Abdominoplasty after weight loss

After major weight loss, with the drastic reduction of abdominal fat volume, there is a flaccid bulging abdomen, formed by an excess of skin. Due to the large skin stretching during the obesity period, the skin loses some of its elasticity, and when there is loss of weight, it does not retract enough, giving a skin surplus  below belly button.

Dr. El Hachem states that a tummy tuck, or abdominoplasty of the abdomen remodels the abdomen by removing excess tissue (skin and fat) that accumulates mainly below the navel and also by adjusting the loose muscular belt. This is a surgery to lose weight but also to remodel the abdomen.

Abdominoplasty after major weight loss

Anesthetic type:
The anesthesia can be epidural or general.

Length of stay:
Generally between 24 and 48 hours, depending on the recovery and Dr. EL Hachem guidance.

The patient will have an abdominal drain for a few days, to be taken out as directed by Dr. El Hachem.

Avoid efforts and remain in a bent position for up to 10 days to avoid tension to the scar. Physical exercise should be avoided for at least one month. You should use an compressive garmen for at least 1.5 months, or for the period stipulated by Dr. El Hachem. Ultrasound and lymphatic drainage sessions after 7 days of surgery, avoid the local fluid accumulation and facilitate internal scarring.
The scar usually become red for a few months, tending to clear in 6 months to a year, depending on skin type and genetics of the patient.

The possible complications of abdominoplasty, can be cited as follows: hematoma, seroma, infection, necrosis (skin injury), dehiscence (opening of the suture), keloid, thrombosis, embolism, anesthesia problems.

Abdominoplasty after major weight loss

Because the most frequent complications happen to patients that smoke, they should refrain from smoking for a month before surgery to minimize the risks. In the case of use of oral contraceptives, the patients should discontinue the use one month before surgery, during which another contraceptive method should be adopted.

Definitive result:
The final result of abdominoplasty is reached 6 months after surgery, which is the time required for the accommodation of tissue and maturation of the scar.


Frequently asked questions to Dr. Charbel El Hachem

Plastic Abdomen after excessive weight loss | Plastic surgery

Information on Plastic Surgery

Abdomen plastic surgery after major weight loss – Abdominoplasty or Dermolipectomia

1) Does Abdominoplasty leave a very visible scar?
The resulting scar from a tummy tuck is located horizontally just above the pubic hair, extending laterally to a greater or lesser extent, depending on the volume of the abdomen. Dr. El Hachem insists that the scar is planned to be hidden under the bathing suits, and inevitably will pass through several stages of evolution until resolving.

2) How long will it take to reach the final result of abdominoplasty?
In the first months, the abdomen becomes insensitive, and would be subject to periods of “swelling” that resolve spontaneously. Over the months, after starting exercises oriented towards the new modeling of the abdomen, the patient will gradually reach the final outcome. A definitive tummy tuck result will not be achieved, before 6 months postoperatively.

3) Is it true that a new navel will be done?
No. Your own navel will be reinserted and, if necessary, remodeled. Dr. El Hachem asks you to take into account that, surrounding the navel there is a scar that will suffer the same evolution of lower scar. Because it is a circular scar, in some cases the changes may not be the one the patient desires, resulting in something “artificial”. This is due to the anomaly in the evolution of the scar, which, however, is likely to be fixed, by “retouch” under local anesthesia, after a few months.

4) What type of swimsuits can I use after surgery?
The type of swimsuit depends exclusively on your own tummy. Remember that the surgeon’s scalpel only enhances your own shape, which can be further improved with the care of a beautician or physiotherapist.

5) Can I have children in the future? The result will not be harmed?
The result of the surgery can be preserved if the pregnancy weight is controlled by an expert. Dr. El Hachem recommends however, that planning for children should be scheduled before undergoing a tummy tuck.

6) I heard that postoperative is very painful. Is it true?
Dr. El Hachem assures you that it is not. The normal evolution of abdominoplasty should not be painful. Certain patients who are simultaneously operated of gynecological surgeries and abdominoplasty, report some post-operative pain. Not all surgeons recommend this combination of surgery, as they are less favorable.

7) Is there danger in this operation?
Rarely abdominoplasty  has serious complications, since it’s held within technical criteria. This is due to proper preparation of each patient as well as considerations of the suitability of the surgery. The danger is not bigger or smaller than a trip by plane or car, or even crossing a street.

8) What type of anesthesia is used for abdominoplasty?
General or epidural anesthesia .

9) How long does the surgery?
On average 3 hours.

11) What is the hospital stay?
1 day (normal evolution)

12) Would a drain be used?
Yes. The drain remains for 3 to 6 days depending on the amount of drained secretion.

13) When are the stitches removed?
From the 7th to the 15th day.

14) When can I take a full bath?
Usually after 2 days or after removal of the drain.

15) What is the postoperative evolution of abdominoplasty?
According to Dr. El Hachem “Be patient because your body will take its time in eliminating all the small imperfection that, inevitably draw your attention.”

Some patients may experience anxiety, due to the transitory aspect (edema, insensitivity, scar transition, etc.). This is temporary and usually reflects the desire to achieve the final result as soon as possible. Remember that no result of abdominal surgery should be considered definitive before 6 to 12 months.

Abdomen surgery after major weight loss ( Abdominoplasty or Dermolipectomia )


Preoperative recommendations :

1) Communication with Dr. El Hachem is required up until two days before the operation, in case of flu or illness.

2) Arrive at  the chosen hospital, obeying the set schedule.

3) Dr. El Hachem strongly advises to avoid alcoholic beverages or large meals the day before surgery.

4) Avoid any medication that results in weight loss for a period of 14 days before the surgery. This also includes diuretics.

5) Schedule your social, domestic and school activities so not to become indispensable for a period of approximately 20 days after the operation.

6) Avoid smoking for at least fifteen (15 days) prior to surgery.

7) Avoid any ingestion of food for about eight (8) hours before the scheduled time of surgery.

8) Avoid any medication containing acid acetylsalicylic (Aspirin,etc..) or any other medication that may affect anticoagulant for at least 7 days prior to surgery.

Postoperative Recommendations:

1) Avoid any efforts for 30 days after the operation.

2) Avoid getting the wound wet during the first 2 days.

3) Walk with a slight bending form and maintain short steps, for a period of 10 days. At bedtime, put pillows behind the back area and below the knees, leaving the abdomen without tension.

4) Avoid any medication containing acetylsalicylic acid (Aspirin, etc…) or any medication with anticoagulant effect at least 7 days after the surgery.

5) Normal diet (except in special cases).

6) Use the garment  for 1.5 months.

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