Why is abdominal aesthetics needed?
Pregnancy, sedentary life, aging process, frequent weight gain and loss cause aesthetic deformities in the abdomen. Examples of these deformities are stretch marks (strias), increased fat deposits, loose and sagging skin. Due to the loosening of the connective tissue and muscles in the abdominal wall, the flat image on the abdominal wall disappears and a bulgy abdomen appears. These aesthetic deformities may not be completely corrected despite reaching the ideal weight, regular exercise or diet.
What are the factors considered when deciding on the procedure in abdominal aesthetics? Which procedures are preferred in which situations?
Factors to be evaluated on physical examination are the amount of excess fat, the presence or absence of skin excess, the location of skin excess, skin quality, skin tonus, tightness of the connective tissue sheath around the abdominal muscles, and quality of the abdominal muscles. Patients with only excess fat (good skin quality, no excess skin) can benefit from liposuction. However, in case of excess skin, tummy tuck surgery, that is, “abdominoplasty”, should be preferred.
What is tummy tuck surgery and how is it done?
Tummy tuck surgery, or “abdominoplasty” as it is medically called; is an operation performed with an incision placed between the upper anterior protrusions of the pelvis and under the cesarean scar. With this incision, the skin and subcutaneous adipose tissue of the abdomen are freed from the sheath (fascia) that surrounds the abdominal muscles. This release extends up to the rib cage curve in the traditional (classical/full) abdominoplasty. In mini tummy tuck, the release is terminated around the belly button. Simply, the released abdominal skin and subcutaneous adipose tissue are pulled down by placing the patient in the appropriate position and the excess parts are removed. In this way, a tight and tense abdomen is obtained instead of a loose and abundant abdomen. In traditional tummy tuck surgery, the belly button is moved to its ideal place. In this process, the stalk of the umbilicus (navel) is preserved and after the excess tissues are removed, this umbilical stalk is exposed from the newly created opening. In mini tummy tuck surgery, the existing belly button is not touched. If required, which is usually needed, the abdominal wall and muscles are tightened with appropriate sutures. In this way, the appearance of bulging in the abdomen is corrected and the waist fold is recreated. In traditional tummy tuck surgeries, drains are placed to allow the solutions accumulated inside or the fluids mixed with blood to come out. Drain is not used in mini tummy tuck surgery. The incision area is repaired with appropriate subcutaneous and skin sutures. Stitches are absorbable and do not need to be removed. The operation is performed under general anesthesia. It takes an average of 2-3 hours, depending on the method and the processes to be combined.
What are the differences between full (traditional/classical) tummy tuck surgery and mini tummy tuck surgery?
Abdominoplasty operations can be simply classified as full tummy tuck (“traditional abdominoplasty”) and mini tummy tuck (“mini-abdominoplasty”). If the skin quality is good and the excess skin is limited only to the area below the navel, mini tummy tuck surgery may be sufficient. However, if the skin quality is not good and the excess skin is not limited to the underbelly area, traditional tummy tuck surgery is usually required. In traditional tummy tuck surgery, the release is up to the rib cage, while in mini tummy tuck surgery, the release is up to the navel area. In mini tummy tuck surgery, the scar is shorter, and a drain is not used. In full abdominoplasty, the navel is moved to its new place, but in mini tummy tuck surgery, the original belly button is preserved. However, it should not be forgotten that the original belly button will be placed a little lower when the closure will be performed after the removal of excess tissues in mini tummy tuck. As a result, mini tummy tuck surgery is a relatively simple operation with faster recovery compared to traditional tummy tuck surgery. We will decide together which of the two methods is more suitable for you and will give the best result, after listening to your story and after our examination.
What are the conditions to be considered before tummy tuck surgeries?
In the history to be taken, your previous pregnancies, previous abdominal surgeries and your future childbearing plans will be questioned; in the physical examination, the amount of excess fat, excess skin, skin quality, skin tonus, structure of the abdominal wall, abdominal muscles and existing hernias will be evaluated. Since tummy tuck surgeries are one of the surgeries where the probability of deep vein thrombosis called “DVT” is relatively high compared to other aesthetic surgery operations, your predisposition to thrombosis will also be questioned and necessary precautions will be taken before the surgery if needed.
Obesity is a major problem in wound healing in this surgery, as in other surgeries. Therefore, it should not be forgotten that the closer you are to your ideal weight, the better the result and the lower the risk of complications. One of the most important points to be mentioned is smoking. Active smoking seriously impairs abdominal blood suppyl and increases the rate of postoperative complications. As a personal approach, I do not perform traditional tummy tuck surgery on active smokers who have not stopped smoking (including electronic cigarettes) at least 4 weeks in advance.
What is the post-operative period after tummy tuck surgery?
