Summary

Abdomen lift, abdominoplasty, or tummy tuck is a cosmetic surgery that tightens and reshapes the abdominal area to an aesthetically pleasing, slimmer overall appearance. A flatter, firmer abdomen can dramatically improve the way clothing fits and looks, helping you feel more confident and comfortable in your body. During the abdomen lift, I will tighten abdominal muscles and remove sagging skin to treat protruding abdomen. The tummy tuck is a standard procedure for men and women, particularly those whose bodies have undergone dramatic weight loss or pregnancy changes. Abdomen lift improves stretch marks below the navel (belly button). There are many variations both to the design of the incisions and the technique itself. In some instances, it may be possible to avoid an incision around the navel. When the amount of loose skin is minimal, and the excess fat deposits are found below the navel, a short

The patient is brought into the operating room, and anesthesia is induced. If the outer thigh and calf are part of the plan for liposuction, then prone positioning is warranted. The patient may be intubated on the stretcher and rotated into the prone position onto the operating room table. A Foley catheter may be placed before turning the patient if 4 liters or higher aspirations are planned. Gel rolls are used to avoid pressure: a small one may be placed across the axillary regions and a larger one across the lumbar area. The arms are placed at right angles to the body, and the elbows are also placed at right angles. All pressure-bearing surfaces are padded with pillows or egg crates. An upper body-warming blanket is placed to avoid hypothermia. I may use lower extremity spreader bars. Single stab incisions are made to address the areas of concern. For the outer thigh, incisions may be formed laterally above and below the interest area and in the intergluteal fold. This incision may also be used for posterior access to the inner thigh. Incisions may also be made around the knee and calf region.

Tumescent solution is infused into the lower extremity until it is turgid. After the adequate time is given for the hemostatic effect of the epinephrine, a 3.0- to 3.7-mm cannula is used to perform liposuction. It is crucial to record the fluid put into the tissues and the fluid aspirated from the tissues to ensure that symmetrical treatment is taking place. Prof Moawad applies different liposuction techniques; syringe liposuction, PAL Power-assisted, and traditional suction-assisted lipectomy are the primary methods used. When the desired contour is achieved, liposuction is complete. The patient is then turned supine and draped in a sterile fashion. Areas that had liposuction posteriorly may be smoothed anteriorly. The patient may be placed into a compression girdle under the garment. The girdle should provide coverage distal to the areas that underwent liposuction.

What can I expect immediately following High DefinitionThigh Liposuction?

After surgery, most patients can walk out of the office without assistance. Recovery time will vary greatly depending on the individual, how extensive the procedure is, and the technique used. Generally, after the process, you will probably have some fluid drainage from the incisions and expect some bruising (bruising typically goes away in 3 weeks; swelling can last for three months depending on the amount of work done). Though tumescent liposuction is more refined, you may still experience pain, burning, swelling, bruises, and temporary numbness. With the tumescent technique, post-operative- discomfort is significantly reduced since the local anesthesia remains in the treated tissue, usually causing numbness for sixteen hours or more after surgery. If required, Extra Strength Tylenol or Tylenol with Codeine is enough to control relatively minor discomfort that may occur following your surgery. Immediately after surgery, you are transferred to our luxurious recovery room, where you are fitted with a support garment that you must continuously wear for two to four weeks. You may remove the garment to shower the day after surgery. You may feel stiff and sore for the first few days after your procedure, but you are encouraged to move about, even a little, since this will aid in blood circulation. You should avoid strenuous activity for about three weeks. Patients may return to work in one week, although many return earlier. You are advised not to take aspirin or certain anti-inflammatory drugs and not to smoke.

Dressings will be removed in several days, so Prof. Moawad and his staff can examine treated areas. You will be scheduled for follow-up visits to monitor your progress and receive an ultrasound massage, lymphatic drainage the day following your surgery, then every other day for the first week. Subsequent follow-up visits are scheduled at one month, then again at 3- and 6-months following surgery. Suppose you have any unusual symptoms between visits, for example, heavy bleeding or a sudden increase in pain or any questions about what you can and cannot do. In that case, you are advised to call MSI immediately.

