What Is Abdominoplasty

What Is Abdominoplasty.This cosmetic surgery, some¬ 
times called a "tummy tuck," reshapes and slims 
the area of the body between the chest and the 
pelvis to give the patient a trimmer body. This sur¬ 
gery may be done by removing a fat deposit that 
does not respond to diet; or by cutting away excess 
skin left after extreme weight loss; or by reducing 
sagging due to pregnancy or natural age-related 
loss of skin elasticity; or by tightening muscles 
stretched by multiple pregnancies; or by repairing 
a pregnancy-related separation of muscle from the 
abdominal wall. 

Procedure 

The common types of abdominoplasty are traditional 
abdominoplasty (also known as complete abdomi¬ 
noplasty or full abdominoplasty), fleur-de-lis (lys) 
abdominoplasty, endoscopically assisted abdominoplasty, 
high-lateral-tension abdominoplasty, partial abdomino¬ 
plasty (miniabdominoplasty or mini-tummy tuck), 
and dermolipectomy. Another procedure, circumfer¬ 
ential abdominoplasty (midbody lift), is used in cases 
where extreme weight loss has left excess skin 
around the entire midsection of the body. 

All forms of abdominoplasty are considered 
major surgery, most often performed under gen¬ 
eral anesthesic and usually in a hospital setting. 
Some patients may be released within hours after 
a partial abdominoplasty, but most abdominoplasty 
patients spend a day or two in the hospital.
Traditional abdominoplasty is surgery to remove a 
large amount of excess skin and fat. The surgeon 


makes one long incision from hip to hip, just above 
the pubic bone, then lifts the skin up and away 
from the underlying tissues. She next removes 
excess fatty tissue; repairs the rectus abdominus 
muscle separation and sutures it into a tighter posi¬ 
tion, bringing the edges of the incision together and 
removing excess skin to make a smooth closure. If 
necessary, she repositions the navel and closes the 
incision with sutures or surgical staples. The pro¬ 
cedure for a partial abdominoplasty is similar to that 
for a traditional abdominoplasty, but the incision is 
shorter; less skin and fatty tissue are removed; and 
the navel is not likely to be repositioned. 

Fleur-de-lis abdominoplasty is also surgery to 
remove large amounts of excess skin and fat. The 
procedure is named for the shape of the two-part, 
T-shape vertical and horizontal incision in the cen¬ 
ter of the abdomen, which resembles the flower of 
Lyons (fleur-de-lis [lys] in French), a heraldic device 
used by French kings. As with a full abdomino¬ 
plasty, the surgeon lifts the skin; removes excess 
fat; tightens the muscle; brings the edges of the 
incision together; repositions the navel (if neces¬ 
sary); and closes the incision. 

Endoscopically assisted abdominoplasty is a proce¬ 
dure used to tighten the abdominal muscles with¬ 
out removing much skin or fat. The surgeon makes 
several small incisions across the abdomen; inserts 
an endoscope (see endoscopy) (a flexible tube with 
a light that enables the surgeon to see under the 
skin) through one incision and a second instru¬ 
ment to lift the skin away from the muscle through 
another incision; stitches and tightens the muscle; 
and closes the incisions.
Miniabdominoplasty is a procedure most often 
used when the abdominal fat is found only in 
the area under the navel. The surgeon makes a 
short incision just above the pubic region, lifts the 
abdominal skin up toward the belly button, trims 
away excess skin, tightens muscles if required, and 
sutures the skin in place under the navel. Dermoli- 
pectomy is similar to miniabdominoplasty, except 
that it may remove more skin but does not involve 
tightening the abdominal muscles; the procedure 
is used for patients whose abdominal skin is looser 
than those for whom the miniabdominoplasty is 
sufficient. 

Circumferential abdominoplasty removes excess 
skin from the stomach, thighs, and buttocks in a 
single procedure. The surgeon makes an incision 
across the abdomen in the area of the navel, frees 
and lifts the skin toward the middle of the abdo¬ 
men, cuts away excess tissue, repositions the navel 
if necessary, and closes the incision. She next turns 
the patient over on the operating table, makes 
an incision across the lower back at a point cor¬ 
responding to the incision on the abdomen, and 
repeats the procedure. Note: Several months after 
this surgery, the patient may undergo additional 
procedures to trim excess skin from under the 
upper arms, breast area, thigh, neck, and face. 

Note: Before closing the incision(s) after abdom¬ 
inoplasty, the surgeon may insert a drain to allow 
blood and other liquids to flow out of the wound 
rather than pool under the skin. 

Risks and Complications 

Common side effects include pain, tenderness, loss 
of sensation at the site of the incision, and/or swell¬ 
ing of the abdomen, the labia (women), and the 
scrotum (men) for up to six weeks after surgery. 

Possible complications include continued bleed¬ 
ing that may cause a hematoma (pooling of clotted 
blood under the skin) that may become infected, 
or a seroma (pool of fluid under the skin that may 
require surgical drainage), or blood loss severe 
enough to require a transfusion. As the wound 
heals, the stitches may fail to dissolve properly. 


The navel may be off-center or otherwise oddly 
positioned due to contraction of the various scars, 
and the blood supply to the newly positioned 
navel or to the abdominal wall may fail to develop 
properly (more commonly in people with vascular 
problems), leading to tissue death requiring a skin 
graft. The death of fat cells/fatty tissue under the 
skin may cause infection requiring further surgery. 
The incision may separate, creating a thicker-than- 
normal scar requiring surgery to reduce it. As with 
all major surgery, there is a risk of life-threatening 
blood clots in legs and lungs, as well as a reaction 
to the anesthetic. Because circumferential abdomi¬ 
noplasty is a more complex procedure than other 
forms of abdominoplasty, it carries a higher risk of 
possible complications. 

Outlook and Lifestyle Modifications 
This surgery is most effective for healthy adults. It 
is not a substitute for proper diet and exercise to 
achieve weight reduction. It is not recommended 
for people who are extremely obese or for those 
who plan to lose more weight or for women 
who plan to become pregnant again, because the 
abdominal muscles may separate from the abdomi¬ 
nal wall during future pregnancies.

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