SEBASTIEN GARSON M.D
This fact sheet was developed under the aegis of the French Society of Plastic Reconstructive and Aesthetic Surgery (SOF.CPRE) as an addition to your initial consultation, to try to answer all the questions you can ask yourself if you plan to use surgery baldness. The purpose of this document is to provide you with all the necessary and essential elements of information to help you make your decision with full knowledge of the facts. Also you is it advisable to read with the greatest attention.
• DEFINITION OBJECTIVES AND PRINCIPLES
The misfortunes that affect the abdominal wall are particularly resented and resented. The advent of liposuction has transformed this surgery. It can, indeed, reduce the importance of interventions and residual scarring. In this area of the abdominal wall, there is no one technique that can be applied to all cases. It should thoroughly analyze the lesions and you take into account several parameters: skin condition, the importance of excess fat, tone the abdominal muscles, general morphology of the patient or the patient: we can deduce the best strategy to each.
Briefly, in the presence of a request for surgical correction of the abdominal wall, two cases can be observed: an abdominal liposuction is considered in isolation, it will be to use a tummy tuck or abdominoplasty.
• THE ISOLATED ABDOMINAL LIPOSUCTION
Refer to the information sheet on LIPOSUCTION.
• plasty ABDOMINAL
Whenever there is significant damage to the skin, with a significant distention, many stretch marks or scars, isolated liposuction is inadequate and this will require a tummy tuck.
Abdominoplasty is a fairly major procedure in plastic surgery, but she took full advantage of many technological improvements in recent years: reduction of anesthetic methods, techniques known as "high voltage greater than" padding methods, development practices sutures progress of compressive bandages and boots ... This expertise has significantly reduced the risk of postoperative ease, much better quality outcomes and optimize the discretion of scars, thus opening the indications cases "lighter" that previously would have been disqualified.
• Objectives and Principles
The purpose of such intervention is to remove the most damaged skin (distended, scarred or stretch marks) and tighten the peripheral healthy skin.
We can associate the same time the treatment of localized excess fat by liposuction and treatment of lesions of the underlying abdominal muscles (diastasis, hernia).
Whenever there are overweight, it will be best corrected (partially or completely) before surgery (term contract weight). The conditions of the intervention will be best both in terms of safety and quality of results.
Classical extended abdominoplasty:
Abdominoplasty is the most commonly performed to ablate a large amount of skin, corresponding to all or part of the area between the navel and the pubis, in a pattern adapted to damage. The overlying skin healthy, located generally above the umbilicus will redraped down, so as to reconstitute the abdominal wall with a good quality skin.
The umbilicus is stored and placed in the normal position through an incision made in the skin decreased. Such surgery always leaves a scar more or less long and more or less hidden, depending on the size and location of damaged skin which had to ablate. Often, this scar is located at the upper edge of hair pubic and goes more or less into the folds of the groin. Its length is predictable in large part before the intervention and (the) patient (s) should be clearly informed (e) because this "scar" remains one of the major drawbacks that will take.
Such extended abdominoplasty can sometimes benefit from a financial contribution for health insurance in certain cases and under certain conditions.
The abdominoplasty located:
In the presence of smaller lesions, we can sometimes provide a more localized abdominoplasty scar which will be reduced.
In these cases, supported by health insurance can not be considered.
• BEFORE THE OPERATION
A usual preoperative assessment is carried out according to regulations.
The anesthesiologist will be seen in consultation at the latest 48 hours before the procedure. Smoking cessation is strongly recommended at least one month before and one month after surgery. Smoking increases the risk of postoperative complication of any surgery. Stop smoking 6-8 weeks before surgery removes the excess risk. If you smoke, talk to your surgeon and your anesthesiologist. You can also call Tobacco-Info-Service (3989) to help you reduce risk and put all the chances on your side.
Stopping any oral contraception may be required, particularly when associated risk factor (obesity, poor venous condition, bleeding disorder).
No medication containing aspirin should be taken within 10 days before surgery.
Skin preparation (antiseptic soap type) is usually recommended the day before and the morning of surgery.
It is essential to continue fasting (nothing to eat or drink) 6 hours before surgery.
• TYPE OF ANESTHESIA AND CONDITIONS OF INTERVENTION
Type of anesthesia:
Abdominoplasty almost always requires a standard general anesthesia, in which you sleep completely.
Terms of admission:
The hospital stay ranged from 2 to 5 days.
Each surgeon adopts a technique of its own and it adapts to each case to obtain the best results. However, it may hold common basic principles:
The layout of the incisions, which corresponds to that of future scars, has already been mentioned: it is, in fact, depending on the location and the amount of damaged skin: in practice, the scar will be even longer than the amount of tissue is important.
The excess fat can be removed by liposuction and strained muscles are given voltage.