Occasionally the skin may have an uneven or slightly rippled effect. The surface can sometimes be irregular or asymmetric, or pigmentation changes may occur, especially in older patients with dark skin. Scars from liposuction are usually tiny and strategically placed.  Overweight patients who have localized areas of fat removed must be willing to accept a higher chance of contour irregularities and less than ideal skin re-draping in exchange for improving the way they look in clothing.

At MSI, we are proud to be the first center in Egypt that offers post-liposuction unique skin tightening programs that involve vacuum, soft laser, and light therapy using LED  speed recovery time and ensure tight skin.  Further tightening effect can be achieved only at MSI using the FDA-approved monopolar radiofrequency device for non-surgical skin lifts.

Post-operative- instructions

• IF YOU EXPERIENCE EXCESSIVE PAIN OR BLEEDING, FULLNESS OR SPREADING REDNESS IN TREATMENT AREAS, OR FEVER, PLEASE CALL US IMMEDIATELY
• DRIVING: A family member or friend must drive you home from your surgery (it is best to have them stay and assist you for the first 24–48 h). Please do not drive if you are taking the prescription pain medication tramadol.
• COMPRESSION GARMENTS: If you had liposculpture performed on your knees, thighs, hips, arms, or abdomen, I put on a particular elastic-type garment at the end of surgery to provide comfort and support while helping your skin conform to your new body contour. The day following surgery, you may remove the garment once a day for laundering, sponge bathing, and bandage changing (if present). Continue wearing the garment 24 h a day for the first two weeks, followed by 12 h a day (remove at night) for the subsequent two weeks.
• BATHING OR SHOWERING: Sponge baths only for the first 72 h when removing the compression garment. After 72 h, you may take a shower or bath when the garment has been temporarily removed. Avoid Whirl Pools and hot tubs for at least one week (until the incision sites have healed).
• TREATMENT SITES: Please keep your dressings as clean and dry as possible, changing every day if wet to help prevent infection. Do not apply heat or ice to the surgical areas.
• You should expect significant drainage (oozing) of blood-tinged anesthetic solution at the incision sites due to fluids injected during your procedure. Although the fluid may appear red, it is primarily an anesthetic solution and saline and only 1% blood. In general, the more drainage there is, the less bruising and swelling there will be. Many patients have found it helpful to use a shower curtain or other protective covering on their mattress for the first few days after their liposculpture procedure. When your incisions stop draining, please clean with tap water and apply topical antibiotic Fucidin ointment to the incisions. Itching, pulling, pinching, hardness, tightness, and/or numbness sensations are normal. All should subside within 24 h to 1 week but sometimes can last for months. This is part of the healing process, and your patience is appreciated.
• ACTIVITY: Rest for the first 12 h. You are experiencing more than mild swelling, and discomfort may indicate that you are overdoing it. It is normal to experience light-headedness when rising or removing/changing your compression garments. Please have someone help you with this for the early few days after surgery. Take it easy for the first week, resuming regular activity as tolerated. Avoid strenuous activities, lifting over 10 Ibis, or aerobic exercise for 2–3 weeks.
• Protect incisions and any bruised areas from the sun until wholly healed; use SPF30 or higher for six months. Avoid tanning until bruising has faded, which generally takes 10–14 days. If you like, feel free to treat yourself to a gentle massage during your post-operative course. Therapeutic massage is beneficial to speed the healing process. It may be done beginning two weeks after surgery, as often as every second day, and as hard as you can tolerate.
• DIET: If you experience any postoperative- nausea, try carbonated drinks and dry crackers to calm your stomach. Take your post-operative medications with food to minimize irritation. If your stomach feels normal, start slowly with liquids and bland foods, progressing to soups, and finally, a healthy diet as tolerated. Drink plenty of clear fluids.
• ALCOHOL: As well as/In addition to refraining from drinking alcohol for at least five days before surgery, it is essential that you do not consume alcohol if you are taking over-the-counter or prescription pain medication following surgery as they may interact.
• SMOKING: We continue to stress the importance of not smoking. Smoking reduces blood circulation to skin and tissues and delays healing. Do not smoke at all during the first 14 days following the procedure.
• EXPECTATIONS: Remember, the goal of fat removal is not weight loss but for improved contour. Since the body retains fluids in response to surgery, you may notice a temporary weight gain, resolving over the first week. In addition, remember that for most people, the goal is a significant improvement, not perfection.
• Lower abdominal patients may experience significant swelling in the pubic area. Post-operative discomfort usually takes the form of deep muscle soreness and improves typically over the following 2–7 days.
• Slight temperature elevation and flushing of the face, neck and upper chest could last 48 h. You may initially experience a mild depression that should begin lifting after the first week once you see the bruising and swelling fade.
• Menstrual irregularities (premature or delayed monthly onset) are a common side effect of surgery. If you treat areas on the thighs, you might have swelling in your calves and ankles for up to 3 weeks.

