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Tummy Tuck Surgery - Lipectomy

Information in spanish Faqs - Postoperative Care

A firm and flat abdomen is a characteristic of beauty. However, this part of the body between the thorax and the pelvis, is frequently affected by different factors such as hormonal imbalance, pregnancy, unhealthy diet, or weight gain. Muscle elasticity and tone may decrease due to frequent fluctuations in weight. Restore these characteristics of the abdomen can become a frustrated feeling. For these patients who have tried in vain to improve their abdominal muscles, the tummy tuck may be the answer.

What is the tummy tuck?


Abdominoplasty or tummy tuck is a major surgical procedure aimed to change the shape of the lower and middle abdomen, trunk and waist, and to tense the muscles and fascia of the abdominal wall. Abdominoplasty is usually recommended to patients with sagging abdominal skin.

The candidate for the tummy tuck

Most patients seeking abdominoplasty have previously tried diet and exercise to reduce the abdomen size. Obese patients who have had a massive weight loss with a subsequent excess skin may require a tummy tuck to remove the redundant tissue. In these patients the sagging skin can also be located in face, neck, arms, etc.

These cases may be treated with abdominoplasty in combination with other procedures to achieve better results. You may discuss this possibility with your doctor.

Abdominoplasty is performed under general anesthesia with intravenous sedation and inhalation anesthesia. You will sleep through the entire operation, feeling no pain and remaining absolutely relaxed. The section about Anesthesia provides complete information on this medical practice along with recommendations and instructions.

How long does abdominoplasty take to perform?

Depending on the severity or complexity of the case, abdominoplasty may take approximately 2-3 hours to complete, but it may take longer if other procedures are also being performed at the same time.

Surgery time for abdominoplasty depends on the technique used, whether it is performed along with mastectomy or post-mastectomy. According to your case, your doctor will inform you approximate time of surgery..

Will I require hospitalization?

Because abdominoplasty surgery is a complex surgical procedure, a short hospital stay may be required. Depending on the complexity of the procedure, your surgeon might recommend a stay at the surgical center to observe your recovery progress. In this way, Dr. Nieto can monitor your recovery and provide after-care.

What are the most common abdominoplasty techniques performed?

The condition of the abdominal area determines which technique to perform. There are different types of abdominoplasty procedures which vary according to the incision shapes and placement. The different abdominoplasty techniques can be combined to treat the skin and subcutaneous tissue laxity, presence of scars, and location of the fat deposits. The most commonly performed techniques include..


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What can I expect after surgery?

Immediately after the procedure, the patient is moved the recovery area. You will find you have a surgical drainage which allows fluids to release. At home, you will be asked to lie on your back with your knees bent in order to reduce tension on the abdominal suture. You should not wake up during the first night after surgery.

What care should I take following abdominoplasty?

Part of the success of surgery depends on the postoperative care. It is very important to follow the surgeon´s recommendations to reach the desired outcome. Dr. Nieto closely observes her patient´s convalescence and healing. Please do not hesitate to contact her if you have questions or concerns. Written instructions will be given for your postoperative care to you and your family.

Patients who may seek a tummy tuck include:

Obese patients

Of course, as with any surgical procedure, there is risk of complication. However, obesity increases risk during surgery. The surgeon should evaluate risks in the obese patient. But the patient must understand that abdominoplasty is a treatment aimed to remove the excess of abdominal skin, not to lose weight. Because obesity is a condition that affects the entire body, it should be understood that abdominoplasty is aimed only to treat the abdomen. Your physician may guide you in a preoperative adequate treatment to lose weight. Once the patient is able to maintain a healthy weight that ensures safe conditions in the operating room, he/she might consider undergoing abdominoplasty.

Sudden weight loss patients

Those patients who have had a massive weight loss as a result of diets, or surgical procedures like the gastric bypass, frequently present excess of abdominal skin. What was once a prominent abdomen, may turn into a hanging bag of skin. In this case, the physician should evaluate the physical condition of the patient before undergoing surgery. The goal is to remove as much redundant skin and subcutaneous tissue as possible, in a safe manner.

Patients with abdominal scars

In patients with abdominal scars, surgery is aimed to correct the affected area. There are different surgical techniques that may improve the appearance of scars.

Women with loose skin after pregnancy

During pregnancy the abdominal wall suffer different tension and retraction forces, which deteriorate the elasticity and tone of the abdominal skin. Many women find they have a saggy and lax abdomen, plenty of stretch marks (striae) after pregnancy.

