Abdominoplasty (surgery): types and scarring. How much?

If you have just had a baby or if you have lost a lot of weight recently, it is possible that the skin on your belly may be slightly left over. Abdominoplasty can help! Read more and find out how this surgery is able to reduce the abdominal circumference of those in need.

What is abdominoplasty?

Abdominoplasty is a plastic surgery that aims to remove excess skin and fat from the abdomen, as well as possible stretch marks in the region, in addition to restoring weakened abdominal muscles.

Read more: Stretch Marks in Pregnancy: types (red), best cream, how to avoid?

It is an aggressive surgery, with painful recovery, but with immediate result.

The aggressiveness of the surgery is due to the damage it causes, as the skin to be removed is cut, the abdominal muscles are separated from the skin and sewn together, and then the remaining skin is pulled to close the cut.

The procedure is not to lose weight, but to remove an excess of skin and fat that can remain after rapid weight loss or after repeated pregnancies.

In some cases, there is also the possibility that the rectus abdominis muscles (those of the six pack) may have moved away from each other due to the volume of the belly, due to obesity or pregnancy. It is called abdominal diastasis .


  

When this happens, the incorrect positioning of the muscles distorts the person’s belly and abdominoplasty can be indicated for the correction.

It is possible to perform the operation in cases of burns or skin tumors, but these cases are usually treated in other ways.

Types

There are three types of surgery, all of which are similar, but involving skin removals of different sizes. Are they:

Classic tummy tuck

The classic version of abdominoplasty removes moderate amounts of skin, requiring the navel to be repositioned and leaving a long, curved scar on the belly. It is the most frequent among the achievements, being able to give a flat stomach aspect.

Mini Abdominoplasty

In this type, a small amount of skin is removed, being less complex than classic abdominoplasty.

But the difference is not to be minor surgery, but to have different recommendations. That is, the patient indicated for mini-abdominoplasty is not suitable for classical surgery.

The scar, in the mini type, is smaller because about 3 cm of skin is removed and the abdominal musculature is only sewn from the navel downwards.

Anchor abdominoplasty

This version of the surgery removes a lot of skin. It is usually used on people who have had bariatric surgery recently and have a large amount of skin left over.

In addition to the cut in the belly, there is also a vertical cut in the center of the belly. The scar, after the surgery is finished, is shaped like an anchor, which gives the name for the version of the operation.

How is abdominoplasty surgery done?

The plastic surgeon performs the abdominoplasty . It is a long surgery and lasts around 2 to 5 hours, although it can reach 7 in cases where liposuction, which often accompanies it, is also done.

The type of cut and length depends on the type of abdominoplasty, but the process is quite similar.

To perform the procedure, the patient needs to be anesthetized. First the doctor makes a cut just above the groin and the skin and fat are detached from the muscle.

In the classic and anchor type, another cut is made around the navel as it cannot be removed.

The abdominal muscles are exposed and sutured (stitched), making them closer to each other, thinning the waist and eliminating abdominal diastasis.

Then, the skin to be removed is finally completely separated from the patient’s body, and what is left of the tissue is pulled down and reconnected to the cut, thus closing the wound.

In the classic and anchor type, a new cut is made so that the navel can pass and it is also sewn.

Indications

Abdominoplasty may be indicated in some cases, such as when there is excess skin due to very accelerated weight loss, especially common after bariatric surgery.

It is also indicated for people with abdominal diastasis, a condition that can appear after pregnancy or after heavy weight loss, which causes the muscles of the abdomen to separate.

Contraindications

Surgery is contraindicated in some cases. Are they:

Uncontrolled diabetes

Cases of uncontrolled diabetes can cause problems for any surgery since, in that case, the body may have problems with the healing process, which is extremely important in such an aggressive surgical procedure.

Plans to get pregnant

If you have plans to become pregnant in the future, surgery is not indicated. Abdominoplasty is recommended for the correction of abdominal diastasis, which is caused by pregnancy.

