Our figure changes continuously over time due to a number of factors. Such changes can be attributed to weight gain, weight loss or pregnancy, which can leave lasting marks on the abdomen, including stretch marks, cellulite, excess adipose tissue and flabby skin. For many, liposuction alone would not suffice to correct these imperfections.
Abdominoplasty is a surgical procedure in which the excess fat and skin is removed from the abdomen in order to achieve a more aesthetically pleasing appearance. For a more even result, skin bearing stretch marks, cellulite and imperfections can also be targeted during the procedure. In most cases, this procedure is performed for purely aesthetic reasons.
In some cases, the fat apron is so large that it hides the lower abdomen, sometimes even stretching down to the thighs. In such severe cases, appropriate hygiene is difficult in affected areas, leading to skin infections and even pressure sores.
Abdominoplasty can be performed alone or, in the case of significant fat deposits in several areas, be combined with a lipectomy of the pubis, the arms (brachioplasty) and/or the thighs.
What does an abdominoplasty entail?
The abdominoplasty incision is designed to be completely hidden by underwear.
It is made directly above the pubis, going across towards the hips. When the targeted skin and adipose tissue are removed, the skin of your entire abdomen is lifted up to your thorax in order to ensure that the surgical wound can close properly and that your navel is preserved. Your navel is then repositioned aesthetically in the superior portion of your abdomen. Once the surgical wounds have been closed with melting stitches, an abdominal support belt (elastic band) will be placed around your stomach. You will need to wear this support belt day and night for several weeks to ensure that the wounds heal properly and that your abdomen maintains a good shape.
Frequently asked questions
The ideal patient for this procedure is in good general health, physically fit and at a healthy body weight (or has reached a stable weight after significant weight loss). The patient’s abdomen is perceived as too prominent in comparison with his or her silhouette. Certain people may also be embarrassed by their physical appearance.
In the case of healthy patients who have little excess weight or flabby skin, abdominoplasty is very safe and leads to few complications.
After any surgical procedure, there is normally some bleeding at the site of the wound. Such bleeding should slow over time and stop altogether after a few days. If, however, there is extensive bleeding that cannot be stopped by applying pressure, another surgical procedure would be required.
An excessive amount of the fluids that are normally produced by the body may accumulate inside the wound. This is not dangerous, but the fluids may need to be drained with a syringe on one or more occasions.
An infection can sometimes occur despite using sterile methods and taking antibiotics before surgery. Depending on the severity of the infection, oral or intravenous antibiotics may be required. If an abscess (an accumulation of pus) develops, it will need to be drained by opening the affected area of the skin or by using a drainage tube.
Wound dehiscence refers to a partial opening of the wound that is not healing well. This can be caused by an infection, a pocket of blood or seroma, or by insufficient blood flow. Dehiscence is usually treated conservatively, that is, either by applying dressings and wound management, or through surgery to close the wound again.
Necrosis of the skin
Necrosis of the skin is a rare complication where a portion of the skin does not receive enough blood to heal properly. Skin that is affected by necrosis can be treated by applying dressings and wound management or may require surgery to close the wound again. Patients who smoke and those who have undergone a number of abdominal surgeries in the past are at greater risk.
Necrosis of the adipose tissue
Fat necrosis is characterized by a flow of liquified fat which can last several weeks. This condition is caused by insufficient blood flow to the adipose tissue and is more frequent in patients who smoke or are obese.
Phlebitis, which is very rare, is an inflammation that can occur in the deep veins of the legs. Blood-thinning medication and compression stockings may be prescribed to treat this condition. The best form of prevention is moving around as soon as possible after the surgery, because contracting the calf muscles greatly improves blood flow in the legs.
The scar will change gradually for up to two years before reaching its final appearance. It may become pigmented, raised, painful or less sensitive to touch. As the scar evolves, your surgeon can suggest various treatments, which might include minor surgery to correct its appearance.
A full abdominoplasty is usually performed under general anesthesia. You must therefore calculate two to three hours in the recovery room after surgery. However, in some cases, a mini abdominoplasty is performed under local anesthesia with intravenous sedation.
An abdominoplasty is considered to be a cosmetic procedure and is not reimbursed by the RAMQ. In rare cases, the RAMQ may reimburse abdominal lipectomy procedures (removal of the fat apron) when the skin of the stomach extends over the thighs, causing significant functional problems. In such cases, a written request must be sent to the RAMQ, whose decision is based on a number of factors, including physical limitations. Only a few surgeons provide this service under coverage in a hospital setting.
Postoperative dressings must remain intact and dry for approximately one week. You may shower once the dressings and drainage tubes have been removed. You must avoid any intense physical exercise during the first six weeks following your surgery in order to give your body a chance to heal comfortably. For the same reason, it is recommended that you sleep with a pillow under your knees. However, it is important to get out of bed and walk regularly in order to activate blood flow in the legs and avoid thrombophlebitis. You will need to wear an abdominal support belt for a minimum of one month in order for the tissue to heal properly.
You can resume your normal physical activities three to six weeks after your surgery. It is important for you to listen to your body. It will tell you if you are ready to exercise and how much exercise you can handle. Pain or discomfort when exercising is a sign that your body is not quite healed and that it would be better to wait a few more days before trying again.
An abdominoplasty lasts approximately two to three hours. However, you must plan some time for preparation before entering the operating room (30 to 45 minutes) and time in the recovery room (2 to 3 hours). You should therefore plan to take a day off from work for your surgery.
Generally, the cost of an abdominoplasty starts at $9,255. The cost of an abdominoplasty en fleur de lys starts at $12,360. Additional charges may apply if the patient has a particular condition or if different surgeries are combined.
PLASTIC AND AESTHETIC SURGEON
Dr. Mario Luc
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We would be glad to help you through the process by answering all your questions and allaying your concerns.