WHAT IS ABDOMINOPLASTY?
Abdominoplasty is a surgical procedure to remove fat and excess skin from the abdomen and to reposition the muscles of the abdominal wall. Because of pregnancies or strong weight fluctuations, the rectus abdominis muscles may tend to move apart, giving a rounder appearance to the abdomen. In these situations, the skin may also lose elasticity, acquire stretch marks, become more flaccid and form folds, all of which an abdominoplasty can improve. Abdominoplasty can be combined with liposuction, in what is called a Lipoabdominoplasty.
FOR WHOM IS AN
Candidates for abdominoplasty must be emotionally mature, and must be sure of their own motivations for performing the surgery. Realistic expectations are important and patients must understand that the procedure brings improvements, but not perfection. Obviously, a person with greater adiposity or with more stretch marks, cannot expect the same results as a thin person with a firmer skin. Ideal candidates for abdominoplasty usually have the following characteristics:
- Stable weight;
- Overall healthy;
- Dissatisfied with the appearance of the abdomen (“apron belly”, flaccidity, localized fat,bulging abdomen);
- Realistic expectations;
- Not considering having more children.
BEFORE AND AFTER CASES OF Abdominoplasty
ABDOMINOPLASTY AND MINI ABDOMINOPLASTY
– THE DIFFERENCES
Both abdominoplasty and mini abdominoplasty aim to remove fat and excess skin from the abdomen to achieve a firmer and more toned appearance. The main differences between the two procedures are:
It is indicated for patients with moderate flaccidity; it repositions the rectus abdominis and removes excess skin at the bottom of the abdomen (below the navel).
It is indicated for patients with more accentuated flaccidity; it repositions the rectus abdominis and removes excess skin, both on the upper and lower abdomen (above and below the navel).
YOUR ABDOMINOPLASTY MEDICAL APPOINTMENT
The first step in your abdominoplasty medical appointment is a careful assessment of the abdomen, health status and lifestyle. This will allow us to draw a fully customized treatment plan for you.
Simulation with Vectra 3D
Vectra 3D XT simulates the outcome of surgeries such as liposuction, abdominoplasty, breast augmentation, mastopexy, reduction mammoplasty, etc.
During the abdominoplasty medical appointment, a personalized treatment plan will be presented and you will be informed on the risks of the procedure, pre- and postoperative care, and the results you can expect.
After the medical appointment, you will be presented with an exact abdominoplasty price. This will depend on whether it is combined with liposuction and/or other procedures.
One of the issues that concerns patients the most is how scars will look. The abdominoplasty scars are around the navel and on the lower part of the belly (below the underwear line). The size of the scar depends on the amount of skin to be removed. It is similar to a c-section, but larger.
TYPE OF ANESTHESIA
Abdominoplasty is usually performed with epidural and sedation. However, the type of anesthesia to be used is defined by the anesthesiologist according to the combination of procedures to be performed and the patient’s medical history. Sedation is administered intravenously so that the patient falls asleep and is aware of nothng. When the patient is already asleep, local anesthetics are administered so that no pain is felt during the whole procedure. The anesthesiologist will be present throughout the surgery for greater patient comfort and safety.
WHAT RESULTS CAN I EXPECT AFTER AN ABDOMINOPLASTY?
Flatter and firmer abdomen
With an abdominoplasty, you will achieve a flatter abdomen with a more toned appearance. You can also get rid of some stretch marks on the lower abdomen.
Better body contouring
Abdominoplasty is often combined with other procedures such as liposuction, buttock augmentation and breast surgery, altogether providing a better body contour.
Abdominoplasty has a very positive impact, namely on quality of life, self-esteem and the way you relate to your body.
MARKING PATIENTS WHILE STANDING
The markings on the abdomen are made with the patient standing so that the areas to be treated can be correctly visualized.
Sedation is administered intravenously by the anesthesiologist who will be present throughout the surgery.
The local anesthetic or epidural is injected with the patient already asleep.
DISINFECTION AND DELIMITATION OF OPERATING FIELDS
The area to be treated is cleaned and disinfected to reduce the risk of infection. Operative fields are placed to isolate this area from the external environment.
The incisions are made around the navel and in the lower abdomen, similarly to the cesarean section, although it is a larger scar. Once the skin is lifted, fat is removed by liposuction and then the rectus abdominis muscles are repaired.
ELIMINATING EXCESS SKIN
Excess skin (below and/or above the abdomen) is eliminated.
