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The abdominoplasty, also known
as a tummy tuck, creates a tight, flat abdomen,
and is one of the most common procedures performed
in plastic surgery worldwide.
When performing an abdominoplasty,
Dr. Chartchai removes excess abdominal skin and
fat by means of an incision just above the pubic
bone, similar to a C-section but longer.
If you can easily grab excess
skin, and pinch a large amount, it is likely that
an abdominoplasty would provide a highly noticeable
improvement. If, on the other hand, the skin feels
very thick, and is not particularly loose, it is
likely that an abdominoplasty is not the procedure
of choice. In this case, liposuction
may be more appropriate.
Dr. Chartchai may advise that
you consider some liposuction with your abdominoplasty.
This would allow him to add an element of body "sculpting"
to the procedure, and to enhance your final results.
Stretch marks can often be removed
during an abdominoplasty depending on where they
are placed and how extensive they are.
The benefits of a properly performed
abdominoplasty are remarkable. The loose flabby
abdominal skin that you thought would never go away
has gone. Your abdomen is once again flat, and you
have a sleeker, more attractive figure. Your stretch
marks are gone. Your waist is smaller. Your clothes
fit much better.
What do you want to change?
Common complaints are: loose skin, excess fat, stretch
marks (especially below the bellybutton), abdominal
pouch below the naval, lack of a waist line, droopy
buttocks, and disproportionately large waist compared
to buttocks and/or breasts. All these complaints
can be helped with abdominoplasty by use of different
techniques
Types of abdominoplasty
Here are the 4 types of abdominoplasty that Dr.
Chartchai performs.
The most appropriate procedure
for you is determined during your consultation with
Dr. Chartchai. He will assess your skin excess,
skin quality, fat excess, fat distribution and body-type.
Together, you will decide what procedure is best
for you.
Mini abdominoplasty / Mini
tummy tuck
The mini-abdominoplasty is the least involved variation.
The incision is relatively short, staying within
the pelvic bones. It is slightly longer than a C-section
incision. It usually does not involve repositioning
of the belly button. The best candidate for this
procedure typically has redundant skin and an abdominal
pouch below the belly button. The mini abdominoplasty
is not meant for someone who has excess skin or
fat in the middle or upper abdomen.
Standard abdominoplasty / Standard
tummy tuck
The standard abdominoplasty is the most common
abdominoplasty. If there is more than 1-2 inches
of excess skin, a standard abdominoplasty is probably
necessary. It does an excellent job in eliminating
the abdominal pouch below the umbilicus especially
in women who have given birth. In the process it
produces a much flatter stomach.
In a standard abdominoplasty,
Dr. Chartchai tightens the underlying muscles in
2 places to flatten the stomach and narrow the waist
line. A bonus of the standard abdominoplasty is
that any stretch marks below the belly button will
likely be removed. A properly performed standard
abdominoplasty will help create an hour-glass waist
line.
With age, weight gain, or pregnancy
the stomach muscles separate in the midline and
create additional bulging. During the abdominoplasty,
Dr. Chartchai tightens the stomach muscles by suturing
them together in the midline. It is usually necessary
to reposition the belly button because of the large
amount of skin that is removed.
A standard abdominoplasty does
not treat fat deposits in the flank area. These
can be addressed with either liposuction
or by performing an extended
abdominoplasty .
If there is only a small or moderate
amount of flank fat, liposuction
may be the best course. If you have a significant
amount of flank fat an extended
abdominoplasty would most likely be best.
The standard abdominoplasty leaves
a scar from hip to hip and requires repositioning
of the umbilicus to avoid positioning it too low
on the abdomen.
Extended abdominoplasty / Extended
tummy tuck
When the redundant skin goes around toward the
back, then there is no other way to remove it but
to extend the excision to include this area. The
extended abdominoplasty involves removing folds
of extra skin and deposits of fat from the flank
and back area (the love handles and upper hip).
No other procedure can produce
such an impressive waist line even in patients who
never had an attractive waist line in their youth.
It makes the buttocks appear much more attractive
and curvy, and the breasts appear larger.
The incision for the extended
abdominoplasty goes to the back of the hip area.
Dr. Chartchai's technique keeps the incision low
so that even low-rise clothing can be worn without
scar exposure. The down side of the extended abdominoplasty
is the additional operating time necessary, the
additional cost, and of course the longer scar.
Circumferential abdominoplasty
The circumferential abdominoplasty is a very
aggressive procedure and is reserved for those patients
with a significant amount of redundant skin usually
after
significant weight loss. For the patient with
flabby hips and droopy buttocks, the hips and buttocks
can be elevated surgically to give a sleeker, more
youthful appearance. This is a most aggressive and
complicated operation that will leave a circumferential
scar.
Liposuction with an abdominoplasty
Dr. Chartchai will perform liposuction
on the abdomen at the same time as the abdominoplasty
being careful not to jeopardize the blood supply
to the skin. In some patients limited liposuction
is possible, if they do not smoke cigarettes.
If you have a significant amount
of extra skin, liposuction
can be done as one of multiple
procedures provided your surgery is in a modern
operating
theatre in a fully accredited hospital. Dr.
Chartchai performs these procedures only in such
a setting.
Recovery time
Most people stay in the hospital 2-3 days after
surgery. Bruising may exist for up to 3 weeks but
may not completely go away for up to 6 months. If
you are returning to a strenuous job, Dr. Chartchai
may suggest you wait as long as 6 weeks before returning
to work. After 4 weeks you may resume light exercise
that doesn't work the abdominal area. It may be
8 weeks or longer until you have absolutely no pain
and can go back to a regular exercise routine.
In the first 6-8 weeks, scars
will become red and thick as the body heals. The
scars gradually become thinner and less red. In
about a year, they become quite light.
Complications
One of the most common and significant complaints
of an abdominoplasty is a large scar. Any abdominoplasty,
even a "mini" one, leaves long scars. The total
length of a scar depends on the amount of redundant
fat and skin you have within the flank area. Dr.
Chartchai is careful to place his incisions below
the bikini line or otherwise minimize the resulting
scar. The final look of the scar depends on each
patient's individual skin quality.
Another complication is a blood
clot formation, which is more common with an abdominoplasty
than with other cosmetic surgery procedures. You
can minimize this event by wearing compression stockings
or garments and making sure you stretch your legs immediately
after the operation even while still in bed.
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