Abdominoplasty

Frequently asked questions about abdominoplasty:

What is abdominoplasty?

Abdominoplasty is a surgical technique used to remove surplus fat in the abdomen and on the waist, to remove excess skin in the lower abdomen and to repair the abdominal muscles. Depending on the condition of the individual patient, a full, mini or endoscopic abdominoplasty is performed.

Who is a good candidate for this procedure?

Persons with excess skin above the navel and “a good handful of skin” under the navel when sitting may consider a full abdominoplasty. If the excess skin is located in the region under the navel, a “mini” intervention is enough. If you only have a few fat deposits too many and if the abdominal wall is still tight, endoscopic intervention is sufficient.

How is full abdominoplasty performed?

The first step is liposuction (link); it may be combined with liposhaping (link). It is followed by an incision three times the size of a Caesarean section which is designed to be easily hidden in clothing. The skin is lifted up as high as the lower ribs, then the abdominal muscles are repaired and tightened, the navel is transplanted a bit higher up, and the excess skin is removed.

How is a mini-abdominoplasty performed?

The first step is liposuction. It is followed by an incision just like in regular abdominoplasty, only shorter. The skin is lifted below the navel only and excess skin is removed. If a small section above the navel is to be tightened as well, the navel is set 1-2 cm higher. If necessary, the muscles in the abdominal wall are repaired.

How is the endoscopic intervention performed?

Endoscopy is the method of choice if the skin in the abdomen is not too loose and the abdominal wall not too weak. Surgery is performed through a small incision (2 cm), preferably in old scar tissue (e.g. Caesarean section) to leave no new traces. This procedure is also preceded by suction of excess fat. In the endoscopic intervention, a tiny camera is inserted through the incision which is used to guide the surgical instruments. Endoscopic tightening does not involve the removal of skin.

What to do and what not to do before treatment?

Three weeks before an invasive / surgical treatment patient must stop smoking and taking aspirin. In the last week, patients must stop taking any anticoagulant (“blood-thinning”) medicine.
The following substances are also prohibited:
•    pain killers such as Apranax, Voltaren and Vermidon (alternative brand names are Minoset and Novalgin)
•    multivitamin tablets containing ginseng, ginkgo biloba and coenzyme Q,
•    green tea, herbal products containing linseed, sour cherry stalks, tomato seeds
•    all diet products.
Before liposuction, patients must be weighed and the share of body fat should be determined. After the intervention, patients are advised to regularly monitor their body weight.

Do I have to lose weight before the intervention?

Overweight is a surgery risk and has a negative impact on the healing process. We, therefore, recommend obese patients first to lose weight. If this is not possible due to their limited ability to move, surgical weight loss is an option.

Does the procedure require anaesthesia?

The operation is performed in a hospital under general anaesthesia.

How long does the procedure take?

That depends on the individual scope of intervention. If no comprehensive liposuction is performed, the full abdominoplasty alone takes 2-3 hours; mini-abdominoplasty and endoscopy take 1-2 hours.

Is abdominoplasty painful?

Contrary to a widely held belief, abdominoplasty is not very painful. All intervention points are locally anaesthetised for about 10 hours. Patients feel no pain for a couple of hours immediately after the intervention. Complaints the next day usually refer to a feeling of tightness in the abdominal region, and the inability to stand upright due to the sutured incision. Mini-abdominoplasty and endoscopy cause only a mild inconvenience.

What happens after the operation?

Compression stockings are put on to prevent embolies, a urinary catheter and surgical drains are placed to remove fluids. A corset is placed around the abdomen. Three hours after the procedure you can eat and get up. In the first 4-5 days after surgery, you should avoid walking upright in order not to strain the scar. In case a mini-abdominoplasty or an endoscopic intervention have been performed you can return much sooner to an upright position. Patients are usually discharged the next morning. The drains may stay in place for a little longer, if necessary. At night you can sleep on the side. You can take a shower 24 hours after drain removal. The sutures are placed under the skin and need not be removed. A week later you can return to your regular activities. After 3 weeks, physical activities are permitted; however, exercises involving movements of the abdomen should be avoided. After 6 six weeks, you are free to exercise as you please.

What complications can occur after surgery?

The most severe complication is pulmonary emboli. The risk increases with age, it is aggravated by overweight, diabetes and cigarette smoking. Heavily overweight patients are, therefore, advised to lose weight before surgery. Other problems are excessive skin removal due to wrongful planning, as well as insufficient bleeding control and difficult wound healing. Serum may accumulate under the skin (seroma) and need to be removed. If the skin is too tight, the scar may spread. However, scar spreading can be corrected a year later under local anaesthesia.

Are the results of abdominal tightening permanent?

The intervention addresses the root cause of the problem and is permanent. After childbirth or if you gain weight again, a certain amount of loosening is unavoidable. A return to the pre-operation status is, however, impossible.

How can I maintain my new body shape?

Patient must maintain their weight; this means in particular a healthy diet and moderate alcohol consumption to prevent abdominal fat formation. Regular skincare to prevent skin cracks and regular physical activities to strengthen the abdominal muscles are also strongly advised.

Is pregnancy possible after abdominoplasty?

Yes. However, childbirth puts new strain on the skin and abdominal muscles. Patients are, therefore, advised to coordinate pregnancy and abdominoplasty.