Abdominoplasty

Abdominoplastika

Abdominoplasty is an invasive surgical procedure which involves the removal of excess skin and fat from the middle and lower abdomen in order to tighten the muscles of the abdominal wall

The procedure can dramatically change the appearance of the "sagging abdomen" and create a more aesthetical silhouette in the waist area. The result will be long-term in case of regular exercise and well-balanced diet. Abdominoplasty is performed under general anaesthesia.

If the fat distribution is confined to the area around the navel, a less demanding procedure will be sufficient, called partial abdominoplasty. In some cases a combination of partial/complete abdominoplasty and liposuction may be more beneficial, which can remove fat from the hips, thereby improving the body contours. Sometimes liposuction alone can bring the best results.

Our plastic surgeon will always recommend you a procedure that is the best for you and whose result will be as close to the desired body shape as possible.

Who is suitable for abdominoplasty?

The best candidates for abdominoplasty are women or men who are in relatively good shape but are bothered by a large fat deposit or loose abdominal skin that won’t respond to diet or exercise. The surgery can also partially resolve stretched muscles and skin of women after pregnancy.

Who is unsuitable for abdominoplasty?

- If you intend to lose a lot of weight, you should postpone the surgery

- Women planning future pregnancies should postpone the surgery; during the surgery vertical muscles are tightened and they can separate again during pregnancy

- If you have scarring from previous abdominal surgery, your scars could be unusually prominent after abdominoplasty

Preparing for surgery

In your initial consultation, the plastic surgeon will evaluate your health, determine the extent of fat deposits in your abdominal region, and carefully assess your skin tone. You will also talk openly with the surgeon about your expectations.

If you smoke, quit at least one to two weeks before your surgery and not to resume for at least two weeks after your surgery. Avoid overexposure to the sun and do not go on a stringent diet, as both can inhibit your ability to heal. If you develop a herpes or infection of any kind, your surgery will probably be postponed. Before the surgery a complete pre-surgery examination will be necessary, which you can undergo at our anaesthetist.

Course of surgery

Complete abdominoplasty usually takes two to four hours, depending on the extent of work required. Partial abdominoplasty may take an hour or two.

Most commonly, the surgeon will make a long incision from hipbone to hipbone, just above the pubic area – above the pubic hair. A second incision is made to free the navel from surrounding tissue. With partial abdominoplasty, the incision is much shorter and the navel may not be moved. Next, the surgeon will separate the skin from the abdominal wall all the way up to your rips and will lift a large skin flap to reveal the vertical muscles in your abdomen. These muscles are tightened by pulling them close together and stitching them into their new position. This provides a firmer abdominal wall and narrows the waistline. The skin flap is then stretched down and the extra skin is removed. A new hole is cut for your navel, which is then stitched in place. Finally, the incisions will be stitched and sterile dressings will be applied. After the surgery a temporary tube may be inserted to drain excess fluid from the surgical site.

In partial abdominoplasty, the skin is separated only between the incision line and ​​the navel. This skin flap is stretched down, the excess skin is removed, and the flap is stitched back into place.

Post-surgery care

After the surgery has been finished and the client has waked up from the general anaesthesia, he/she will stay at the inpatient department of the Clinic  for the next 24 to 48 hours for observation. A nurse is always available to the client. The administration of infusion and analgesic therapy will be terminated and all physiological functions will be monitored. On the second day after the surgery the wound dressings will be changed and temporary tubes, if used, will be removed. The client will be discharged into home treatment, accompanied by another person, according to the doctor’s instructions. Post-surgery check-ups are performed after agreement with the surgeon. In urgent cases, the check-up may be carried out immediately. The stitches will be removed 14 days after the surgery. During these 14 days, we recommend that the client not go to work. For the first few days after the surgery your abdomen will probably be swollen and you are likely to feel some pain, which can be controlled by medication. Though you may not be able to stand straight a few days after the surgery, you should start walking as soon as possible. The surgery will produce a permanent scar which, depending on the extent of the original problem and the extent of the surgery, can extend from hip to hip.

Convalescence

Convalescence can take weeks or months. If you start out in top physical condition with strong abdominal muscles, recovery will be much faster. Some patients return to work after two weeks, while others take 3 or 4 weeks to recuperate.

Easy abdominal exercise after 2-4 weeks will help you heal better - (lifting legs, doing eights with raised legs). Vigorous exercise, however, should be avoided until you feel comfortably.

Your scars will be visible for a certain period after the surgery. They may actually appear to worsen during the first three to six months as they heal. It takes nine months to a year before your scars flatten out and lighten in colour.

