What are the basic elements of abnormalities of the abdominal contour?
Most patients seeking a tummy tuck want to correct a defect of the contour, which generally consists of a complex composed of numerous basic problems. Four key areas should be evaluated at consultation room:
- 1. The degree of redundancy and skin flaccidity of the abdomen.
- 2. The degree of excess fatty tissue and its location.
- 3. Separation and laxity of the muscles of the abdominal wall.
- 4. Evaluate the scars and stretch marks and their location.
These four basic elements direct the surgical procedure to achieve optimal correction of anatomical problems.
What is the basic surgical procedure for abdominoplasty?
One of the most important steps in the abdominoplasty starts before surgery with the patient’s abdomen marking in the supine and upright position. It isdetermined with marking laxity of the skin and the area of resection. A transverse incision is made in the lower abdomen and from here the fatty tissue and skin from the muscle wall is peeled off. This detachment allows repairing the abdominal wall by sutures that strengthen it and narrow the waist. The excess skin and fat are removed, and the navel is repositioned in its new location. It can be associated with liposuction surgery in areas where it is needed, especially the flanks and upper thighs.
What are the indications for miniabdominoplasty?
Miniabdominopalsty employs a transverse incision in the lower abdomen, and it is primarily used in patients with excess skin or fat, limited to the area below the navel and with scarce muscle laxity only in this infra-umbilical area.
Detatchment in these cases is lower than in abdominoplasty and the navel is not treated and it is left in place.
What are the relative contraindications for abdominoplasty?
Abdominoplasty contraindications mainly focus on disorders that may predispose to decreased blood supply to the abdominal skin after detachment. Among the examples previous scars above the navel, a history of heavy smoking, cardiovascular disease and morbid obesity are included. Although they are not true contraindications, you should always discuss issues before surgery such as a prospective pregnancy and unreasonable expectations of the results.
When is muscle plication or repair indicated?
It is indicated in all patients with lax abdominal wall muscles. Different techniques depending on the type and degree of laxity may be used. The purpose of these is to reinforce the abdominal wall, flattening the area and thus avoiding the warpage which occurs. In addition to suturing the muscles in the midline we manage to mark the waist.
This procedure corrects the sequels after pregnancies in which there is a stretch of the muscle-aponeurotic system in this area.