Three factors are involved in the choice of the intervention: fat, skin and muscles.
- If there is an excess of FAT with good skin tone and muscles of good quality, isolated liposuction can be performed (generally combined with a diet).
- If, in addition to the fat, the SKIN is distended (or flabby) and the MUSCLES relaxed, in addition to the liposuction an abdominal lipectomy (tummy tuck) will be required.
Liposuction is for female patients with an excess of localised fat (not for obese patients) with FIRM, TONED SKIN (see the section on liposuction).
ABDOMINAL LIPECTOMY OR ABDOMINOPLASTY (lifting the abdomen or abdominal dermolipectomy)
Abdominal lipectomy is for patients who, with or without excess fat, have LOOSE SKIN (from flabby skin to a stomach apron) and sometimes flabby muscles.
In addition to liposuction (and dieting) it will be necessary to re-stretch the skin (and sometimes the muscles).
In the case of a large apron (covering the pubis), Social Security may eventually (after first visiting the Consultant Doctor) cover part of the costs of the procedure.
The abdominoplasty operation
The operation lasts between one and three hours.
Abdominoplasty generally begins with liposuction of the abdominal region and the thighs. An incision is then made from one iliac crest to the other, in a line below the pubis (at the same level as a caesarian section but the incision is longer) as well as another incision from the umbilicus (belly button) which will make it possible to detach the flabby skin and re-stretch it while removing the excess. If necessary, the detaching of the skin can be used to re-tighten the abdominal muscles if they have become separated (hernia or mere diastasis). In some (very rare) cases, it may be necessary to add a vertical scar between the umbilicus and the pubis.
Drains will be inserted to prevent hæmatoma and will be removed during the next few days (as soon as they are free of liquid).
Sutures are made with re-absorbable thread so there are no stitches to remove.
After the operation
The dressing will be changed every two to four days for a fortnight at the clinic then at the doctor’s office.
Hospitalisation lasts from two to five days (rarely longer) and post-operative rest is required lasting from a fortnight to one month.
Precautions will be taken to prevent phlebitis and thrombosis and these must be observed during and after the operation (compression stockings, intraoperative pressotherapy, doppler scan, early ambulation, anti-thrombosis treatment).
A compression corset, put in place during the intervention, must be worn for one to three months.
The scar, which is always long, will take at least a year to become less visible. It is important to do everything to ensure it is as unobtrusive as possible (stopping smoking, massages, compression with silicone gel). The scar, which is usually thin, may sometimes be wider depending on skin quality and tobacco consumption (smoking must be STOPPED COMPLETELY at least one month before and after the operation).
Sequels and any complications from abdominoplasty will be explained to you by Dr COURBIER during the consultation and in the literature supplied to you.