Liposuction and abdominoplasty
Your doctor may recommend performing abdominoplasty in combination with liposuction. As we age pubis tends to lose its shape. Liposuction can be an effective way to improve this area.


Preoperative Evaluation

During your preoperative evaluation you must speak candidly about your expectations from the procedure. You should be able to express why you want undergoing abdominoplasty and what you would like to accomplish with the procedure. Your physician will listen carefully to your requirements, and will discuss the possibilities according to your physical characteristics. The surgeon will ask for your medical history and will perform a thorough physical examination, evaluating the following factors: Skin quality.
Abdominal wall defects.
Excess of adipose tissue.
Location of the belly button.
Situación del ombligo.
If the excess of skin is focused on the abdomen or includes other areas of the body.
Presence of scars (cesarean scars).
Position of the scar.
Presence of stretch marks (striae).


The surgeon will evaluate the anatomic characteristics of the patient, which are different for men and women, as well as the fat deposits. Men have thicker skin than women. Women skin tends to develop laxity and stretch marks (striae). In the same manner, the physician should evaluate the possibility of performing abdominoplasty in conjunction with other procedures, in order to achieve better results. Abdominoplasty can be combined with liposuction of the abdomen to contour this area.

The physical examination should include anatomic measurements with the patient in both upright and supine position. The presence of adipose tissue in the abdomen, fat deposits in the inframammary region, lower thorax, and contour of the abdomen, waist, flanks and fat deposits should be evaluated. The physician will establish according to her criteria the fat deposits location. The treatment is viable for subcutaneous fat deposits. When the adipose tissue is located within the organs of the abdominal area, -intraperitoneal-, the treatment is not recommended. Dr. Nieto may take photos of different angles of your body to analyze them through the computer, document the procedure and evaluate the postoperative results.

Your whole body will be evaluated, torso, hips, breasts, and knees. It would be wrong to focus only on the abdomen area. Abdominoplasty preoperative evaluation should consider the entire body in order to achieve a well-proportioned result. Therefore, your physician may recommend treatments for other areas of your body.

Abdominoplasty considerations

Abdominoplasty is a major procedure that involves the portion of the body between the chest and the pelvis. This procedure may require a brief hospital stay and a more extended convalescence. The complexity of your procedure , as well as any health issues specific to your case (your age, pregnancy, etc.), will be consider when determining the type of abdominoplasty technique for your surgery. The patient must understand that abdominoplasty involves the presence of a scar. Your surgeon will make every effort to make your scar as inconspicuous as possible. However, you should understand that abdominoplasty will leave a significant scar. Abdominoplasty may improve significantly the appearance of your abdomen. In the same manner, the appearance of stretch marks (striae) and cellulite may be improved through the procedure. However, these conditions may persist after abdominoplasty. Abdominoplasty is not a procedure to treat obesity. The appendectomy scar does not represent a problem for abdominoplasty. Abdominoplasty involves separation of the abdominal skin and fat tissue from the underlying fascia and repair of the weakened abdominal muscle fascia. This maneuver will help to improve the skin tone. The scars resulting from abdominoplasty may take some months to a year to become softer and more natural in colour and texture. As time passes, you may begin to notice an improvement to your abdominal shape. Abdominoplasty produces excellent and long-lasting results.


The procedure - What are the most common abdominoplasty techniques performed?

The condition of the abdominal area determines which technique to perform. There are different types of abdominoplasty procedures which vary according to the incision shapes and placement. The different abdominoplasty techniques can be combined to treat the skin and subcutaneous tissue laxity, presence of scars, and location of the fat deposits. The most commonly performed techniques include:


Minimal access abdominoplasty

It is recommended for patients with mild excess skin, and subcutaneous tissue, and fat deposits that can be treated with liposuction. Traditional liposuction or ultrasound liposuction can be used. Incisions of about 5-10 cm long are made on the inferior abdominal crease. Once the surgery has been performed, the site is wrapped in bandages which will be changed to an elastic compressive garment that the patient should wear for 2-6 weeks.

Mini-abdominoplasty

Mini-abdominoplasty is reserved for patients with mild excess skin, moderate laxity, and flat superior abdomen. This type of procedure is not recommended for those patients with moderate supraumbilical laxity. Liposuction may be performed depending on the amount of fat accumulation. The length of the incision depends largely on the amount of skin to be removed. Unlike other abdominoplasty techniques, in the mini-abdominoplasty there is no umbilical transposition. Through the incision the abdominal fascia is tightened at the midline above and below the umbilicus depending on the degree of laxity.

