A pleasing abdomen has toned muscles, firm skin and shapely contours due to the right distribution of fat. The abdominal muscles provide structural support to the abdominal cavity, protect the abdominal organs and also give counter-support to the spine. There are four major muscles namely: external abdominal oblique, internal abdominal oblique, transversus abdominis, and rectus abdominis.
Many women are unable to achieve a flat and toned abdomen even with proper diet and exercise; particularly after pregnancy or major weight loss. In many of them, the rectus muscles are separated or weakened. Some also have exercise resistant fat on the tummy and flanks as well.
Abdominoplasty or tummy tuck is a cosmetic procedure which removes excess skin and fat from the abdomen and tightens the abdominal wall muscles to restore a firm and toned abdomen.
Lipoabdominoplasty is a procedure which combines liposuction and abdominoplasty to remove the excess fat and loose skin of the abdomen. The procedure preserves important structures within the abdomen such as lymphatic vessels, nerves, and blood vessels. Lipoabdominoplasty is a safe procedure which prevents the complications and tissue trauma that can be involved with standard abdominoplasty such as hematoma (blood clot within the tissues), seroma (fluid accumulation in tissues), necrosis (tissue death) and fat necrosis.
Indications and contraindications.
Lipoabdominoplasty is not suitable for patients with skinny abdomens that have excess skin. These patients would be suited for traditional abdominoplasty.
Lipoabdominoplasty is indicated in the following conditions:
Presence of excess fat and redundant skin on the tummy, flanks and around the back
Excess fat in the lower abdomen or pear shaped body
Obese individuals with more fat in the abdominal wall.
Weakened abdominal muscles
Excess superficial fat in the upper abdomen
Fat in the abdomen and flanks giving an appearance of rolls
Before your procedure, a detailed medical history is obtained, and a thorough physical examination is performed. During your consultation, your doctor will advise you to stop smoking, if you smoke, so as to avoid post-surgical complications and delayed healing. You should eat a healthy diet and avoid any restrictive dieting during this time. You should inform your doctor of all medications that you are taking and also about significant medical conditions and previous surgeries if any.
Lipoabdominoplasty is performed under the effect of general or epidural anesthesia. Steps involved in lipoabdominoplasty include:
Your surgeon injects tumescent fluid, a mixture of saline, lidocaine and a vasoconstrictor, into the fat cells of the abdomen. This anesthetic fluid helps to decrease swelling, bleeding and facilitates removal of the fat during liposuction.
Liposuction is performed to remove the maximum quantity of fat from the abdomen, flanks and back.
After liposuction, an incision is made in the lower abdomen from hip bone to hip bone. The skin is elevated up to the umbilicus or navel in a special plane. The skin around the navel is then isolated.
A tunnel dissection is performed to expose the upper abdominal muscles. If required, the muscles are tightened.
The upper abdominal skin is pulled down over the lower part of the abdomen; excess skin is removed, and the edges are sutured.
Then, an umbilicoplasty or a belly button surgery is performed to create a new opening for the already attached umbilicus to the abdominal muscles. The new umbilicus is similar to that of the natural umbilicus.
The fluid collected under the skin flap may be drained or the space may be pre-closed depending on the surgeon’s choice.
After lipoabdominoplasty, medications will be prescribed to relieve pain. You will be advised to rest with your hips and knees bent to minimize tension on the repair. You will wear a contoured elastic garment for extra support around the abdomen. You will be able to walk the following day. Most patients are discharged after an overnight stay and instructed about proper wound care at home. Stitches are usually dissolving and internal. Full recovery is achieved within 2-3 weeks.
Risks and complications.
Lipoabdominoplasty is a safe procedure with a lower rate of complications compared to abdominoplasty. But as with any surgery, lipoabdominoplasty involves certain risks and complications. They include:
Delayed healing of wounds
Deep vein thrombosis
The complication rates of lipoabdominoplasty are lower compared to traditional abdominoplasty. It is a safe procedure, less painful and promotes faster recovery. Removal of abdominal fat provides an improved abdominal shape. The procedure preserves abdominal nerves, blood vessels and lymphatic vessels thus providing better viability to the abdominal region.
The combined procedure of liposuction with abdominoplasty called lipoabdominoplasty is safe, provides excellent aesthetic enhancement to the abdominal region and has a low rate of complications. Consult your surgeon if you have any concerns before undergoing lipoabdominoplasty.