ABDOMINAL LIPECTOMY
(Belly
Tuck)
50 yo with Abdominal Hernia, Abdominal Wall Paunching and Lipodystrophy
(excess fat in the back and flank areas)
Treatment: Major Abdominoplasty (Bellytuck) and Liposuction of the Flanks and
Back.
40 yo with Abdominal Hernia and Lipodystrophy (excess fat) of the Abdomen.
Treatment: Mini Abdominoplasty (Belly Tuck) and Liposuction.
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EH a 35 yo woman following two pregnancies
desirous of a flatter belly and repair of abdominal hernia
The Belly Tuck is a wonderful Aesthetic Plastic Surgical Procedure designed to reverse and repair the unwanted abdominal features caused by pregnancy, obesity, weight loss and aging: Abdominal wall fat deposits (lipodystrophy), skin stretch marks (after pregnancy or weight loss), and weak abdominal muscles causing abdominal protrusion or paunch. These findings are repaired with an abdominal lipectomy.
The fat deposits in the abdomen, like elsewhere, are due to a combination of weight gain and the peculiar nature of target fat cells found in the abdomen. These fat cells selectively attract more fat calories than fat cells in other areas. Many patients especially men, have thin torsos and extremities, yet have quite prominent abdominal bulges. In women, especially after pregnancy or periods of non exercise due to illness or design, fat accumulates in the abdomen leading to an unsightly bulge in clothing.
Stretch marks and excess skin-Following pregnancy or weight loss this condition may prevent many women and men for that matter, from enjoying poolside and beach activities due to the need to expose themselves in revealing swim wear. Fortunately, these conditions of excess skin and wrinkles exist in anatomical areas of the abdomen where the majority may be removed with inconspicuous and hidden incisions and resultant scars.
Muscle Weakness Abdominal Paunch- Following pregnancy the paired midline abdominal musculature separates due to the growing child in the Mother's womb. Many times after delivery, these muscles remain separated. This conditions worsens with multiple births. The condition may also occur in men with much intra abdominal fat that separates the musculature just like a growing pregnancy.
The abdominal lipectomy addresses each of these findings and indications. The abdominal musculature is repaired by permanently rejoining the muscles in the midline. Excess fat is surgically removed or liposuctioned utilizing tumescent and/or ultrasonic techniques. The excess skin and stretch marks are removed by utilizing incisions that are usually hidden by underwear briefs, bathing suits, or sport attire.
ABDOMINAL LIPECTOMY -The procedure
Abdominal Lipectomy is now performed as an outpatient procedure. Although once considered a hospital procedure, with the technological advancements in anesthesia and the use of After-care Facilities, the procedure has become a safe and routine part of office plastic surgery.
The lipectomy may be performed alone or frequently with other plastic surgery as liposuction and body contouring procedures. The procedure takes 2-3 hours to perform.
Any patient over forty may be asked to see their internist for medical clearance. Special tests will be requested of all patients to insure that they are healthy and, there will be satisfactory healing. Smoking and aspirin ingestion is prohibited for two weeks before and two weeks after surgery. Aspirin will cause more bruising and bleeding, thus prolonging the recovery period. It has been found that smoking may lead to delayed healing and more noticeable scars. Occasionally, a hyperbaric oxygen treatment is recommended for smokers to prevent postoperative complications.
You will be given prescription for homeopathic and pharmaceutical preparations to prepare your system for surgery.
As you will be required to wear an abdominal binder for two weeks after surgery, this garment will be provided for you, prior to your surgery date. You will also be asked to wear special support stockings during your early recovery period to prevent any venous stasis (slow blood return) complication in the legs.
General Anesthesia is the anesthetic of choice for our patients undergoing abdominal lipectomy. This ensures that there is complete rest, safety, and no discomfort during the procedure. You will have an opportunity to discuss these options with Dr. Sokol and our Anesthesia staff.
You will enter the Nova Surgicenter through a private and discreet entrance. After routine charting is accomplished, you will meet with Dr. Sokol. He will review your photos with you and with a mirror explanation and your input, he will point out the areas on your abdomen (belly) that will be addressed surgically. He will then mark the areas to be operated with special indelible ink including the proposed abdominal scar. This scar will be designed low on your abdomen in a location that will usually be concealed by your underwear and bathing suit. If you have a special bathing garment or article of underclothing to be considered for camouflage of the scar, you are requested to bring it in for consideration during these markings.
The anesthesiologist will then prepare you for surgery with all the special monitors, medicines and equipment to ensure the procedure is not only safe for you, but comfortable as well.