Complications

Like any other surgery, abdominoplasty is associated with some risk. Post-operative complications, such as infection and blood clots, are rare, but can occur. Poor healing, which results in conspicuous scars, may necessitate a second operation. Smokers should quit smoking, since smoking may increase the risk of complications and delay healing.

Komu je zákrok určený

Klientovi, ktorý má relatívne dobrú postavu, ale je nespokojný s veľkým množstvom tuku a voľnou kožou na bruchu. Operačný zákrok dokáže čiastočne vyriešiť aj natiahnuté svaly a kožu u žien po tehotenstve.

Kontraindikácie

- v prípade, ak plánujete radikálne znížiť svoju hmotnosť – operáciu treba odložiť
- ženy, ktoré plánujú tehotenstvo 
- v prípade jaziev po predchádzajúcej brušnej operácii - jazvy sa môžu po abdominoplastike neobvykle zvýrazniť

Predoperačná príprava

Pred a po operácii aspoň dva týždne nefajčite. Pokožku nevystavujte nadmernému slnku a vyhnite sa prehnaným diétam. Oba tieto faktory znižujú schopnosť hojenia. Nevyhnutné je kompletné predoperačné vyšetrenie. 

Priebeh operácie

Kompletná abdominoplastika väčšinou trvá od dvoch do štyroch hodín. Parciálna abdominoplastika trvá hodinu až dve.

Vo väčšine prípadov rez siaha od jedného boku po druhý tesne nad pubickou oblasťou - nad genitálnym ochlpením. Druhý rez sa robí na uvoľnenie pupka od okolitého tkaniva. Nasleduje uvoľnenie kože od brušnej steny po rebrové oblúky a zdvihnutie kožného laloka, čím sa odkryjú vertikálne svaly brušnej steny. Svaly sa napnú vzájomným priblížením a zafixujú do novej polohy - zabezpečí sa priamejší tvar brušnej steny a zúži oblasť drieku. Kožný lalok sa natiahne smerom nadol a odstráni sa nadbytočná koža. Vytvorí sa nový otvor pre pupok, ktorý sa prišije na nové miesto. Na záver sa koža v mieste rezu zošije a prekryje sterilným krytím. Pooperačne môžu byť z brucha dočasne vyvedené drény, ktorých úlohou je odsávať nadbytok tekutín z operačného poľa.

Pri parciálnej abdominoplastike sa koža uvoľňuje len medzi miestom rezu a pupkom. Kožný lalok sa natiahne smerom nadol, nadbytok kože sa odstráni a lalok sa prišije späť. Pri parciálnej abdominoplastike je rez kratší a pupok nie je nutné posunúť. 

Pooperačná starostlivosť

Po operácii klient zostáva počas najbližších 24 – 48 hodín na lôžkovej časti kliniky na pozorovanie. Na druhý deň po operácii je vykonaný preväz rany, ak boli použité drény, odstránia sa. Po 14-tich dňoch od operácie sa odstránia stehy. Niekoľko dní po operácii môže byť brucho opuchnuté a citlivé. Aj keď sa nebudete môcť vystrieť, chodiť by ste mali začať čo najskôr. Po operácii vznikne trvalá jazva.   

Rekonvalescencia

Môže trvať týždne až mesiace. Ak sa operácia uskutoční v čase, keď bol pacient v dobrej fyzickej kondícii a mal pevné brušné svaly, rekonvalescencia bude rýchlejšia. Niektorí pacienti sa vrátia do práce po dvoch týždňoch, iným to trvá 3 až 4 týždne.

Ľahké brušné cvičenie po 2 až 4 týždňoch pomôže k lepšiemu hojeniu – (dvíhanie nôh, robenie osmičiek so zdvihnutými nohami). Treba sa však vyhnúť nadmernému cvičeniu.

Jazvy budú určité obdobie po operácii viditeľné. Po 9 mesiacoch až roku vyblednú a stanú sa plochými.

Možné komplikácie

Pooperačné komplikácie ako infekcia a tvorba krvných zrazenín sú zriedkavé. Vyskytnúť sa však môžu.

Ďalšiu operáciu si môže vyžiadať prípadné nedokonalé hojenie jazvy.

Before & After

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Prices

Abdominoplasty (doesn't include anaesthesia)from 1.800,-€ (depends on difficulty)
Mini abdominoplasty (doesn't include anaesthesia)from 1300,-€
anaesthesia and pre-anaesthesia examination:from 300,-€

Dá sa to aj na splátky!

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