Tummy Tuck

What you need to know regarding abdominoplasty, tummy tuck, mini-tummy tuck, lipo-abdominoplasty, plastic surgery of the abdomen, scar, recovery and complications.

With pregnancies, aging, alternating gain and weight loss, there is a flaccid bulging of the abdomen, consisting of fat and skin excess.

A tummy tuck, also known as abdominoplasty, is the surgery of the abdomen that consist of removing the excess tissue (skin and fat) that accumulates below the belly button and adjusting the loose muscular belt. This is not a surgery dedicated to lose weight but to remodel the abdomen area.

In the case of patients that have localized fat in the abdomen in addition to sagging and excess skin, Dr. EL Hachem will perform liposuction to remove fat while abdominoplasty corrects sagging and excess skin.

Anesthetic type:
Usually general anesthesia but epidural can also be used.

Length of stay:
Usually advised 24 hours, depending on the recovery, extend of surgery and the Dr. EL Hachem guidance.

The patient gets an abdominal drain for a few days and it will be removed with respect to the drained daily volume of the patient. The drain is a tube inserted by Dr. El Hachem beneath the skin, to prevent the accumulation of the liquid (seroma) , facilitate healing and recover faster.

Avoid efforts and remain in a bent position for up to 10 days to avoid tension to the scar. Heavy physical exercise (gym) should be avoided for a minimum of 3 months. You should use a garment for at least 1.5 months, or for longer period depending on the evolution process. Dr. El Hachem advises that ultrasound and lymphatic drainage sessions are carried out, after 7 days of surgery, in order to avoid the accumulation of local fluid, and inducing resolution of edema and internal scarring.

The scar usually becomes red for a few months, healing in a period of about 6 months to a year, depending on the skin type and genetics of the patient.

These complications are infrequent, and include: hematoma, seroma, infection, dehiscence (opening of the suture) and anesthetic problems.
However, with Dr. El Hachem’s accurate surgical indication, well performed surgical technique and optimal postoperative follow-up, complications are rare.
Take into account that smokers patients should abstain from cigarettes for a month before surgery to minimize the risks.

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


Frequently asked questions to Dr. Charbel El Hachem

1) How much weight will I lose with abdominoplasty?
A surgery that removes a certain amount of skin and fat will definitely allow a reduction in body weight, which varies according to the volume of your abdomen. According to Dr. El Hachem, its not the removed “kilos” that defines the overall aesthetic result, but the harmonic proportion between the abdomen and the rest of the trunk and limbs. Paradoxically, the abdomens that have better aesthetic results are precisely those with smaller removal.

Most women have certain “flabbiness” of their abdomen after giving birth, with a predominance of skin over the amount of fat. These cases allow for excellent results. In other cases, where the patient is above normal weight, the result will be compensatory and proportional to the rest of the body.

2) Does abdominoplasty leave a 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.

3) After how long will I achieve the final result of abdominoplasty?
In the first month, the abdomen will be subject to periods of “swelling” that resolve spontaneously. At this stage, you may be present a “flat” abdomen. After a few months, the patient will reach gradually the final outcome. The final results should not be considered before 6 months .

4) It is 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.

5) Does abdominal dermolipectomy corrects excess fat on the stomach region?
Not in all cases. This depends on your type of trunk (thorax + whole abdomen). If it is kind of short, it is unlikely to be fixed. Having a long type, allows the results to be more favorable. The thickness of adipose tissue (fat thickness) that covers the body is of great importance. Sometimes it is necessary to combine liposuction with abdominoplasty, to remove fat and remodeling of the abdomen.

6) Can I have children in the future? The result will not be harmed?
In order to preserve the results, Dr. El Hachem recommends however, that all the children be programmed before undergoing a tummy tuck.

7) I heard that postoperative abdominoplasty is very painful. it is 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.

8) Is there any danger in this operation?
It is seen that abdominal dermolipectomy (tummy tuck)surgery rarely has serious complications, since it involves high technical criteria. Indeed, each patient is prepared intensely for surgery, with strict recommendations from Dr. El Hachem. The danger of this procedure does not exceed a trip by plane or car, or even crossing a street.

9) What type of anesthesia is used for abdominoplasty?
Usually general, can be epidural anesthesia.

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

11) How long would the patient have to stay at the hospital after the operation?
1 day (normal evolution).

12) Does the procedure require using a drain?
Yes. The drain remains for a period of 3 to 6 days depending on the amount of drained secretion.

13) When are the stitches removed?
Dr. El Hachem advises that they’ll be removed between one or two weeks after the operation.

14) When can you take a full bath?
Usually after 2 days of the operation or after the 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.


Preoperative recommendations:

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

2) Showing up in 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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