The incisions are closed using absorbable suture threads. The patient may then check the result and symmetry.
The glue is applied over the scars and seals the skin, isolating the scar from the external environment. It does not require dressings and falls off gradually after 15 days.
Before being transported to recovery, the patient is dressed with an abdominal binder that must be worn for 30 to 45 days. The patient is awakened by the anesthesiologist and is then transported to the recovery room where he/she will remain under medical observation for 24 to 48 hours before being discharged.
PREPARATION FOR ABDOMINOPLASTY
- Perform all preoperative exams requested by the medical team and send them as early as possible.
- Do not take aspirin or anti-inflammatory medication in the 10 days prior to the surgery, to reduce the hemorrhagic risk. You must inform the medical team of any medication you are on and any medical condition you suffer from;
- Do not smoke in the month before the surgery, neither thereafter. Smokers have a higher risk of complications, including difficulties in healing and tissue oxygenation.
- Carefully read all the documentation that was given to you, as some questions may arise before the day of the surgery.
- If you get sick or feel ill in any way in the days prior to the surgery, the medical team should immediately be informed.
- If you have young children, organize your routines in advance. You should be helped at home, especially during the first two weeks.
- Do you have questions about the surgery preparation or postoperative care? Do not wait for the day of surgery and ask all your questions beforehand.
- On the day before surgery, you should have light meals only, in order to avoid indigestion. On surgery day, you must be fasting since midnight - do not eat or drink any liquids including water.
- Shower with the prescribed antiseptic shower gel the day before and the day of surgery.
- Do not wear any accessories and do not wear make-up or nail varnish, as these can interfere with vital sign measurement.
- Bring comfortable/loose clothing to wear after being discharged.
- After discharge, you can neither drive nor go home unaccompanied. If you have no one to take you home and help you there for the first few days, you must inform us before the day of the surgery. You must be permanently accompanied for the first 48 hours.
- All social and professional activities must be programmed in order to guarantee complete tranquility in the days following the surgery.
Recovery and postoperative care
- The recovery period depends on the complexity/combination of procedures, but it also depends on the patient. In general it takes between 2 and 3 weeks.
- You may experience a tightness feeling in the abdomen, some discomfort, and moderate pain that can be relieved with the prescribed medication.
- Essentially rest during the first week and then gradually return to your routine. You should not lie down all the time - it is important to walk around to promote circulation and prevent the formation of blood clots.
- For 4 to 6 weeks you should not make any physical effort. Family help at home is therefore extremely important.
- Keep a balanced and healthy diet, and drink plenty of liquids to maintain a good hydration.
- Strictly follow all medical instructions regarding medication and/or other postoperative care, such as lymphatic drainage and the use of the compression garment.
BENEFITS OF ABDOMYOPLASTY
Abdominoplasty is amongst the most common surgeries performed worldwide by women who gave birth or by individuals who lost a lot of weight. The benefits of abdominoplasty go beyond the aesthetic issue as weakened abdominal muscles are often associated with lower back pain and posture problems. The outcome of an abdominoplasty is directly linked to an increased well-being and self-esteem, as the patients who undergo the procedure, feel more comfortable wearing less concealing clothes and performing activities with which they were not comfortable before. For many patients, abdominoplasty is the first step towards a healthier lifestyle.
Dr. Alice Varanda Pereira / Plastic Surgery
Member of The Portuguese Medical Association, Nr. 47051
Graduated by the Faculty of Medicine of the University of Lisbon, she completed her master’s degree in human sexuality and is currently developing her PhD at this same institution.
She joined the University faculty academic staff in 2008 as a lecturer of the Institute of Anatomy. It is in this unit that she produces most of her research projects, mainly in the area of surgical anatomy, whilst also supervising master’s thesis for undergraduate students.
Dr. Marta Gouveia Duarte / Plastic Surgery
Licenciada em Medicina pela Escola de Ciências da Saúde da Universidade do Minho, onde concluiu a sua tese de Mestrado em Envelhecimento Humano.
Concluiu a especialidade em Cirurgia Plástica Reconstrutiva e Estética, no Centro Hospitalar de Lisboa Central – Hospital de São José.
Colabora em vários projetos de investigação na NOVA Medical School.
