incision may be red, itchy and very visible, especially in the first months (3-4 months) after surgery. Over time, especially after the sixth month, it is expected that the color of the surgery scar will lighten and the itching will decrease. This process continues for up to two years. Even after two years, a skin-colored scar remains, albeit thin, in the surgery area. Efforts are made to keep this scar within the panties and bikini line during the operation plan. However, today, due to the variety of underwear, it is not possible for the scars to remain in the underwear. In the postoperative period, long-lasting and sometimes permanent numbness occurs, especially in the area below the navel. These are expected to get better over time. You may not be aesthetically satisfied after tummy tuck surgery.