Despite the poet Vinicius, who sang that a belly project is fundamental, who never dreamed of having a well defined belly? Oh that envy of that flat abdomen, that does not make any volume under the clothes and that is glorious inside a bikini! Not always a thousand crunches, a healthy diet and leaving the beer aside solve the problem.
Pregnancy, the folding effect of fat-thinning diets, as well as the weight of age accumulate fat and cause sagging skin and muscle weakness in the abdomen.
Liposuction solves cases where there is localized fat but no sagging of the skin. For others, the solution is abdominal surgery or abdominoplasty, which improves the contour of the popular belly, removing excess skin and fat, correcting the sagging muscles of the abdominal wall and leaving the abdomen flat and the waist thinner.
According to plastic surgeon Rodrigo Mangaravite, who works in São Paulo and Rio de Janeiro, abdominoplasty is indicated for patients who have localized fat and muscle weakness in the abdomen associated with sagging skin – that is, cases that liposuction does not solve. But they are not exclusive techniques: there are cases in which, for a better result, liposuction and abdominoplasty procedures should be associated.
When there is only excess skin and fat below the navel, the traditional abdominoplasty can be replaced by the mini abdominoplasty.
Finally, in patients with generalized obesity abdominoplasty should not be employed.
According to Dr. Rodrigo Mangaravite, it is better for women to undergo abdominoplasty when they no longer intend to have children, since pregnancy can cause skin flaccidity and muscle laxity again.
For both genders, abdominal surgery should be performed with the patient at the ideal weight because the risk of postoperative complications in the obese body is greater. In addition, excess weight may compromise the end result.
The surgery of the abdomen lasts between two and four hours. Dr. Rodrigo performs his surgeries with all possible attention and calm, following a detailed and personalized surgical plan for each patient and using all his technical capacity and resources to reach the best possible result. Dr. Rodrigo only leaves the surgical center when he is sure that he has reached the desired result to the maximum. It is only in this moment that the surgery can be finished.
The plastic surgeon Dr. Rodrigo Mangaravite explains that the umbilicus will be remodeled in the abdominoplasty. There are several techniques for reimplantation of the umbilicus, all of which are subject to future surgical revisions due to some anomaly in the evolution of cicatrisation. The correction is done with local anesthesia after a few months.
Aspiration drains are used to prevent the accumulation of seromas (fluid between the skin and muscles), aiding in the reduction of swelling. They remain for five to seven days and the aspirated volume should be measured daily. The abdomen is bandaged with cotton that can not be wet for two days. In the first week, the incision site of the abdominoplasty is protected with a micropore tape, which will be removed by the medical staff. The patient is not allowed to manipulate the dressing.
The navel receives gauze protection for two weeks. From the fourth day, it should be changed daily after bathing, applying a layer of ointment to protect it before replacing the gauze.
– Do not smoke for at least a month after abdominoplasty, so as not to impair healing and decrease the risks of skin necrosis and infection.
– Rest for a week. A feeling of tiredness may occur in this period due to the trauma of abdominal surgery. Try to rest and feed yourself well.
– In the first week after tummy tuck, tummy tuck is recommended, with the headboard elevated and pillows below the knees to keep the legs semi-flexed. Avoid lying on your side, but if you sleep on your side, do not forget to bend your legs. This is one of the points of greatest discomfort for the patient. If you turn at night, sleeping, no problem, just keep your legs bent.
– There is no need for absolute rest after abdominal surgery. Small walks indoors are recommended after the first 24 hours: they help the circulation of the lower limbs and aid in the exit of liquid through the drain.
– It is good to stay seated from the second day after abdominoplasty. It is the best and most comfortable position. Do not stand in a fully upright position. Maintain a curved posture, with the body slightly inclined forward, for up to 15 days, not to provoke tension in the place of the scar.
– Try to eat nutritious food during the postoperative of abdominal surgery, not greasy. Do not make strict regimes during this period. You may get compromised immune system, impairing healing.
– Do not drink alcohol for at least a week after your abdomen surgery. Alcohol can increase edema. It is common for the gut to be slow in the first few weeks, but it is important to regularize it. If it does not work for two days, in the third it is recommended to use a bowel regulator (under the guidance of your doctor).
– Do not take sun for two months after abdominoplasty. If there are purple spots, it is essential to apply the sun block. Unprotected exposure is only allowed two months after abdominal surgery or according to medical release. These care can help prevent dark spots and scars.
– Avoid sexual intercourse for the risk of bleeding and trauma in the first two weeks. Do not make any significant physical effort in the first week. Physical exercises will only be released from 30 days or at medical discretion, depending on your recovery. Any sport with a risk of trauma (eg, ball or physical contact) should be avoided for 60 days after abdominoplasty.
– Give preference to comfortable clothes and fine fabrics the first week after abdominal surgery. Avoid tight or difficult-to-wear clothes because they will get tight and uncomfortable in the first month because of post-operative swelling.
– Use the strap placed at the end of the abdominoplasty 24 hours a day for four weeks, taking only during the shower, which is usually released after five to seven days when the drain has already been removed. The strap should not be tightened to avoid damaging the circulation, causing discomfort and delaying healing.
– Lymphatic drainage sessions are indicated after a week of abdominal surgery to hasten fluid drainage at the site, facilitating healing and eliminating swelling. In some cases, it is recommended to use a weight of 1 to 2 kilos (eg, packet of sugar, flour or similar) in the region above and below the navel, to accelerate tissue adherence and drainage.
In the first week, the site will become swollen and with some areas of purple spots (bruises), especially in the region of flanks. This swelling is greater in the morning and regresses throughout the day, with one side becoming more swollen than the other. It is important to remember that this is temporary and does not interfere with the final result. From the second week, there is a progressive improvement of the swelling, providing greater comfort each day.
The abdominoplasty scar lies just above the pubic hairs and is easily hidden by the underwear and bikinis.