ABDOMINOPLASTY

Reconstruction of the abdominal wall is one the most gratifying aesthetic surgery.

The woman, after giving birth, sometimes finds that the abdominal wall appears stretched and flaccid.

This stretching causes a globular appearance of the abdomen and sometimes it comes along with a fold made of fat, causing discomfort and it is not solved with dieting.

The correct treatment consists of performing an anatomical assessment of the structures involved, and think about 3 levels:

• First of all, skin must be assessed deciding if it is exceeding or not, if striation is present and if it is stretched.
• In second place, we have to assess the fat tissue deciding if there is an excess of fat and if it is asymmetrically distributed like in upper abdomen, flanks, waist …
• In third place, the muscle wall must be assessed, if the muscles are together, if proper muscle tone is present or an hourglass shape abdomen is present or if the muscles are stretched and separated resulting in rectus diastasis.

To plan the surgery we have to take in account two major points; first of all we have to design the incisions to remove the leftover skin; and in second place we have to hide the scar below the underwear and the swimsuit, and in order to accomplish the goal we have to make an “U” shape incision avoiding lateral prolongation towards the groin.

In older woman, we have to assess if the mount of venus is horizontalized in order to verticalize and rejuvenate it after surgery and tightening is performed; and also if it is very prominent liposuction can be performed as well.

It is important to have the abdomen empty of gases, for that reason, it is important to provide low gas producing meals and also to give medication to eliminate them, during preoperative period.

Three planes reconstruction is performed during the surgery: skin surgery, fat remodeling assisted by liposuction in some cases, and in third place plication of rectus abdominis muscle and muscular reconstruction.

Afterwards, the incision is closed using subcuticular running suture to avoid zip-shaped marks along the scar. We advise the patient to rest (not completely) for two weeks before beginning more active physical exercises to permit better muscular wall remodeling and healing.

Applying all these measures, satisfactory aesthetic outcomes are obtained.