Abdominoplasty or lipectomy
The abdomen sometimes presents during life a significant variation in volume. Pregnancy in women, excessive weight gain or major weight loss often leave significant sequelae. These sequelae particularly affect the skin, which loses its elasticity and may show significant stretch marks. The abdominal wall can also be permanently damaged by multiple pregnancies, especially if there are twin pregnancies. This procedure only removes the stretch marks present on the skin that will be resected. It is particularly suitable for people who have loose abdominal skin that does not improve with exercise or diet.
The intervention consists in resecting the skin under the umbilicus in order to restore tension to the remaining skin. It can also be performed at the same time a plasty on the distended muscle wall or an aspiration of excess abdominal fat. The horizontal scar on the lower part of the abdomen can be longer or shorter depending on the amount of excess skin to be removed. At most this scar extends between the two hips. It is sometimes necessary to make a vertical scar under the umbilicus. The procedure is usually performed under general anesthesia. The suture threads are generally absorbable threads hidden in the scar. At the end of the intervention, a drainage system is put in place to collect the fluids and prevent the formation of a collection.
The initial consultation
The initial consultation allows you to jointly reflect on the different types of treatment according to your wishes and the surgical possibilities. The amount of excess fat, scars, the quality of your abdominal strap can modify the surgical procedure. You will also be asked to evaluate a possible tobacco intoxication which can in certain cases contraindicate the intervention. The consultation will also be an opportunity to check whether your intervention can be covered by your health insurance. The intervention may be postponed due to excess weight, and will only be possible after a weight loss diet.
Lipectomy is a heavy intervention but the consequences are generally simple. Any surgical procedure, even carried out with competence in conditions of maximum security, carries a risk of complication. There are risks of hematoma, infection or reaction to anesthesia. You should know that the anesthetic techniques, the products used and the monitoring methods have made immense progress. They offer optimal safety, especially when the intervention is performed outside of the emergency room and on a healthy person, but they can nevertheless carry the risk of serious complications.
The most feared complication is the migration into the bloodstream of a clot from a vein in the lower limb (phlebitis) to the lungs (pulmonary embolism). This complication can, when it is massive, lead to death. Wearing stockings with varicose veins, getting up early and anti-coagulant treatment can prevent this risk. Exceptionally, skin necrosis may appear around the scar, which will result in aesthetic sequelae. These necroses are very often secondary to persistent tobacco intoxication. A smoking cessation is imperative at least two months before the intervention.
A decrease in abdominal sensitivity may be noted during the first months. A return of sensitivity is generally observed between the 6th and 18th month. The evolution of scars is unpredictable and can be unfavorable with the occurrence of pigmentations, hypertrophy (red and inflammatory scar) or even keloids (hard and purplish bulge). These scarring complications can compromise the aesthetic appearance of the final result. If an early complication appears, close monitoring is necessary and compliance with the instructions imperative.
Before the intervention
The anesthesiologist will be consulted less than a month before the operation. Smoking must be completely stopped at least one month before the procedure. No medicine containing aspirin should be taken in the 10 days preceding the intervention. It is imperative to remain on an empty stomach (do not eat or drink anything) 6 hours before the intervention. Just before the intervention and the two previous days an antiseptic soap will be used for the shower.
After the procedure
The postoperative course is generally painless. Hospitalization is two to five days. The first dressing is usually done on the day of discharge. The drain will be removed at this time. The sutures are generally absorbable hidden in the scar and do not need to be removed. A compression sheath will be worn the month following the operation. A work stoppage lasting 8 to 15 days is generally necessary.
A 3-month suspension from all sporting activity is recommended. It is important not to expose the scar to the sun for at least 6 months and to protect it with a total screen after this period. The dark scars at first will gradually lighten and take on their final appearance after 24 months. They are generally barely or not visible.
This text provides basic information on the principles and procedure of a lipectomy. A more detailed information sheet will be given to you during your consultation. A good understanding of the course of the intervention and the expected result is essential before considering this intervention. It must be emphasized that the purpose of this surgery is to bring about an improvement and not to obtain perfection. If your wishes are realistic, the result will satisfy you.