General
The abdominal wall can slacken due to various reasons and hence influence your bodily feeling. Next to pregnancies considerable weightloss are frequently the cause for the slackening. Abdominoplasty alone oftentimes is not enough so that a bodylift needs to follow to ensure an optimized result of the surgery. The skins’ flabbiness can occur from the hip to the back and even the outward side of the thighs as well as the inside can be affected. During the consultation I will determine together with the patient how the scar should run on the abdominal area - the pathway is variable and subject to the patients’ preference and request. A corresponding exact drawing will be performed before the surgery. Smokers should refrain from smoking 4 weeks before surgery or significantly reduce it to minimize the risk of disturbed wound healing. A liposuction on existing fatty tissue in the hip area will be carried out during the same surgery.
Technique
The incision will be prepared originating a fatty skin tissue up to the bow of the rib whereby the belly button will be left out. The skin tissue will be pulled down and the excess part removed. The finer points depend on the surgeons’ skills: The shaping and the sewing in of the navel - the moulding of the so called „Champagnerrinne“ or the layout of an exact cosmetic stitch. Generally abdominoplasty takes about 2-3 hours. To be on the safe side 3 drainages will be drawn on large wound areas.
Aftertreatment
The patient will have to lie in bed upright to prevent tension on the abdominal wall and ensure an undisturbed wound healing. On the 2. or 3. day the drainages can be removed. Right after the operation the patient will be given an abdominal binder which he ought to wear consistently for the next 2 months. From the 2. day on the patient can be released home. An Antibiotic should be taken in for 5 days after the surgery just to be on the safe side. At the same time a prophylactic against thrombosis in form of one-way-injections is needed once aday. The patient can do this by himself once demonstrated by the medic or by the nurse. Todays suturing material does not require removal as the threads dissolve by themselves. A special scar treatment is not necessary initially - the first weeks only Bepanthen ointment should be applied. When intense redding and/or bulging occurs I recommend the application of a special silicon-foil. Intense physical strain is to be avoided for a period of 6-8 weeks particularly if the additional abdominal wall musculature has been tightened. The outcome of the surgery is evident after 3-6 months later when all swelling has settled. The maturation of the scar can take up to a year which is perfectly normal. A medical check-up is planned after 2 and 3 weeks, and 3 and 6 months after the surgery. The patient should avoid insolation for 3-4 months to avoid a pigment irritation. This operation mostly leads to an enhanced silhouette, and this new body and self-confidence compensates for the exertions of the procedure.
