Abdominoplasty is the most commonly performed body contouring operation following massive weight loss as it removes large amounts of hanging skin from the lower abdomen, contours the hips and flanks and tightens the rectus abdominus “six pack” muscles. The abdominal pannus (excess abdominal skin) can be difficult to hide in clothing after losing large amounts of weight. The pannus can also make exercise and moving uncomfortable. Thrush, boils and chronic skin infections can only be definitively managed by removing the loose abdominal skin rolls. There are many types of abdominoplasties that are defined by the location of their incision lines. Dr Sanki will discuss with you the best operation to achieve your goals. In general, women who plan to have children are advised to have a classic or extended abdominoplasty without a permanent muscle repair.
A classic abdominoplasty (orange incision) operation removes excess skin and fat from the lower abdomen, tightens the six pack muscle and repositions and reshapes the belly button to restore your waistline and flatten your abdominal contour. The operation is often complimented by liposuction to the flank and hip areas.
An extended abdominoplasty (green incision) removes excess skin from the abdomen and hip areas and results in a scar that curves in the pant line around the hip bone. It is recommended to people whose abdominal fold extends round to their backs, or to people who have loose, outer thigh skin.
A Fleur de Lis abdominoplasty (blue incision) removes skin in vertical and horizontal directions from the abdomen. It is an operation that is recommended to people who have a lot of loose skin in the lower and upper abdomen. It results in a long vertical midline scar of the tummy as well as the traditional lower scar of a classic abdominoplasty.
A reverse abdominoplasty removes skin from the upper abdomen only and places the scar under the braline at the top of the abdomen. It is rarely recommended to massive weight loss patients as it only tights skin the upper third of the abdomen.
A Corsetplasty (pink incision) combines a fleur de lis abdominoplasty with a reverse abdominoplasty. It is a 5-6 hour operation that involves the removal of skin from the upper, middle and lower abdomen. It is an excellent operation for tightening the appearance of the abdomen in people who have lost very large amounts of weight (usually over 50 kilograms), and also recruits loose midback skin.
Abdominoplasty operations are performed under general anaesthetic in an accredited hospital. A classic abdominoplasty usually takes 3 hours. The operation first begins with careful planning of the skin to be removed. Once the patient is anaesthetized, the excess skin and fat of the lower abdomen is then surgically excised. The abdominal skin flap is lifted off the underlying muscle layer all the way to the rib cage. A strong stitch is used to bring together any separation of the rectus abdominus muscles. The rectus muscles separate during pregnancy to allow growth of the uterus. After multiple pregnancies or large pregnancies, the muscles lose their elasticity and cannot return to the midline. This gives the abdomen the appearance of being “constantly pregnant” as the muscles are too weak to support the underlying organs. The anaesthetist will then bend the surgical bed into a V position to allow Dr Sanki to close the abdominal skin. The mons pubis skin is also shortened and tightly pulled up to meet the abdominal skin. The belly button is repositioned and
reshaped to give it a youthful almond shape. The skin is closed with sequential sutures between the abdominal skin and the underlying muscle. This minimises the need for drains
Recovery from Abdominoplasty surgery
Recovery from abdominoplasty surgery reflects the duration of the operation and the amount of skin that was removed. In general, patients having small amounts of skin removed will
have less post operative pain, less post operative drainage and will manage to go home after one to two nights in hospital. Corset and Fleur de Lis abdominoplasty patients usually spend 5 nights in hospital and will experience a slower recovery. In all cases, patients are able to return to work after 3 weeks, and are usually able to drive after one week.