Tummy Tuck

Tummy tuck is represented the 5th most frequent procedure in plastic surgery worldwide in the year 2009, also known as dermolipectomy. It is a complex surgical technique of reconstruction of the abdominal wall, which regardless of sex manages to reshape the abdomen, waist and shape of the patient’s trunk, undoubtedly improving the body contour, with radical change and evident from the immediate postoperative also frequently combined with liposuction. This result is impossible to achieve by other means.
Those patients who should lose a lot of weight should postpone surgery, as well as patients who intend to have future pregnancies, and in relation to the latter if it happens, it can arrive perfectly without any problem at term.
In those patients who, after a massive loss of weight, and where, in addition to the abdomen, the skin of the back also hangs in several folds, it is perfectly possible at the time of the abdominoplasty to extend the incisions towards the posterior region to perform a torsoplasty, which recovers the loss forms in the trunk, firmness and the correct location of the tissues of the back and buttocks are returned, generating a circular or a belt scar.

Are you a good candidate?
The best candidates for this surgery are those who are in good physical condition, with realistic expectations, regardless of sex, have flabby skin with accumulations of fat in the abdomen and laxity of muscles at that level, either after the significant loss of weight or in the exclusive case of the women as a result of the pregnancies.

Anesthesia and Surgical Times
It has an average time of approximately 2 hours and is usually performed with regional anesthesia (epidural block) plus sedation for the patient’s tranquility and relaxation.

Incisions and scars
Whatever the technique the scar is practically invisible passing unnoticed, since it is perfectly covered with the underwear or the swimsuit. Usually is horizontal and very low at level of the pubic area, extending to each side of the hip where it was previously marked prior to surgery, and whose length is directly proportional to the degree of abdominal flaccidity of the patient. Proceeded with the resection of excess dermograso tissue and strengthening of the abdominal wall by joining and tightening the muscles at the level of the midline. The navel is formed again giving the final result a completely natural appearance.
In some cases, the so-called “minibdominoplasty” is performed where through an incision that only covers the area of the pubis proceed to perform above until the lower hemiabdomen level, without the need to reconstruct the navel, being indicated only in selected cases.
It is important that the patient knows that in all cases of abdominoplasty, a drainage is left through a punctate wound at the level of the pubis, which leaves minimal scarring.

Time of hospitalization
The patient is usually kept for 24 hours in the hospital, as this allows greater vigilance in the immediate postoperative period, besides being able to carry out better management of the pain, which is controlled by an external infusion pump connected directly to the epidural catheter placed on his spine before the surgery, and through which special drugs are administered continuously that will give the patient during the first hours a greater comfort. To be removed the next day before leaving the hospital.

Postoperative Care
The person during the first days should plan to rest and while lying down should do so a semi-posed position with the legs bent (to avoid tightening the skin of the abdomen too much), take the prescribed medication as directed, eat normally according to the tolerance of and drink plenty of fluids. Also recommended to start walking as soon as possible.
Daily wound care should be performed on operative wounds, to maintain proper dressing and drainage care, and to avoid doing any type of force or exercise for at least the first few weeks.

Recovery and time
This period implies that the patient must maintain a bandage that will keep his abdomen covered, being removed between the 4th and 5th day after surgery along with the drainage, from which time he will have to use a special medical belt 24 hours a day during 8 weeks, and because of the potential for inflammation of this procedure the patient is subjected to ultrasound therapy or post-operative lymphatic drainage. Absorbable sutures are generally used for these procedures, thus avoiding the patient’s discomfort to remove them, except at the navel level, which are removed on average of 8 days, and can be said to be about 10 days time recovery period, returning the patient to his daily activities one or two weeks after the procedure, provided that he is not exposed to physical exertion.

Risks
Although it is very rare that they occur, any surgical procedure, however small, involves risks and we must think of them as a possibility for how unpredictable these can be, and within complications may include hematoma formation, infection, collection of fluid (seromas), changes in sensitivity, alterations in healing, and even necrosis of tissues (especially in smokers).

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