Dr. B Venkata Ratnam, MBBS,MS(Ortho),M Ch(Plastic Surgery),FAPS(Germany), ISAPS, Plastic Surgeon.
Abdominoplasty means making the abdomen “flat”. However, a truly “flat” abdomen is unnatural. Hence, in practice, it implies that this operation is meant for correcting abdominal contour deformities and making the abdomen look more youthful, with its natural curves and other attractive features.
The most common cause of abdominal contour deformity is pregnancy. During pregnancy, the abdominal wall stretches and it will not retract completely after delivery. Another common cause is extreme weight fluctuations. And rarely, the cause is unknown.
There are two vertically oriented muscles in the front part of the abdomen, attached to the rib cage above and bony pelvis below. They lie within their-own sheaths and these sheaths, in turn, are connected in the midline by a fibrous sheet called “linea alba”. During pregnancy or massive weight-gain, this sheet (linea alba) gets stretched. As it is not a muscle, any amount of muscle-strengthening exercise will not be able to make it tight again. Accordingly, the key-step in the abdominoplasty operation is plication of this linea alba to tighten the tummy. Other aspects of surgery include repositioning or recreation of the umbilicus (belly-button), liposuction of the sides, and removing the redundant skin.
It can be done at any time but it is advisable to wait till the pregnancies are completed. It is also advisable to wait for at least 6 months’ period, after delivery.
It is important to understand the roles of liposuction and abdominoplasty in abdominal contouring. If there is a considerable amount of fat in the abdominal wall, abdominal wall bulging is minimal, the patient prefers a smaller procedure and is willing to accept only a moderate correction; liposuction is the preferred choice. And, amongst the liposuction techniques, ultrasound assisted liposculpturing (UAL) is the best. On the other hand, if there is less fat, more of abdominal laxity and hanging skin and the patient wants maximum result after the surgery; abdominoplasty is the procedure of choice. For individuals who require both of these procedures, it is safer to perform liposuction first, followed four to six months later by abdominoplasty. However, a limited contouring by liposuction of some parts of the body, such as hips, is safe and nowadays, is usually combined with abdominoplasty, in a procedure called “Lipoabdominoplasty”.
Important considerations in abdominoplasty include:
A hospital stay of 3-4 days, on average.
It usually requires a month’s period to resume regular physical activities.
It leaves a long, curved or wavy-scar in the area covered by “bikini”.
Stretch-marks on the abdomen can improve, but not disappear.
Pregnancy is possible after abdominoplasty.
Benefits of abdominoplasty can be retained during subsequent pregnancy.
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