Getting pregnant after the procedure is not necessarily prohibited or dangerous, but it does cause the muscles to part again and the procedure will have been in vain.

Read more: Exercises for pregnant women (pre-delivery): swimming, breathing and more

Anterior tummy tucks

If the patient has already undergone an abdominoplasty, the doctor must assess whether the surgery cannot present greater risks, leaving it to the doctor to choose whether the new operation is indicated.

Collagenoses

Collagenoses are autoimmune diseases that affect connective tissue, which is responsible for connecting the skin to the muscle. During abdominoplasty surgery, the connective tissue is disrupted and during recovery it regenerates.

However, people with collagenosis can have great difficulties and even the impossibility of tissue regeneration, so this type of surgery may not be indicated. The doctor must evaluate each case.

Smokers

Smokers can have healing problems and are more likely to develop thrombosis. The risks are greater for these people and the doctor should assess the case to see if surgery is indicated.

Non-adapted eating habits

Another situation that can cause diastasis is obesity. In the case of weight loss – whether by surgical procedures or not – the skin may be left over and the muscles of the rectus abdominis may also separate, making abdominoplasty possible.

However, if there is no adaptation of eating habits after weight loss, the weight can be recovered and the abdomen muscles can move away again, undoing the surgery.

Read more: How to lose weight healthily: diet, exercise, medicine, menu

Preoperative

Before the operation, there are some preparations that you need to make. The doctor will give you the details and tell you if your case, in particular, needs other preoperative actions. Among the preparations are:

Exams

The doctor will indicate, before the surgery, several tests that must be performed to find out if there is any complicating factor for the procedure. These examinations must be carried out for the safety of the patient.

Avoid alcohol

Do not consume alcoholic beverages until 48 hours before the operation. The substance can cause problems during the procedure.

Avoid cigarette

It is essential to spend a few days without smoking before the operation, as nicotine and other substances present in cigarettes can increase the risks related to surgery.

Inform the medicines you are taking

The doctor needs to know of any medications you are taking to avoid drug interactions, in addition to being able to prepare for possible complications related to them.

For example, if you are taking anticoagulants, the risk of bleeding may become too high during the surgery and it should be postponed until you have stopped taking it.

Fasting for 8-12 hours

In all anesthesia surgery, fasting is necessary so that the patient does not feel sick or run the risk of vomiting during the operation.

In the case of abdominoplasty, in addition, the operation takes place in the abdominal region and a dilated stomach with food or liquids can alter the result.

Postoperative

The postoperative period is considered by many to be the most difficult part of abdominoplasty, since recovery can be extensive and complicated.

On average, it takes between 15 and 21 days for the patient to be able to gradually return to activities such as driving and working.

However, during the four months following surgery, great efforts and weightlifting should be avoided.

Adequate rest and respecting medical guidelines are important for complete recovery. The main cares include:

Rest

Rest is extremely important for your body to recover from surgery. It is recommended at least 10 days in complete rest.

Getting up and walking are activities that should be carried out as little as possible. The patient cannot work or make efforts during this period.

Compression brace

The compression belt, as well as several other modeling clothes are used to ensure that the blood flow will follow normally, preventing venous thrombosis (vein obstruction), in addition to preventing the cut skin from leaving the place and generating protrusions in the scar.

Compression is essential to avoid complications from surgery and the braces should not be removed before eight days after surgery.

After that time, it is possible to remove them for bathing, for example, but they should be used most of the time for at least 45 days, always following medical guidelines.

Hematomas

There may be very long-lasting bruises on the skin after surgery. Take care of the sun, don’t expose them for too long and always use sunscreen. Sun exposure can cause spots on the skin in areas with bruises.

Bath

The post-operative bath is complicated. During the first 8 days, it is not possible to bathe in the shower due to the compression strap, which cannot be removed.

You can use damp cloths or hygienic wipes to clean yourself. After 8 days, the baths are, in general, released. It is important to follow medical guidelines regarding the use of soaps, water temperature and shower time.