Following surgery you will be moved into our recovery area. A trained nurse is present at all times to ensure that your vital signs are stable. In addition you are placed on a specially designed bed with continuously circulating warm air to prevent a chill and increase your sense of well being. Constant attention is given to your operative area to make certain there are no complications. If there is any question, Dr. Sokol is just steps away and will check your wounds. When you wake, you will find that you are in a flexed or semi-sitting position in bed. The maintenance of this position for the next several days is extremely important as it reduces any tension on your abdominal wound. You will also find that a urinary catheter has been placed in your bladder during surgery. This device assists the staff in assessing your fluid needs. In addition, postoperatively, it allows the patient more comfort without the need for trips to the bathroom. Finally small thin plastic tubes, called drains, are used to insure against any fluid accumulation in your operative area.
After a period, not less than two hours, you will be released by the anesthesia staff and transferred out of the recovery room to your aftercare facility.
After Care Facilities - Many patients elect to use an aftercare facility in a nearby hotel. These are fully staffed with 24 hour expert nursing care. All patients using these facilities have had cosmetic surgical procedures. Thus the nurses are experienced with the needs of this surgery and highly attuned to your privacy and comfort. Meals and transportation to your postoperative visits are provided.
In addition these facilities have specially designed, motorized beds that will allow the flexed position required by your surgery. This will ensure safer healing, less pain, and a better scar. This position is maintained for the first 2 to 3 days. Thereafter, you may find it more comfortable to occasionally lie on your side in a curled (fetal) position. The nurses will assist and instruct you in the technique required in leaving and entering your bed after the first day. The catheter, placed in your bladder during surgery, will be removed after the first or second day. The small, thin plastic tubes called surgical drains, will be removed when there is no significant drainage, generally by the fourth or fifth day.
You will be seen by our nursing staff the next day after surgery for a dressing changes and to inspect your operative area. The nurse will arrange for your next visit generally on the 4th or 5th day.
Many patients experience little or no pain following surgery. Special medicines are utilized during the procedure to prevent postoperative pain. Everyone is different, however, and you may feel some discomfiture. You will be provided with a prescription for pain pills that will assist you during the first 48 hours. This is the period that some patients experience pain. You will be permitted to shower after the drains are removed, generally by day 4 or 5. The supportive abdominal garment is cleaned or replaced with a fresh one and worn night and day for the first seven days and daytime only thereafter for an additional 7-10 days. Most bruising and swelling will be gone by day seven. You may be requested to see a physical therapist for ultrasound and massage. This treatment given 2-3 times per week speeds the healing by reducing the swelling and bruising more quickly. Numbness in the abdomen and upper thighs is normal for the first 6 weeks to 6 months. The return of sensation may be associated with an occasional nerve paresthesias characterized by minor electric shocks or crawling sensations. These are good signs, signaling an early return of sensation..
It is recommended that for the first 2-3 days that you sleep on your back with the head and knees elevated so as to maintain a semi-sitting position. In walking, you are to keep your knees bent and body flexed on your hips looking downward. After 5-7 days your body will allow you to walk more and more upright as your abdominal skin relaxes. As mentioned, this flexed position will reduce your pain by keeping tension away from your abdomen and ultimately lead to a better scar. The compressive stockings may be removed by day 5 or 6 when activity resumes
Complications are rare in abdominal lipectomy (belly tuck). Some of the more well known are bleeding, infection or hematoma requiring drainage. After the drains are removed from your abdomen, it is not unusual to have some fluid (seroma) reaccumulate. Most of the time this fluid is reabsorbed by the body, occasionally it may require drainage during one of the postoperative visits.
Other complications are called irregularity of healing. These are more severe and consist skin loss, scar deformities including keloids and permanent numbness. These complications may require further operative and or non operative treatment. Dr. Sokol's patients have rarely experienced these complications although some scar revisions have been necessary. These complications may lead to permanent unfavorable results. In general, however, these long term or permanent complications are quite rare.
A more youthful, flatter abdomen is the goal of the abdominal lipectomy. The nicest compliment you can be paid is that you look thinner. The other goal is, of course, that without the excess abdominal skin, stretch marks and paunch, you may wear more revealing clothes, especially bathing attire. The low abdominal scar may be covered by today's underwear and swimwear. Occasionally with a large abdomen it can not be totally covered. Even in this infrequent situation, it has been generally accepted as a welcomed trade off by our patients for the correction of these unsightly abdominal features.
