Tummy tuck: 12 questions about abdominoplasty clarified

Brazil is in the ranking of the countries that most perform plastic surgery in the world. Liposuction, breast augmentation or reduction, rhinoplasty (nose surgery) and abdominoplasty are examples of highly sought-after procedures.

Each surgery, of course, has very specific objectives and also possible risks, which may or may not be suitable for a person. Therefore, it is essential to only undergo plastic surgery if it is performed by a reliable professional who, in addition to having experience, can guide you correctly on all the details of the procedure, so that you can evaluate the pros and cons and make your decision on whether to do so or not.

Abdominoplasty in particular, a highly sought after procedure, is surgery that removes excess skin from the abdomen. Maieve Corralo, plastic surgeon, full member of the Brazilian Society of Plastic Surgery (SBCP), of the Brazilian Association of Craniomaxillofacial Surgery (ABCCMF) and of the American Society of Plastic Surgery (ASPS), director of the ELEV clinic (RJ), explains that abdominoplasty it is usually associated with liposuction, and leaves a scar that is “at the height of the bikini”. “It is one of the most sought after procedures in our office, about 30% of surgeries”, she comments.

André Barbosa, plastic surgeon and medical director at All Clinik, reinforces that abdominoplasty is the surgery performed to correct sagging and excess skin in the abdomen and, in most cases, also corrects the diastasis (detachment) of the rectus abdominis muscles.

Who is abdominoplasty suitable for?

As in the case of other plastic surgeries, it is very important to evaluate the indications for abdominoplasty, it is not enough to simply “want to do it”.

Maieve comments that this surgery is indicated for patients who have sagging skin in the abdomen, especially after pregnancy or weight loss.

Barbosa highlights as main indications: cases in which there is sagging and removal of the abdominal wall (straight muscles move away during pregnancy and, after the uterus involutes, the muscles do not return to the previous location) and when there is excess skin. “A typical example is the ‘apron abdomen’, where the sagging is so much that the skin folds over the abdomen”, he says.

That way, both men and women can undergo this surgery. On the other hand, abdominoplasty is not indicated when there is no excess skin and there is not enough sagging, as highlighted by Barbosa.

“Smokers should avoid the procedure while smoking, patients who wish to become pregnant should postpone the surgery until after pregnancy. Young patients with accumulation of abdominal fat without flaccidity should undergo liposuction and not abdominoplasty”, guides Maieve.

How is the surgery?

The specialist explains that, to perform an abdominoplasty, it is necessary to perform preoperative tests according to the clinical picture and fast for eight hours before surgery. “The procedure has a variable duration, on average three hours. It is necessary to use a modeling belt for 2 months postoperatively”, adds Maieve.

“In the surgery, we resect a large abdominal flap (usually from the cesarean section to the navel), then we perform a detachment of the skin that remained until the xiphoid process. Then, we correct the diastasis (detachment) of the rectus abdominis muscles by stitching the entire length. Then, we pull this skin until it covers the entire area of ​​the skin and fat segment that we dried at the beginning. We incise the skin at the level of the anterior navel, and stitch the edges of the umbilical scar, leaving this navel as discreet as possible, without the appearance of an operated navel”, explains André Barbosa.

How is the scar from the surgery?

Maieve explains that the scar is in the pubic region, occupying the entire anterior portion of the abdomen, inside the bikini mark, and another on the circumference of the navel.

Barbosa points out that, the scar being positioned inside the bikini, it is not apparent with swimwear and lingerie.

What are the risks of abdominoplasty?

Surgeon André explains that, as in any plastic surgery, when the proper consultation is carried out and all preoperative and surgical risk exams are requested, there is great safety in the procedure. “Even so, all surgery has risks inherent to any procedure, among them embolism is the most important, due to skin detachment. We routinely perform all embolism prophylaxis with our patients, such as the use of active pneumatic massage (devices that massage the legs throughout the surgery, and then in the apartment, until the patient gets up and walks. We also use specific medication in the postoperative period when the patient has more chances, such as, for example, who has varicose veins”, he explains.

How is the recovery from tummy tuck?

Barbosa points out that, around 15 days, it is necessary to rest longer. “Then, gradually, the patient is released. “It is still important not to stretch the abdomen too much, so as not to force the scar, in addition to wearing a brace for two to three months and not driving in the first month,” he says.

Maieve adds that the recovery period also requires the patient to sleep semi-sitting for a period of 10 to 15 days, as well as walking hunched over. “It is recommended to sleep with the belly up for 2 months and use a surgical brace during this period. You cannot lift weight for 3 months. It is recommended to avoid sun exposure while the scars are reddened,” she says.

