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Dr. Roberto Velázquez

Dra. Tamara Velázquez

Dra. Olga Montoya

 

Tummy Tuck or Abdominoplasty
As a consequence of pregnancy, or loosing a considerable amount of weight, men and women might develop a wrinkled, loose and hanging abdominal skin. A separation in the Rectus Abdominis Muscles might have occurred, or an umbilical or abdominal hernia has developed. If you want to eliminate these conditions, liposuction will not be enough to do the trick. You will need to have a Lipectomy with correction of the hernias commonly known also as a Tummy Tuck.

The Lipectomy will improve your abdominal silhouette by giving you a smoother, flatter stomach and waistline. The trade-off with a tummy tuck is a flatter, smoother abdominal wall, versus a conspicuous permanent scar. Depending on the amount of skin removed, the scar can be anything from a small incision to a long line running from one hipbone across the pubic area, above the hairline, an average of three inches scar from the hairline to bony hips. The extension or length depends on the excess more or less hanging skin. The results will be seen after one year. However, if you gain a lot of weight during or after your recovery, your abdominal wall may increase in size due to the expansion of the remaining fat cells.

BEFORE THE SURGERY EVERY PATIENT MUST:

Surgery Costa Rica will schedule an appointment with your doctor for you. During this visit you can ask him any questions you might have about the surgery. Have a complete medical check up, an electrocardiogram and laboratory blood and urine tests; including a complete whole blood count, partial tromboplastin time, prothrombin time, platelets, and HIV. Take antibiotics such as Augmentin 500mg, (one capsule three times a day with each meal) Cipro or Ceclor 500mg (one capsule twice a day with a full breakfast and dinner); two days before surgery, the day of the surgery, and seven more days after the surgery.

Inform doctor of your daily vitamin and medication intake. Notify doctor if you have developed a cold or the flu a week prior your surgery date. Please avoid: aspirin, more than 500mg of Vitamin E, ginkobiloba, ginseng, or any blood thinners two weeks prior your surgery. Also avoid alcohol intake, and passive or active smoking for one month before and one month after the surgery. Remember that nicotine and alcohol delays and might even complicate your healing processes.

THE DAY OF SURGERY:

You may rinse and brush your teeth, but do not eat or drink cofee or tea. Please do not wear make-up, remove your contact lenses or dentures before the surgery. Do not put any moisturizer on the areas where you are having your procedure.. Please remove your nail polish. The evening and the morning prior your surgery, clean the operative area with soap and water. Please do not bring any jewelry or valuables to the Hospital. Please wear a robe, housecoat or warm up suit that buttons or zips in the front and flat shoes after the surgery. No tight-fitting clothes. Someone must drive you home, to your Hotel, or to the Recovery Home you choose to stay at. *Postoperative instructions regarding activity, medications and office visits will be given following your surgery.

THE SURGERY:

This surgery takes approximately three to four hours. Add an additional half hour for preparation of local anesthesia and sedation. You will be given antibiotics through your left I.V. during surgery. Because this is considered mayor surgery, the doctor might have an assistant present.

Unlike liposuction, Abdominopalsty is an extensive procedure. An incision is made from under one hipbone, down under the low abdominal crease across the pubic area and up to the other hipbone. An incision may also be made around the umbilicus (belly button.)

The skin is freed up (separated) from the abdominal incision line clear up to above the rib cage area under the breasts. The abdominal fat pad and the skin are surgically removed, and if a hernia removal was necessary, which is very common, the surgeon tightens the loose underlying tissue suturing both muscles with the Rectus Abdominis. This procedure will diminish the size of the waistline to a certain degree after six to twelve weeks after surgery, but do not look for an hourglass waistline post –op. This will not happen.

The freed up skin is brought downward, and the surgeon cuts a new opening for the belly button that is the sutured around the navel. The excess skin and the fat are trimmed away to fit the abdominal incision, and two drains are inserted into the abdominal area for a week to drain local anesthesia and the serum. The abdominal incision is immediately closed with sutures that will be removed in 12 days. The tapes over the scar reinforce the sutured incision line. After two weeks, and for two months after surgery a firm elastic binder must be worn within the area, cleared up to the rib cage.

POST-SURGICAL INSTRUCTIONS:

Physical activity should be limited to movements that are comfortable. For the first two days you should stay reclined with bent knees, getting up only to go to the toilet. Stay close to home the first two weeks after surgery. Antibiotic Ointment or Vitamin E can be applied to the sutures daily until the stitch removal (approximately seven days). Use cotton tipped applicator to apply the ointment. Continue the antibiotics as instructed. If you develop diarrhea, discontinue the antibiotics and notify your doctor. Anesthetics, sleeping tablets and pain medication tend to produce constipation. High fiber diets and stool softeners will help reduce the constipation following the surgery. After showering, dry the incision areas very gently with a towel. Re-apply Antibiotic Ointment and a clean cotton dressing.

You might drive after pain medication is discontinued, and consult your doctor before you do. Please take a multivitamin and an iron supplement following surgery. Be sure to discuss your dosage with your doctor before taking it, because it depends on your blood loss. Do not exercise or do aerobics for six to eight weeks after surgery, and consult your doctor before you excercise

THE RECOVERY PERIOD:

You should expect to feel weak for several weeks after surgery. It usually takes at least eight full weeks to recover your normal energy. It is a common reaction, and it will pass as your regain your strength. Be prepared for some serious discomfort following this surgery. You will need to remain in a sitting position during the first two to four days. In other words, even when you lie down or stand up, your knees must remain bent at all times. If you straighten up, you may rip out your stitches! The first couple of weeks will be very uncomfortable, and you will need to take prescribed pain medication during this period, and perhaps even a little longer. Prepare yourself for some serious swelling and bruising for several weeks; and please wear your surgical girdle continuously, it will help control the swelling.

Another temporary problem that often develops is a sloughing of the skin in the area. You will recover from such condition after the fourth week after surgery. Actually, you will see some skin sloughing around most all-surgical incision lines, whether they have been pulled tight or not. It all goes away.

Do not get depressed if the abdominal scar looks thick and puffy. The scar will flatten out within 6 to 12 months. In some cases, patients opt for a little liposuction to reduce any remaining fullness around the healed incision. Sometimes an unacceptable scar will remain, and you will want to have a scar correction. The scar correction, is reasonably uncomplicated, and a knowledgeable and careful surgeon can accomplish major improvements with this procedure.

Maintain a healthy and balanced diet during the first few post-operatory weeks. You can usually return to work (depending on the extent and severity of the surgery) three to four weeks after the procedure.

PROBLEM SIGNS:

If there is any sign of infection, call your doctor as soon as possible. Raised, sore, and uneven swollen areas are symptoms that could indicate internal bleeding. Your doctor must be informed immediately.

Any build up of fluid in the abdominal area is a serious problem that your doctor needs to know about right away. The area will be swollen and you will actually be able to feel water inside. Your doctor will surgically drain the fluid out of the area soon as possible.

PLEASE CONSIDER:

In many cases, the Lipectomy procedure gives a better result in the patient’s silhouette when it is done in conjunction with Liposuction.

Thank you!



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