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GENERAL INFORMATION
When women have had children, the lining of the abdominal muscles, the
so-called fascia, can rip and the abdomen can develop a bulge. This is
a type of hernia, and other types of hernia may develop as well. The patient
can often feel a layer of fat on the lower abdomen. The layer below that
is called the fascia. Liposuction alone removes excess fat, but cannot
tighten the fascia or remove hanging skin; for that, an abdominoplasty
is necessary. There are several types of abdominoplasty, ranging from
a minor removal of hanging skin (a mini-tuck) to a major abdominoplasty
where a new umbilicus is made and the entire abdomen is tightened.
Abdominoplasty is an operation performed to remove excess fatty tissue
and skin folds in the mid and lower abdominal region and to tighten up
the abdominal wall. Diet and exercise alone cannot provide correction,
since this condition is often accompanied by separation and stretching
of the abdominal muscles and weakening of the abdominal wall.
Abdominoplasty is not directed toward weight reduction. It is designed
to remove only as much excess skin and fatty tissue as is practical and
safe. Stretch marks, where possible, will be removed along with the excess
skin. However, stretch marks on the remaining abdominal skin cannot be
removed.
Photographs are as important to the plastic surgeon in the proper care
of his patients as X-rays are to the physicians in other medical specialties.
Therefore, photographs are taken before and after the surgery and become
a permanent part of the patient's confidential medical record.
Abdominoplasty is considered major surgery and usually is performed in
our outpatient surgical facility.
THE ANESTHESIA
Abdominoplasty surgery is performed under a "light" general anesthetic
(patient is asleep). This technique provides excellent operating conditions
while affording maximal patient comfort and safety.
The anesthetic is administered by a Board certified anesthesiologist (M.D.)
who remains in attendance throughout the operation. All of the required
monitoring, anesthesia delivery and emergency equipment are present at
all times.
Further information, including any questions you may have, will be explained
and discussed fully by our anesthesiologist prior to your surgery.
PRE-OPERATIVE PREPARATIONS
You must be in good health to undergo any elective cosmetic surgery.
A physical examination and routine lab work will need to be performed
by your own primary physician. If you do not have a primary doctor, we
can refer you to local doctors in our area. We do not provide these services.
It will be required that all this pre-op paperwork be in our office
1-2 weeks prior to surgery.
It is very important that our office is aware of any medical conditions
and all medications you are taking.
It is imperative that you not smoke 2 weeks prior to surgery, and 2 weeks
after surgery. This would impede your healing greatly. Talk to us about
options.
It is a required that someone drive you home upon your discharge. Also
arrange for transportation to and from our office for your post-operative
appointments until your doctor gives you permission to drive.
DO NOT take aspirin or aspirin-containing products for
2 weeks prior to surgery and for 2 weeks after surgery.
An adequate diet with vitamin supplements, especially Vitamin C, is recommended.
You should be in the best nutritional state possible prior to surgery.
If you will be preparing your own meals at home after surgery, have on
hand easy to prepare foods.
THE SURGICAL PROCEDURE
The procedure takes approximately 3 hours to complete. There are usually
two incisions associated with this type of surgery. One incision extends
along the lower abdomen just above the pubic hairline. The other is a
circular incision around the navel, as the operation frequently requires
repositioning the navel to a higher, more natural level. The abdominal
skin and fatty tissue are raised away from the underlying abdominal structures.
When necessary, repair of the abdominal wall and muscles is done at this
time. The tissue is then stretched in a downward direction and the excess
is removed.
Small rubber drains may be inserted in the wound to remove
blood and serum that may accumulate. The incision is closed either with
suture material, special tapes or metal clips. A large pressure dressing
is applied followed by a supportive abdominal binder. An I.V. is routinely
placed in the hand or arm prior to surgery for fluid maintenance and remains
in place usually until the next morning. A urinary catheter may be inserted
at the time of surgery and will be removed usually immediately after surgery,
sometimes in 24 hours if staying in aftercare.
POSSIBLE COMPLICATIONS
Complications are rare but when they do occur, they usually respond promptly
to proper treatment without unfavorably affecting the final result.
Bleeding: If bleeding occurs after the operation, it may accumulate
in the operative area and require opening the wound to remove the blood
and prevent further bleeding.
Infection: This occurs rarely and usually responds to
antibiotics.