12 questions about tummy tuck clarified

As with other surgeries, there are many doubts about abdominoplasty. Below, professionals clarify the main ones.

1. Is it true that this is one of the most painful surgeries? Because?

Pain is very relative. “The longer the surgery, the more painful stimulus. Surgeries such as liposuction are usually more painful because they take longer. Discomfort is reported due to plication of the rectus abdominis muscles, as well as respiratory restriction due to the tying of the muscles and the belt”, highlights Maieve.

Barbosa points out that, in fact, what bothers are the points given to correct the removal of the rectus abdominis muscles, in addition to the patient feeling the abdomen more trapped and stretched. “This feeling occurs more in the first week,” he says.

2. Does a person need to be at their ideal weight for the person to have a tummy tuck?

The closer to the ideal weight, the better the results. “It is not recommended to perform any plastic surgery in patients with a BMI (body mass index) greater than 30, as there is a greater probability of complications, such as thrombosis, infection and suture dehiscence”, explains Maieve.

“The ideal would be to be with the ideal weight, so that we can correct all that is left of skin and, thus, better model the patient’s contour. But I usually indicate surgery even if the person is a little above (not obese) in weight, because the surgery serves as a stimulus for them to continue the weight loss process”, adds the plastic surgeon Barbosa.

3. What are the actual results to be expected from abdominoplasty?

Maieve explains that the maximum recommended by the Brazilian Society of Plastic Surgery for removal in a surgery is 5% to 7% of the weight. “So patients who are more than this overweight cannot expect a ‘flat abdomen’. Surgery improves the contour, removes localized fat and excess skin, however, it should not be seen as a form of weight loss”, he highlights.

4. Is it true that a person who undergoes a tummy tuck “will never gain weight again”?

Lie. “Those who undergo abdominoplasty gain proportionally less weight in the abdomen than those who did not undergo this surgery, but the fat cells hypertrophy throughout the body if the patient gains weight”, explains the plastic surgeon.

5. Can a woman who has not yet had children, but plans to have children, resort to this surgery?

“It is recommended to wait for pregnancy to perform an abdominoplasty. It is not forbidden to get pregnant after two years of the procedure, but the patient will be more prone to the formation of stretch marks and may lose the result of the surgery”, explains Maieve.

6. Is it possible to have a tummy tuck right after delivery?

Barbosa points out that no. “The ideal is to wait for the body to return to normal. I often ask the patient to wait a year after giving birth,” she says.

7. Does the surgery get rid of stretch marks on the abdomen?

“Usually, from the belly button down, all the skin and stretch marks come out. Whatever is above that, and where it has not been resected, the stretch marks remain, but thinner, as they stretch along with the skin of the abdomen”, explains Barbosa.

Maieve points out that the stretch marks below the umbilical scar are removed with this surgery. “For stretch marks above the umbilical scar, the association of CO2 laser after surgery is recommended”, he says.

8. How is abdominoplasty with lipo performed? (What is the difference from a normal tummy tuck)

“Today, it is rare to do abdominoplasty without lipo. Liposuction improves the contour of the abdomen, leaving the silhouette more natural. Surgery without liposuction leaves the abdomen square, without curves”, explains Maieve.

9. Miniabdominoplasty x abdominoplasty: what’s the difference?

“Miniabdominoplasty is indicated for patients who have mild sagging in the lower abdomen, without sagging above the navel. In classic abdominoplasty, we remove all the skin below the navel; in the mini, the main part of the surgery is liposuction and muscle suturing, the skin is removed through the cesarean scar”, explains the plastic surgeon.

10. What are the main precautions in abdominoplasty so that the belly button is “as natural as possible”?

Maieve points out that the first step is to choose a plastic surgeon who is concerned with hiding the umbilical scar. “Then, be very careful with the bandages and move slowly so you don’t open any stitches,” he says.

11. Is it possible to associate abdominoplasty with the placement of silicone in the same surgery?

Maieve replies that it all depends on the patient’s clinical status. “If it’s all right, it’s possible,” she says.

12. How to maintain the result obtained with the surgery?

Having a routine of physical activity and a balanced diet is the recommendation to maintain the result of any plastic surgery, as highlighted by Maieve.

In addition, recalls Barbosa, it is necessary to follow all the guidelines given by the doctor.

It is worth highlighting the importance of only undergoing plastic surgery with a trusted plastic surgeon, registered by the Brazilian Society of Plastic Surgery. In addition, it is essential to have real expectations about the procedure.

Therefore, you should clear all your doubts about plastic surgery with your doctor and, also, be honest during the consultation, when you will be asked about your health, desires and lifestyle.