Ache

The postoperative period can be extremely painful in some cases. In others, the pain may not be as prominent. This varies from person to person, but there is likely to be considerable pain during recovery as it is a very aggressive surgery.

In general, the doctor usually prescribes painkillers after surgery.

Drains

Drains are necessary to prevent lymph , the fluid that remains in the lymphatic vessels, from accumulating during recovery, which can hinder healing.

In order for the extra skin and fat to be removed, they have to be detached from the muscle and the tissue needs time to re-adhere to the region.

The skin is what prevents the body’s liquid from evaporating into the environment. If there is space between the skin and the muscles, this liquid can accumulate in the region. That is why drains are necessary in the post-surgical period of an abdominoplasty.

Lymphatic drainage

The lymphatic drainage can make a difference in the postoperative period and in the healing process.

The technique is a type of massage that helps to prevent the liquid from standing in the space between capillaries and cells, as it can improve circulation in the region, prevent edema (swelling due to fluid accumulation), in addition to preventing the formation of fibrosis in the post-surgical period.

The procedure must be performed by specialized professionals, as it requires technique, pressure and specific knowledge of performance.

Read more: What is lymphatic drainage for?

Curved floor

For the first fifteen days, walking with the spine slightly curved forward is necessary. As the skin is pulled to cover the space left by the extra skin, leaving the spine erect can burst the stitches, in addition to causing a lot of pain due to the healing process.

It is recommended to lie on your side to sleep, or on your back with your spine supported and your legs flexed, to ensure that your belly will not be stretched during sleep.

Thus, it prevents the abdominal muscles from stretching before the time, which can compromise the surgery.

Help

You will need help. Do not think about having the surgery if there is no one who can help you. Especially in the early days, hygiene will depend on other people, as will any necessary effort, which can range from cooking to lifting weights.

Modeling clothes

Modeling clothes are necessary to prevent thrombosis and ensure that healing will happen properly, without removing the skin. Without them, the risks related to surgery are much greater.

Do not lift weight

Do not make efforts during recovery, especially with the muscles of the abdomen, as this can cause enormous pain, in addition to affecting the results of the surgery.

In the first 15 days, no effort should be made. After that time, the patient is allowed to make very light efforts.

Gradually, walks are recommended to maintain routine exercises, respecting the limits of the body and being performed slowly and gradually.

How long does it take to recover from an abdominoplasty?

At least 10 days of complete rest are required. 15 days may be necessary for the patient to return to work, but full recovery takes 2 to 4 months, which can be even longer if, together, other operations were performed, such as liposuction and mammoplasty.

What are the risks of an abdominoplasty surgery?

As with any surgery, abdominoplasty has risks, especially considering the size of the cut made for this operation and its aggressiveness. These risks are increased when liposuction or mammoplasty is performed together, which is common. Care is required after the operation.

Among the main risks are:

Thrombosis

Thrombosis is one of the main concerns related to this surgery. Since recovery requires a lot of time at rest, blood vessels can be constricted, which facilitates the formation of thrombi , which are clots within the circulatory system.

These clots can be very dangerous as they can impede the flow of blood in certain areas of the body.

The most common is that they affect the legs, but it is possible that the clot is carried through the bloodstream to the heart, lung or even the brain, bringing serious consequences such as pulmonary embolism and stroke.

Fibroses

Fibroses are scars that form on the inside of the body. In the case of abdominoplasty, they can appear in the region where the skin reconnects with the muscle and can cause undesirable effects on the aesthetics of the belly.

To prevent the formation of fibrosis, lymphatic drainage is recommended, which must be performed by professionals prepared to deal with patients who have just come out of surgery.

Reduction or loss of sensation

The cut can cause loss of sensation in the region, as well as the detachment of the muscle skin. It is a risk that is taken when performing an abdominoplasty.

Infections

As the cut for abdominoplasty is large, it is possible that infections will appear. To avoid this, surgeons prescribe antibiotics for patients who have undergone surgical procedures.