POST-OPERATIVE MEDICATIONS.

Please take the antibiotics and pain medications as advised or prescribed by your doctor. If you have no allergies, you may start with regular paracetamol (1,000 mg every six h). If this does not relieve discomfort or pain, you can take the prescription pain medication in addition to the paracetamol. Do not take aspirin, Brufen, or Neurofen. If antibiotics are prescribed, you must complete the entire course.

POST-OPERATIVE APPOINTMENTS.

For maximum healing and optimal long-term results, you must follow the appointment schedule that is made following your surgery.

Are Results of  High DefinitionThigh Liposuction  Permanent? Will Fat Return?

On condition, you stay at your post-operative- weight, and a proper diet and exercise become part of your routine, the liposuction results will be permanent since there are now fewer fat cells in those areas that were contoured.  Weight gain is the actual enlargement of existing fat cells, not the creation of new ones. The fatter cells in a specific location, the more difficult it is to reduce in that area only by dieting. Dieting usually reduces the size of all fat cells proportionately but to no small degree leaves the basic silhouette unchanged. If you gain a few pounds, you will more evenly distribute the weight than accumulating in the same problem areas before the procedure. Doctors believe that once fat cells have been removed by liposuction, these same cells do not return.

Will I Need a Second Procedure after High DefinitionThigh Liposuction?  If so, when?

Most patients require just one procedure. Less than ten percent of patients need a fine-tuning process after of period of after least six months.

There are many variations both to the design of the incisions and the technique itself. In some instances, it may be possible to avoid an incision around the navel. When the amount of loose skin is minimal and the excess fat deposits are found below the navel, a short horizontal incision is all that is necessary. This procedure is called a partial or “mini” abdominoplasty. Sometimes liposuction may be used alone or in conjunction with abdominoplasty to remove abdominal fat.  Your plastic surgeon will discuss the method they recommend for achieving the best result in your case. No two patients start with the same concerns, nor will any two patients share the same goals. Your cosmetic surgeon will recommend the type of tummy tuck that will do your desired outcome and create natural-appearing results with the minor scarring possible.

Classic or “Full” Tummy Tuck: Improves the Upper & Lower Abdomen

Are you bothered by roundness and excess skin folds above and below your belly button? A full tummy tuck, which addresses the entire length of the abdominal wall, may yield the best results. Through a horizontal or U-shaped incision made above the pubic mound, your cosmetic surgeon will remove excess skin and tighten the abdominal muscles. In some cases, a second incision is formed around the navel to address excess skin above the belly button and do the most natural-looking results. The resulting scar from a full tummy tuck looks like that for a mini-tummy tuck but will typically be more extended, running from hip bone to hip bone. Even so, I can usually hide an entire tummy tuck scar beneath a swimsuit bottom. Benefits of a full tummy tuck include a much flatter, smoother abdomen, reduced appearance of stretch marks, and enhanced comfort in pants and skirts. You will also find that form-fitting dresses and swimsuits have a more flattering fit.

