Abdominoplasty is used to remove excess skin from the abdominal region and to tighten the rectus abdominis muscle. Excess skin frequently occurs in women after childbirth, especially frequent childbirth, when the skin of the abdomen is exposed to the enormous pressure of the growing foetus and its elasticity is reduced.

Another cause of excess skin is obesity. Adipose cells are present not only in the subcutaneous area but also inside the abdominal cavity. In this way, the skin ruptures and small scars are formed. In the event of a high weight loss, the skin remains loose.

These problems can be eliminated through plastic surgery. The extent thereof should be determined by the plastic surgeon individually based on the agreement with the patient.

The surgery is performed under general anaesthesia and takes approximately 2 to 3 hours. The incision is usually made in the lower abdomen region to the sides so that the scar can be concealed by underwear. If the incision is elsewhere and subsequent scarring can be expected, the patient will be informed during the consultation with the plastic surgeon.

The skin with the subcutaneous region are separated from the underlying tissue and pulled downwards and excess skin is removed. In some cases, liposuction should also be performed to achieve a better result. The wound is sutured and covered with a bandage. If the rectus abdominis muscle is loose, it should be sutured in the middle line. After the surgery, the client should wear an elastic binder belt which protects the area and facilitates healing.

After the surgery, the patient must walk several steps several times daily every day to prevent embolism. Otherwise, he/she will spend the first two days on the bed. The length of time the patients will remain under hospital care will be determined by the doctor. The typical stay is two days. Additional outpatient check-ups will be determined by the doctor upon discharge from the hospital. The sutures are usually removed on the 10th to 14th day after surgery.

The patient is advised to rest for six weeks and should wear the elastic binder all the time. The post-operative scar will gradually fade over time, and the quality of the scars depends on the patient’s individual healing ability.

Abdominoplasty can be divided according to the extent of the procedure as follows:

• Minor abdominoplasty – the scar is present only in the lower part of the hypogastric region. The skin is removed in the hypogastric region and in the lower abdomen (from the umbilicus downwards).  In minor abdominoplasty, the upper part of the abdomen is not tightened, and the umbilicus need not be moved to a new position on the skin surface.
• Minor abdominoplasty with liposuction – during the removal of excess skin in the lower part of the abdomen, fat aspiration is performed from the given region.
• Major abdominoplasty – the scar is present in the lower part of the hypogastric region – usually the scar is longer than in minor abdominoplasty. In some cases, the scar should also be led vertically upwards towards the belly button. In major abdominoplasty, the skin is detached from the lower and upper part of the abdomen and excess skin is removed. The belly button must be moved to the surface across the newly tightened skin.
• Major abdominoplasty with liposuction – in most cases of major abdominoplasty, excess fat in the abdominal area is aspirated in addition to the removal of excess skin. Liposuction of the sides is also recommended in certain cases for a better final effect.

Summary:

• Duration of the procedure: 2 to 3 hours
• Type of anaesthesia: General
• Stay at the clinic: 2 days
• Recommended stay in Prague: At least 6 days after the surgery
• Suture removal: 10 to 12 days after the surgery or absorbable sutures
• Final effect: 2 to 3 months after the operation
• Additional information: During the first six weeks after the surgery, the client should not lift heavy objects, exercise or expose himself/herself to the sun, and should strictly observe hygiene routines. In case of any unusual reactions, seek medical attention or contact Asklepion.

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