Dr. Mariana da Rocha Martins / Plastic Surgery
Member of The Portuguese Medical Association – Nr. 55124
Graduated by the Abel Salazar Institute of Biomedical Sciences at the University of Porto and specialized in reconstructive and aesthetic plastic surgery at Hospital de São José, in Lisbon.
Throughout her specific training in plastic surgery, she worked in internationally renowned institutions such as Institut Kaplan (Barcelona), La Clinic (Montreux) and Great Ormond Street Hospital (London).
IS ABDOMINOPLASTY A SAFE SURGERY?
Yes. Abdominoplasty is safe as long as it is performed in an accredited clinic and by a plastic surgeon with experience in this type of procedure. It is equally important to perform the prescribed preoperative exams and strictly comply with pre and postoperative care.
HOW MUCH DOES AN ABDOMINOPLASTY COST IN LISBON?
The price of an abdominoplasty is different for every patient as it depends on the initial state of the body, whether or not liposuction is required, and the extent of this liposuction (small, medium or large, depending on the amount of fat to be removed). The exact price of the abdominoplasty/lipoabdominoplasty will be disclosed during your medical appointment, after diagnosis. The price of abdominoplasty includes all medical fees, anesthesia, follow-up appointments, postoperative medication, nursery care and abdominal binder.
WHAT IS THE MOST ADEQUATE PROCEDURE FOR MY CASE: LIPOSUCTION OR ABDOMINOPLASTY?
Liposuction only eliminates localized fat and is indicated for patients with elastic / retractable skin. If you have flaccidity, excess skin and separation of the rectus abdominis muscles, liposuction will not be enough to achieve a flat and firm abdomen. In this case, an abdominoplasty will be necessary.
DOES ABDOMINOPLASTY ELIMINATE STRETCH MARKS?
There is no specific surgical procedure to eliminate stretch marks. However, depending on the location of the stretch marks and the amount of skin to be removed, abdominoplasty can eliminate part or all of the stretch marks on the lower abdomen and the region immediately above the navel.
HOW LONG DO I HAVE TO WAIT AFTER GIVING BIRTH TO PERFORM THE SURGERY?
Women who give birth must wait for the body to recover. The time it takes is different for every woman but, on average, it lies between 6 and 12 months. It is also important not to be breastfeeding anymore and having a stable weight.
CAN I GET PREGNANT AGAIN?
Ideally, abdominoplasty should be performed when having children is not a plan anymore, not because there is any incompatibility with the pregnancy, but because the results of the surgery might be compromised. If you want to get pregnant again, it is advisable to wait.
ARE THE RESULTS OF ABDOMINOPLASTY DEFINITIVE?
Abdominoplasty does not guarantee lifelong results as the body is still subject to the natural aging process, weight fluctuations and future pregnancies. To have long-lasting results, it is important to follow a healthy lifestyle, a balanced diet, and regular exercise.
DO SCARS DISAPPEAR?
The scars are permanent regardless of the surgery performed, but, over time, they become thinner and lighter. The final appearance of the scars is variable and depends on the genetic characteristics of each person and the post-operative care. The final result is expected after 12/18 months.
WILL I NEED DRAINS?
The use of drains is extremely important to help to eliminate the fluids that accumulate after abdominoplasty, thus minimizing the risk of complications. They are used whenever necessary and are usually removed after 48 hours.
HOW PAINFUL IS THE RECOVERY?
Recovery from an abdominoplasty can take 2 to 3 weeks. In the first few days, it is normal to experience tiredness, discomfort and moderate pain. It is important to strictly follow all medical recommendations, respect the rest time and take the prescribed medication to relieve the pain and experience a more peaceful recovery.
WHEN CAN I RESUME PHYSICAL ACTIVITY?
You should not perform any physical activity or any type of physical effort for 30 to 45 days, after which you can gradually resume activity. Being careful during the recovery period is crucial both to experience a quick recovery, ant to obtaining the best possible results.
IS THE RESULT IMMEDIATELY VISIBLE AFTER THE SURGERY?
The result of an abdominoplasty is visible immediately after surgery. However, for some time, the swelling will distort the result. After three months you can get a very real sense of the result, but the end result is usually only visible after 6 to 12 months.
WHAT ARE THE RISKS AND COMPLICATIONS OF AN ABDOMINOPLASTY?
Like any other surgery, abdominoplasty is not without risks and complications, (e.g. bad reaction to anesthesia, bruising, changes in skin sensitivity, etc.). The possible risks and complications of abdominoplasty will be thoroughly explained during the medical appointment.