Extended Tummy Tuck: Improves the Upper & Lower Abdomen and Flanks

Have you lost a lot of weight and now have excess, sagging skin hanging around the front half of your body? Or, have you noticed significant laxity in your abdominal muscles following multiple pregnancies? An extended tummy tuck may be the best choice to discuss your concerns. Although it involves a longer incision, an extended tummy tuck removes excess, hanging skin from the front (upper and lower abdomen) and the flanks and tightens the abdominal wall. The resulting scar from an extended tummy tuck can often be hidden by clothing, including many swimsuits, but I may not entirely cover it for some patients. Even so, many patients consider some visible scarring an excellent price for a much-improved body shape.

Reverse Abdominoplasty

Reverse abdominoplasty forms the removal of the upper abdominal skin excess that may be too high to reach with a traditional abdominoplasty. This procedure is often performed secondary to a conventional abdominoplasty to tighten the upper abdomen and remove epigastric skin excess. Reverse abdominoplasty reduces skin excess in the epigastric region, between the inframammary fold and the umbilicus. The massive weight loss patient population may have extra skin pockets and folds unsafely or inadequately addressed with a traditional abdominoplasty. A reverse abdominoplasty is nicely performed in conjunction with breast surgery, where the fold may be positioned at a higher level.

Fleur-de-Lis Abdominoplasty

This technique not only directly addresses the vertical abdominal excess but also deals with the horizontal. Often patients are willing to trade a midline scar for improved contour. If the patient has an earlier midline incision, it is incorporated. The operative dissection can be considered an extension of the high lateral tension dissection because lateral perforators are preserved. I should approach the marking of the horizontal and the vertical excisions independently.

Are you bothered by a “pooch” or loose skin and stretch marks below the belly button? A mini-tummy tuck may be the right choice for you. This technique involves a single incision made just above the pubic mound, through which your cosmetic surgeon will tighten loose muscles (flattening the “pooch”) and remove excess skin to restore a smooth, flat abdominal wall. The resulting scar from a mini-tummy tuck is a thin, horizontal line typically a few inches long. Benefits of a mini-tummy tuck include a shorter, less involved procedure, a quicker recovery, and a flatter, slimmer lower abdomen that looks better in swimsuits and fitted clothing.

What Should I Expect During Tummy Tuck (abdomen Lift) Surgery Recovery?

During your tummy tuck recovery, dressings or bandages may be applied to your incisions, and you may be wrapped in an elastic bandage or a compression garment to decrease swelling and support your abdomen as it heals following surgery.

• You will be given specific instructions that may include:
• How to care for the surgical site and drains
• Medications to apply or take orally to aid healing and reduce the potential for infection
• Specific concerns to look for at the surgical site or in your general health
• When to follow up with your plastic surgeon
• The results of tummy tuck surgery may be initially obscured by swelling and your inability to stand fully upright until internal healing is complete.
• Within a week or two, you should be standing tall and confident in your new slimmer profile. Your tummy tuck will result in a flatter, firmer abdominal contour that is more proportionate with your body type and weight.
• Earlier abdominal surgery may limit the possible results of a tummy tuck.
• Tummy tuck scarring
• In women who have undergone a cesarean section, the existing scars may be incorporated into the new injury.
• The tummy tuck scar may take several months to a year to fade as much as it will.
• Although good results are expected from your procedure, there is no guarantee. It may not be possible to do the best results with a single surgical procedure, and another surgery may be necessary for some situations.
• Following your physician’s instructions is essential to the success of your surgery.
• It’s essential that the surgical incisions are not subjected to excessive force, swelling, abrasion, or motion during the time of healing. Your doctor will give you specific instructions on how to care for yourself.

How Will I Look and Feel after Tummy Tuck (abdomen Lift) Surgery Initially?