The excess skin is excised and drainage tubes are placed. This technique may vary depending on the patient´s needs. Usually, hospitalization is not required and shorter recovery time is needed.

Endoscopic assisted abdominoplasty

The endoscopic assisted abdominoplasty is a procedure indicated in patients with mild skin laxity and good elasticity of the skin. The incisions are hidden in or around the umbilicus and on the pubic bone, in such a way that incisions are inconspicuous. Through these tiny incisions, repair of the muscles and abdominal fascia is made. This maneuver restores skin tonicity. The surgeon may determine if liposuction is required. Once the desired reduction has been performed, incisions are closed and compressive bandages are placed. This technique may vary depending on the patient´s needs.

Extended abdominoplasty

Extended abdominoplasty is addressed to patients following large weight loss. Frequently these patients present skin excesses in abdomen, hips and back. Liposuction may be used to improve the results. During surgery, the inferior incisions are made on the pubic hair line to the inguinal fold.

The excess skin and fat tissue are excised and the sutures are closed. This technique may vary depending on the patient´s needs.

Classic transverse abdominoplasty

The transverse abdominoplasty removes excess skin and fat accumulations located between the umbilical and the pubis. This type of abdominoplasty characterized by two incisions: a transverse incision at the pubic hair line up to the inguinal folds, and a second vertical midline incision with umbilical transposition. The umbilical scar around the navel, usually remains hidden in the natural depression of this part of the abdomen. When the patient presents excess skin around the umbilical region, the periumbilical area is defatted and umbilical transposition (very common) or de-epithelization is performed.

The plication of the abdominal muscles is made through the incision of the abdominoplasty by approaching the muscles to the abdominal wall. In this way the abdomen acquires a flat appearance. The surgeon will select the most convenient technique according to the condition of the abdominal tissues. The umbilicus transposition is a very frequent practice in the transverse abdominoplasty.

This means that the skin of the umbilicus region becomes the skin of the pubic area.

The surgeon will determine if the old umbilicus is fixed to its new place or if a different one will be made. The upper transverse supraumbilical abdominoplasty is a different way of approaching, in which the incision line is extended to the level of the inframammary crease. This technique may vary depending on the patient´s needs.


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Abdominoplasty Preparation

It is considered you are in surgery from the moment you arrive to the surgical area until you have sufficiently recovered from anesthesia. Before surgery, your surgeon, anesthesiologist and the nursing staff will meet you in the pre-operative area, to discuss your medical condition and answer your questions.

The anesthesia


What kind of anesthesia is used for abdominoplasty?

Abdominoplasty is performed under general anesthesia with intravenous sedation and inhalation anesthesia. You will sleep through the entire operation, feeling no pain and remaining absolutely relaxed. The section about Anesthesia provides complete information on this medical practice along with recommendations and instructions.

How long does abdominoplasty take to perform?

Depending on the severity or complexity of the case, abdominoplasty may take approximately 2-3 hours to complete, but it may take longer if other procedures are also being performed at the same time.

Surgery time for abdominoplasty depends on the technique used, whether it is performed along with mastectomy or post-mastectomy. According to your case, your doctor will inform you approximate time of surgery.

Will I require hospitalization?
Because abdominoplasty surgery is a complex surgical procedure, a short hospital stay may be required. Depending on the complexity of the procedure, your surgeon might recommend a stay at the surgical center to observe your recovery progress. In this way, Dr. Nieto can monitor your recovery and provide after-care.

Preparation for surgery
* For abdominoplasty your surgeon may recommend to have a shower or bath with an antiseptic substance 2 days before the surgery.

* Preoperative markings are done with the patient standing upright in front of a mirror and also with the patient lying down. A pinch test is performed to determine the amount of excess skin to be removed. Asymmetries and scars will be considered. Patient preparation includes treating the surgical site before surgery, using appropriate antiseptic agents for skin preparation.

* In the operating room the intravenous therapy or IV will be initiated. The IV is the giving of liquid substances directly into a vein. Through a needle you will receive saline solution, anesthesia, and other medications you may need during surgery.


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TUMMY TUCK


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Women, Tummy Tuck Surgery Surgery
seemed very good, except for the particular drain but everything went as intended.


Women, Tummy Tuck Surgery
I'm happy with the service, the results have far exceeded expectations.