Abdominoplasty
Abdominoplasty Overview
Abdominoplasty is one of our favorite procedures for significantly reshaping your body. We have refined this procedure over the past 25 years and have hundreds of satisfied patients. It’s the ideal procedure for simultaneously tightening the skin, repairing the abdominal wall, and removing excess fat from the lower abdomen.
Best Candidates
Cosmetic abdominoplasty is best suited for those patients who are otherwise healthy, at a stable weight, and are not significantly overweight. Proper diet and exercise after surgery will only improve your result.
The No-Drain Technique
For many years we routinely placed drains following abdominoplasty. However, several years ago we changed our technique, placing progressive tension sutures internally to both better shape the tissues, avoid tension at the incision, and make drain placement unnecessary. The benefits to our patients have been dramatic. Many people who have undergone abdominoplasty in the past said that having a drain was one of the most bothersome aspect of their recovery. We now find we are able to do all types of abdominoplasties (described below) without drains.
Types of Treatments
Abdominoplasty is not just a single operation. Each patient needs to be individually evaluated to determine which type of abdominoplasty would best suit their needs. The quality of the skin, the strength of the abdominal wall, the amount of excess fat, and any underlying abnormalities (hernias, previous surgical scars, etc.) all need to be considered in choosing how the abdominoplasty will be performed.
Limited abdominoplasty
This involves a shorter scar and less extensive skin and fat removal than a traditional abdominoplasty. Through this shorter scar we are still able to tighten the abdominal muscles and remove a modest amount of excess skin and fat, but it is not an operation well suited to those with excessive or poor quality skin.
Full abdominoplasty
This “typical” abdominoplasty allows tightening and repair of the abdominal wall, removal of a significant amount of excess skin, removal of lower abdominal fat, and resetting and contouring of the umbilicus (belly button). The trade-off for this longer scar is better overall contouring of the abdomen than can be achieved through a short scar technique.
Extended abdominoplasty
When patients have a significant amount of excess skin, such as after significant weight loss, we may recommend an extended abdominoplasty. This longer incision typically extends all the way across the abdomen onto the side of the body, allowing more excess skin to be removed.
Circumferential abdominoplasty
When there is significant skin excess that extends all the way around the waist, we may suggest a circumferential procedure. This more extensive procedure leaves a scar that is long (most or all the way around the body), but can result in a dramatic improvement in patients with significant skin excess, especially after massive weight loss.
Panniculectomy
Panniculectomy is anatomically a more limited procedure. During a panniculectomy, we remove the excess skin and fat from the region between the umbilicus and the pubic bone (lower abdomen). The umbilicus is not repositioned and the muscles are not routinely tightened. This is typically a functional operation designed for those who are experiencing significant problems resulting from overhanging skin and fat (pannus) resulting in recurrent skin breakdown and infections. Although improvement in appearance is usually seen, the goal is really a functional one, not cosmetic. Insurance may sometimes cover this procedure, especially after significant weight loss.
Patients who require a panniculectomy for functional reasons but desire a better cosmetic result may be advised to undergo a full or extended abdominoplasty.
Combination Procedures
Abdominoplasty can often be combined with other procedures, both cosmetic and reconstructive. For many patients, this is a very good option, as it enables them to address more than one problem in a single trip to the operating room, and recover from both their abdominoplasty and their other operation at the same time. Some common operations we have performed with abdominoplasty include:
- Breast surgery (augmentation, reduction, breast lift)- The “Mommy Makeover”
- Liposuction
- Hysterectomy (working with your gynecologist)
- Hernia repair
- Bladder suspension (working with your urologist)
- Facial cosmetic procedures (blepharoplasty, etc.)
We are comfortable working with your gynecologist, urologist, general surgeon, or others to carry out other procedures at the time of your abdominoplasty. In some cases, we may suggest you NOT combine other procedures with your abdominoplasty, especially if it will significantly increase your time in the operating room or increase your chances of complications. Doing the operation well and safely is always our first concern.
Abdominoplasty Corrections
We have seen a number of patients over the years who have undergone abdominoplasty elsewhere with results that leave them dissatisfied. We welcome the challenge of correcting these kinds of problems. While some corrections can be fairly straightforward (a minor scar revision), others can be more complex and may involve essentially redoing the abdominoplasty procedure. We would be glad to meet with you to discuss how the results of your previous abdominoplasty can be improved.
The Surgery
We perform abdominoplasty surgery at either the Lawrence Surgery Center or Lawrence Memorial Hospital. Both are fully accredited and well equipped for your surgery and care afterward. The operation will be performed under a general anesthetic and generally takes around 2-4 hours depending on the extent of the procedure performed. Patients may be kept overnight for monitoring after more extensive abdominoplasty procedures under the care of nursing staff and discharged on the following morning. Patients undergoing less extensive procedures may go home on the same day.
Recovery
The rate at which you recover is highly individual, depending on the extent of the procedure performed and your own rate of healing. Patients usually require strong pain medications for the first few days, then can progress to less sedating drugs. If your job requires a fair amount of physical activity, we suggest you plan on being off work for about 10-14 days. Of course, some patients may return faster but this can be hard to predict. We usually have our patients wear an abdominal binder or other supporting garments during their recovery to help support the repair of the abdominal wall.
Financing & Payment Options
If you have significant problems related to overhanging skin and fat, particularly after massive weight loss, your medical insurance may cover part or all of your procedure. Coverage is sometimes available for panniculectomy or abdominoplasty if you have a history of multiple episodes of skin breakdown, infections, rashes, etc., related to this excess tissue. If we feel insurance coverage is a possibility we can submit a letter to your insurance company prior to the procedure to determine if your procedure will be covered.
Patient Forms
Please fill out paperwork at least 24 hours before your scheduled appointment.
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