The day after surgery, you will be encouraged to get out of bed for short walks to promote blood circulation. Although you may not stand up completely straight, it is best to not sit for long periods during the first several days. Avoid any strain, bending, or lifting.  These activities increased swelling or even bleeding. I may instruct you to sleep on your back with a pillow under your knees. After one week, our medical staff will help you to remove any surgical drains. At the same, they will change or remove dressings. You will wear supporting garments for six weeks. After two weeks, our medical staff will remove stitches will be removed in stages over one or two weeks. Swelling and bruises will disappear over the coming weeks. However, it may be months before all swelling subsides, and you see the result of your abdominoplasty. You may also notice some numbness over portions of the abdominal area, which may persist for several months. Incisions will initially be red or pink. They will remain this way for many months following surgery and may even seem to worsen before they finally begin to fade.

When Can I Resume My Normal Activities after Tummy Tuck (abdomen Lift) Surgery?

It is The skin to realize that the amount of time it takes for recovery varies among people. Depending on the extent of your abdominoplasty and your general physical condition, you may be able to return to non-strenuous work anywhere from one to three weeks after surgery. In many instances, you can resume most of your everyday activities, including some form of mild exercise, after a few weeks. You may continue to experience some mild, periodic discomfort and swelling during this time, but such feelings are normal. I should report severe pain to your doctor. I should avoid any sexual activity for a minimum of two weeks, and your plastic surgeon may recommend you wait longer.

Abdominoplasty will enhance your body contour by making your abdomen firmer and flatter. You may find that you feel more comfortable in your clothing and are more confident about your appearance. The incisions from the procedure will heal and fade over time. It is important to realize, however, that the incision lines will be permanently visible. In some instances, they will eventually be only faint lines.

How Long Will the Results of Tummy Tuck (abdomen Lift) Surgery Last?

Unless you gain or lose a significant amount of weight or become pregnant, your abdomen should stay firmer and flatter for many years. However, gravity and the effects of aging will eventually take their toll. If, after years, you again become dissatisfied with the appearance of your abdomen, you may choose to undergo a second procedure to restore a more youthful body contour.

What Are the Risks of Tummy Tuck (abdomen Lift) Surgery?

Every year, many thousands of people undergo successful aesthetic surgery of the abdomen, experience no major problem, and are pleased with the results. Anyone considering surgery, however, should be aware of both the benefits and risks. The subject of risks and potential complications of surgery is best discussed on a personal basis between you and your plastic surgeon or with MSI staff members. Some of the possible complications discussed with you include bleeding, infection, and reactions to anesthesia. Tissue loss along portions of the horizontal incision is a possibility when the abdominoplasty is very extensive. This complication, which delays healing and prolongs recovery, is more common in patients who smoke or have medical conditions such as diabetes. Revisionary surgery is sometimes helpful in certain instances where incisions may have healed poorly. Following surgery, occasionally, fluid may accumulate under the skin. Removal of this serum is a painless process but may need several visits to MSI. You can help to lessen certain risks after the advice and instructions of your plastic surgeon, both before and after surgery.

The decision to have plastic surgery is highly personal. You’ll have to decide if the benefits will do your goals and if the risks and potential complications of tummy tuck surgery are acceptable. You will be asked to sign consent forms to make sure that you fully understand the procedure and any risks.

Tummy tuck risks include:

• Anesthesia risks
• Bleeding
• Infection
• Fluid accumulation (seroma)
• Poor wound healing
• Skin loss
• Numbness or other changes in skin sensation
• Skin discoloration and prolonged swelling
• Unfavorable scarring
• The recurrent looseness of skin
• Fatty tissue found deep in the surface might die (fat necrosis)
• Deep vein thrombosis, cardiac and pulmonary complications
• Asymmetry
• Suboptimal aesthetic result
• The possibility of revisional surgery
• Persistent pain

I will thoroughly discuss these risks and others before your consent. It would be best if you addressed all your questions directly with your plastic surgeon.

Notes

I can determine the specific risks and the suitability of this procedure for a given individual only at the time of consultation. All surgical procedures have some degree of risk. Minor complications that do not affect the outcome.

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