Compression stockings are put on to prevent thrombosis (formation of clot) from the leg before starting the tummy tuck surgery. You will come out of the surgery with these compression stockings. These socks are removed when you start walking actively (within 1-2 days). At the end of the operation, a special medical corset is worn to reduce pain / edema, to help the abdomen take the desired shape and to support it. It is highly recommended to use this corset between 4-6 weeks after surgery. During traditional abdominoplasty surgery, 2 drains are placed to prevent blood and other fluids from accumulating in the abdomen, and these drains are removed on the 1st or 2nd day after the surgery. Drains are generally not used in mini tummy tuck surgery. In standard tummy tuck surgery, you can be discharged the next day or after 2 days, depending on the situation, and the next day in mini tummy tuck surgery.
Pain after surgery is normal in the early stages because the abdomen is in the center of the body and plays an important role in movements. It is normal for the stretched abdomen to ache with movement after the surgery. However, this pain gradually decreases and responds well to painkillers. After the operation, if possible, the patient is encouraged to walk on the night of the operation, if not, the next day. However, in order not to increase the tension on the abdominal wall and not to damage the abdominal wall blood supply, you should walk obliquely instead of straight (this movement posture will be shown to you). In the post-discharge period, care should be taken to walk obliquely for the first 2 weeks.
You can take a shower 3 days after the operation. You can start short-distance walks after 1 week and start your daily activities that will not force your abdomen after 2 weeks. However, it should not be forgotten that the full return to social life will take the 6th week (this time is earlier in mini-abdominoplasty). The edema, which will start after the surgery and will be maximum on the 3rd day, will also decrease to a great extent at the end of the 6th week. Later on, in order to preserve the result, healthy nutrition and regular exercise are very important after the surgery.
What are the aesthetic procedures that can be combined with tummy tuck surgery?
The most frequently combined procedure with this surgery is liposuction, which can also be considered as a part of this surgery. Deformities and excess fat are usually not limited to the abdominal region. Along with tummy tuck surgery, liposuction can be performed on the upper abdomen, waist, hip, and genital pubic region in the same session (See Liposuction (Fat Removal) Section).
Another procedure that can be combined with tummy tuck surgery is “Mommy Makeover”. In this combination, which includes a series of operations such as breast lift / breast augmentation / breast reduction, genital aesthetics and liposuction can be performed in the same session with tummy tuck surgery (See Mommy Makeover Section).
Will there be scars in tummy tuck surgery?
As in any surgery, there will be a scar in this surgery. This scar will be located between the upper anterior protrusions of the pelvis, under the cesarean section scar. It will be shorter in mini-abdominoplasty. If traditional tummy tuck surgery is performed instead of mini-abdominoplasty, there will also be a scar around the belly button.
Since this scar on the lower abdomen will remain inside the underwear or bikini used, it can be easily hidden. In addition, at the end of 6 months – 1 year, if there is no abnormal wound healing, the visibility of these scars will decrease, and these scars will become barely noticeable.
Abdominoplasty is one of the surgeries which is done with relatively large scars in aesthetic surgery. Because a longer scar is required for a more beautiful appearance of the abdomen. However, thanks to the happiness created by the improvement in the form of the abdomen, the presence of these scars is not usually a complaint by the patients.
What is the relationship between tummy tuck surgery and pregnancy?
Abdominoplasty should ideally be performed at least 1 year after birth. Is it possible to get pregnant after tummy tuck surgery? There are publications in the literature showing that women who have had tummy tuck surgery became pregnant and gave birth without any problems. However, it should not be forgotten that if you become pregnant after tummy tuck surgery, the skin will expand again and the likelihood of similar deformities will be formed after birth. Therefore, as a personal approach, I recommend this operation to women who do not plan any pregnancy in the future, in order to have the best possible and permanent results.
What are the conditions that cannot be corrected with tummy tuck surgery?
Abdominoplasty should not be considered as a weight loss surgery. This surgery does not cure obesity either. The main purpose of this surgery is to remove the excess and sagging abdominal skin fat and to provide a more aesthetic abdominal appearance.
This surgery cures stretch marks (strias) in the abdomen. However, the stretch marks mentioned are the ones under the belly button. Strias above the belly button are not included in the tissues to be removed, therefore, the existing stretch marks in the upper part of the navel level will continue to exist after the surgery.
Summary
Tummy tuck surgery is one of the relatively difficult operations of aesthetic surgery, considering the earliest stages of recovery. Post-operative pain is an expected situation, but it should be noted that this pain will decrease over time with painkillers. Although it is one of the surgeries performed with a relatively large scar, this scar does not usually disturb the patients due to its location and nature. However, it should not be forgotten that the most effective way to correct abdominal deformities such as sagging and excess skin &fat which do not respond to many exercise and diet methods, is tummy tuck (abdominoplasty) surgery. You can browse the related articles in the References section. Best regards.
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