Take your medications exactly as your doctor tells you . Making mistakes with antibiotics can be fatal, as an infection in a wound the size of a tummy tuck can easily lead to death.

Scar

When performing an abdominoplasty, it is not possible to escape the scar. It is usually large and at the base of the abdomen, just above the groin.

The region can usually be easily hidden by underwear and most bikinis, especially in cases of mini-abdominoplasty and classic. In addition, over time, it tends to become less flashy.

The size of the scar varies according to the amount of skin removed by the surgery, but it is always extensive and needs care.

To prevent the scar from becoming more marked than it should, or from forming a keloid , which is an excessive growth of tissue, it is important that the patient rests well and does not apply any effort to the region during recovery.

Following medical guidelines, it may be necessary to use creams, changes in diet and care with exposure to the sun.

Read more: Tattooing good warns of diseases and hides scars

Price: how much does abdominoplasty cost?

The price varies a lot from doctor to doctor, but the procedure can cost between R $ 10 and R $ 20 thousand reais, depending on the region and the city where you are. In addition, it is necessary to consider the costs related to the postoperative period, with care and medications.

Abdominoplasty by SUS

The Unified Health System (SUS) offers abdominoplasty, but not for purely aesthetic use.

In order to be able to perform the surgery for free by SUS, it is necessary to prove the need, as is the case of leftover skin after bariatric surgery or abdominal diastasis.

Abdominoplasty with liposuction

Rarely, abdominoplasty is performed separately from liposuction. This is because lipo, which is a procedure that aspirates fats from certain parts of the body, helps to shape the silhouette, preventing the abdomen from looking unnatural after surgery.

It is important that the doctor evaluates if there is a need or if liposuction is really indicated in conjunction with abdominoplasty for each case.

LPF (Low Pressure Fitness)

If your case is abdominal diastasis, there is an alternative to surgery. The so-called LPF or Low Pressure Fitness (in Portuguese, low pressure gymnastics) is a method of gymnastics aimed at reducing abdominal circumference through muscle strengthening.

LPF is a postural and respiratory training that can help in cases of diastasis, as it allows the muscles to return to the place, being an option for patients who have no recommendation or do not want to undergo surgery.

Although the technique does not need devices and accessories, it can be done at home, it is necessary to seek professional guidance so that it is correctly apprehended and to avoid execution errors.

Common questions

Need to lose weight to do abdominoplasty?

It depends . It is good to follow the advice of your trusted doctor in this regard. Abdominoplasty is not a treatment for weight reduction and does not replace diet and exercise.

The operation is indicated for people with excess skin and abdominal diastasis, but who in general are at a healthy weight.

If you plan to lose weight, it is recommended to do this before surgery, as losing too much after the operation can cause the abdomen tissue to become flabby again.

How long after surgery can I do an abdominal?

Light exercise can be done from 30 days after surgery, with care. However, for exercises that involve the abdominal muscles , it is recommended to wait 60 days .

The period of 2 months is also recommended so that you can do more intense exercises.

How long after surgery can I get pregnant?

Pregnancy should only be considered 1 year after surgery. As the procedure leaves the abdominal muscles with less capacity for movement, before that there may be problems for the uterus to grow with the baby.

However, even with the wait of more than a year, pregnancy can compromise the surgery and ruin its results.

A new abdominal diastasis may also appear, even after this time. Therefore, it is recommended to perform abdominoplasty only when you do not think you will want to have more children, whether you have several or none.

What is the difference between abdominoplasty and liposuction?

Liposuction and abdominoplasty are different procedures, but often performed together. While abdominoplasty removes the skin and fat by cutting it directly, liposuction uses a small tube to suck up adipose tissue.


Abdominoplasty is an aggressive surgery, recommended for those who have leftover skin after pregnancy or major weight loss. It is the treatment indicated for abdominal diastasis and can do well for self-esteem.

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