Tissue loss: This is very rare. Should this happen,
a reconstructive operation can be performed with satisfactory results
at a later date.
Keloids/Hypertrophic scars: For those prone to keloids, (overgrowth
of scar tissue at the incision site) steroid injections can be administered
to breakdown and flatten scar.
WHAT TO EXPECT AFTER SURGERY
Activity: Post-operatively the patient is encouraged
to ambulate soon after surgery, with frequent periods of resting.
Pain: There is a minimal to moderate amount of pain associated
with this type of surgery. Medication is available to control any discomfort
experienced while in an after-care facility or at home. Coughing, laughing,
sneezing or other anything that exerts the abdominal muscles will produce
discomfort post-operatively. Splinting (using counter
pressure with a pillow) is best to reduce discomfort. A feeling of tightness
in the lower abdominal area will be experienced after surgery, necessitating
a somewhat stooped posture. This is temporary and usually lasts 7-10 days.
Dressings: A large abdominal binder or garment will be applied
immediately after surgery. Sometimes drains are placed in the lower pubic
area, and are removed 5-10 days after surgery. This binder
should be used for two weeks after surgery, and then a department store
girdle may be purchased and worn for an additional several weeks. We've
had patients get fitted at Ms. Stevens Lingerie here in Beverly Hills
(corner of Olympic Blvd and Maple) (310) 278-7987
Scars: The scars left by this procedure are generally
predictable and although they fade with time, they are permanent. Occasionally,
a scar revision procedure is necessary to attain the best cosmetic result.
These procedures are minor and can be carried out in the office under
local anesthesia. A pouching of the tissue immediately above the incision
line may be apparent after surgery. This is usually temporary and gradually
smoothes out over a period of months. There are several options for scars
i.e.: topical gels, laser treatments, steroid injections. All of which
are offered when appropriate for the patients. We will discuss these options
with you.
It is not unusual for a patient to experience a period of the "blues"
during the convalescence. This is temporary. It's helpful to remember
that it is impossible to judge the final result of your surgery until
all of the swelling has subsided and the operative area has smoothed out.
POST-OPERATIVE CARE
Avoid lying on your abdomen for 2 weeks. Optimal sleep position is elevated
on your back with 2 pillows. A pillow under each arm, and a pillow under
your knees to keep your abdomen flexed.
If applicable, empty drains twice a day, morning and night. Call the office
if experiencing excessive drainage.
On your third post op day you may remove your dressing, discard any sponge
padding (leave steri-strips alone) and sponge bathe only until drained
have been removed. Once drains have been removed, a quick shower is ok.
It is normal to experience oozing from the drainage site after the drain
has been removed.
Take your temperature occasionally and call the office for any fever over
100 degrees.
RESUMPTION OF PHYSICAL ACTIVITIES
GENERAL RULES OF THUMB
TWO, FOUR, SIX RULE
FIRST WEEK: TAKE IT EASY!!! PATIENTS WHO ARE TOO VIGOROUS
FREQUENTLY DEVELOP COMPLICATIONS!
At two weeks: take long walks on a flat surface. No other
kind of workouts. Any activity that would raise your blood pressure would
compromise the healing incisions and newly developing blood supply.
At four weeks: light exercise such as aerobics, but no
weight training. Start light. For example, if you normally do 30 minutes
on a treadmill, begin with 15 minutes, then increase as your body gets
used to things.
At six weeks: resume all previous activities with clearance
from Dr. Moelleken. Avoid sun exposure to incision site for months following
surgery, as this may result in a hyperpigmented scar. |
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Abdominoplasty with flank extension, liposculpture of abs, flanks, thighs.
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Abdominoplasty with flank extension, liposculpture of abs, flanks, thighs.
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Full abdominoplasty with liposculpture
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Full abdominoplasty with liposculpture
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Full abodminoapslty with liposculpture to flanks, abs, waist
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Full abodminoapslty with liposculpture to flanks, abs, waist
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Massive weight loss, full abdominoplasty with -flank extention, thighlift, liposculpture
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Massive weight loss, full abdominoplasty with -flank extention, thighlift, liposculpture
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Abdominoplasty and Bilateral Flank Panniculectomy.
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Abdominoplasty and Bilateral Flank Panniculectomy.
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Hybrid abdominoplasty - liposculpture to abs, flanks
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Hybrid abdominoplasty - liposculpture to abs, flanks
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