To remove excess skin on the abdomen and design a new navel, there is abdominoplasty.
An apron or tablecloth of skin and fat (because it hangs from the front of the abdomen) is the name given to that unpleasant mark that remains in this area in women who have suffered serious weight changes due to pregnancy or in those who have suffered from morbid obesity.
The dreaded apron, as well as scars from cesarean sections and other procedures, can be eliminated with abdominoplasty, “a surgical procedure that aims to achieve a more aesthetically pleasing abdomen by removing excess skin and fat,” says plastic surgeon Rafael Pérez.
Candidates for this surgery are assessed in three aspects of the abdomen during a medical consultation: “skin quality, in which the degree of flaccidity and the number of stretch marks can be identified; subcutaneous fat, of which the quantity and location can be determined; and the muscles of the abdominal wall that can be separated by weight changes or pregnancies,” adds the surgeon. After this assessment, it is determined whether the skin can be retracted with the latest available technologies, that is, Vaser-assisted lipoplasty or Microaire. Otherwise, the candidate would be an abdominoplasty, in which, in most cases, liposuction is also performed on the back to achieve a more harmonious overall shape.
With abdominoplasty, “first a percentage of fat is removed from the sides and back, with a laser device that helps to dilute it for later extraction,” explains Andrés Gómez, director of Plastic Surgery at the Colombian Clinic for Obesity and Metabolism. “Then an eye-shaped cut is made in the area to be trimmed, the excess is removed and a new navel is designed. This is used to tie the rectus abdominis muscles, as they say colloquially, and achieve a greater tone in the abdominal wall.”
In this procedure, the navel is also reconstructed, but not in all cases. “It basically depends on the amount of skin that needs to be removed. In people who do not require such a large resection, the skin and fat flap is raised, the muscles are sutured, the excess dermofat is removed and the navel is repositioned,” explains Pérez. “In those who require a larger resection, the navel is remade.”
According to Gomez, in some women (or men too) the flap of skin is not that big, so the excess skin can be removed from the navel down, which is called a minilipectomy. If it is required to be more stretched, then it is done above the navel, which means that the outer part of it is also cut and a new one needs to be designed.
To remodel the navel
There is no scale of measurements that determines whether a woman requires a cosmetic abdominoplasty, however the specialist must assess the real needs of each patient. “There are those who do not have enough skin but do have a lot of flaccidity, so a maneuver is performed in which, almost without destroying the navel, a portion of skin is removed to leave the abdomen smoother or flatter. And in cases of excess skin due to morbid obesity, the apron or abundant fatty tissue can be trimmed without removing fat,” emphasizes Gómez.
This surgery can be performed under general or regional anesthesia (local anesthesia is not recommended) and lasts, on average, four hours. It is also recommended for those who have scars on the abdomen resulting from other surgical interventions other than a cesarean section or to remove part of the stretch marks left by pregnancies.
Like most invasive procedures, this requires an optimal state of health and also depends on the clinical parameters being normal and adequate to be a suitable candidate for the procedure. It is not recommended “in patients with diabetes and uncontrolled hypertension, coagulation disorders or lupus,” says plastic surgeon Mauricio Linares. “If you have hernias, they should be corrected first in surgery.”
The scar left by the abdominoplasty occupies the lower part of the abdomen and varies in length depending on the amount of skin that needs to be removed. It can be hidden under underwear or a bathing suit. And after the procedure, some pain and discomfort occurs during the first week after surgery. During this period, medical management is crucial. Post-surgical therapies reduce recovery time, which can last about a month.
To maintain the results, postoperative care must be followed, which consists of drainage and specialized massages, thermotherapy, ultrasound and other technologies that the surgeon considers. Likewise, a girdle must be worn for a reasonable period of time. All body contouring surgeries must be supported by a balanced diet and exercise, which is resumed when the specialist deems it prudent to prevent the wound from opening.
Abdominoplasty, which costs an average of 8 million pesos, is a different procedure from abdominal contouring. “In the first, the skin is cut and in the other, the abdominal muscles are defined and there are no cuts,” says Gómez. Abdominal contouring is done using “a liposuction technique with Vaser and microair, and it is what is called 3D Lipo, which highlights the abdominal muscles with a very athletic result,” explains plastic surgeon Rafael Pérez.
Now, can a woman who undergoes abdominoplasty undergo abdominal marking? According to Pérez, yes, but it depends on each case. “To ensure the vitality of the flap, abdominal marking is postponed for at least 6 months,” he concludes.
Advice: Andrés Gómez, Director of Plastic Surgery at the Colombian Clinic of Obesity and Metabolism, Tel. (1) 622 4419, www.clinicacolombianaobesidad.com, Bogotá. Online consultations at [email protected]. Rafael Pérez Franco, Plastic, Reconstructive and Aesthetic Surgery, www.drrafaelperez.com, Tels: 218 6647 – 300 618 8765/56. Mauricio Linares Garzón, plastic surgeon, www.mauriciolinares.com.
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