The remaining skin (above the navel) is redraped down and can benefit from a "padding" to reattach the muscle to the underlying wall, thus improving the delivery voltage (especially the upper portion) and to condemn the separation space and reduce the risk of effusion.
After surgery, a dressing is crafted modeling, with or without the introduction of a sheath of contention.
The duration of the procedure varies between 90 minutes and 3 hours, depending on the amount of work to accomplish.
AFTER THE INTERVENTION: THE OPERATING SUITES
There should be dressing for a couple of days after surgery. Wearing a support sleeve is recommended for 2 to 4 weeks, day and night.
There must be a work stoppage 2 to 4 weeks. The scar is often dew during the first 2 to 3 months, then it disappears, usually after the third month and it gradually over 1-3 years.
It should not be exposed to sunlight or UV before 3 months.
The practice of sport can be resumed gradually from the sixth postoperative week..
• THE RESULT
It can not be judged until one year after the intervention. It should, indeed, have the patience to wait the time needed to mitigate the scar and realize during this period proper supervision at the rate of a consultation every 3 months for 1 year. Regarding the scar, its optimal position usually allows the hide easily in conventional underwear or swimwear.
You should know that if it fades well in general with time, it does not disappear completely. In this regard, we must not forget that, if the surgeon who performs the suture, the scar, it is the fact of (the) patient (s).
Beyond the cosmetic improvement is often substantial even spectacular in terms of silhouette, the abdominoplasty usually bring the patient (or patient) a significant improvement in terms of comfort.
In addition, this functional improvement and psychological well-being obtained help the patient or the patient in adjusting their weight balance. The goal of this surgery is to make an improvement and not to achieve perfection. If your wishes are realistic, and you're ready (s) to take the scar, the re-sult obtained should give you a great satisfaction
Anyway, this is an important and delicate surgery, for which the quality of the indication and the severity of the surgical procedure is put in no way immune to a number of shortcomings or complications.
• FAULTS OF THE RESULT
In most cases, a tummy tuck properly indicated and performed makes a real service to the patient (s), with obtaining a satisfactory and consistent with what was expected result.
However, it is not uncommon for localized imperfections are observed, but they are real complications:
• relate these imperfections including scar that is sometimes a little too visible, adherent or asymmetrical or ascended. This scar may, in some cases, become enlarged, thick or keloid.
• the umbilicus may be imperfectly externalized and have lost some of its natural.
• small excess lateral skin are sometimes found,
• some irregularities due to liposuction may persist
• Finally, in case of excessive strain on the banks of the suture, a rise of pubic hair can be seen.
These imperfections result are generally accessible to further treatment, "touch" surgical-realistic Lisée under local anesthesia or depth from the 12th postoperative month, local anesthesia on an outpatient basis.
• POSSIBLE COMPLICATIONS
Abdominoplasty, although performed for aesthetic reasons in part, is nevertheless a real surgery, which involves the risks associated with any medical procedure, however small it may be.
We must distinguish the complications of anesthesia and those related to the surgery.
Regarding anesthesia, during the consultation, the anesthetist inform himself the patient anesthetic risks. You should know that anesthesia in the body sometimes unpredictable, and more or less easy to control: the fact of using a fully qualified anesthetist, working in a surgical context (recovery room, possibility of resuscitation) that the risks are statistically very low.
You should know, indeed, that the techniques, anesthetic products and monitoring methods have made tremendous progress over the past thirty years, providing optimum safety, especially when the procedure is performed outside the emergency and in a healthy person.
Regarding surgery: choosing a qualified and competent plastic surgeon, trained in this type of surgery, you limit these risks, without removing them completely.
Indeed, complications can occur with the waning of a tummy tuck, which is the heaviest interventions for Aesthetic Plastic Surgery.
Among these possible complications, it must include:
• The thromboembolism (blood clots, pulmonary embolism), although generally quite rare, are the most formidable. Rigorous preventive measures should minimize the impact: port anti-thrombosis stockings, early mobilization, possibly anti-coagulant therapy.
• The hematoma, actually quite rare, can justify an evacuation to avoid secondary damage to the aesthetic quality of the result.
• The occurrence of infection, is uncommon, requires SITERA surgical drainage and antibiotic treatment. It can sometimes leave unsightly scars.
• It is not uncommon from the 8th day post-opera-tory, the occurrence of an effusion associated with a flow of lymph and oozing fat. Compression and the rest are in the best preventions. Such an effusion may need to be punctured, and dries in general no particular sequel.
• Skin necrosis may be observed in a limited and localized rule. Significant necrosis are in fact rare. They are much more common in smokers (her), especially if smoking cessation was not strictly adhered to.
Prevention of these necrosis is a well-posed indication and the achievement of an appropriate and prudent technical gesture, avoiding excessive tension on the sutures.
• Alterations in the sensitivity of the wall, including a decrease in sensitivity in the dominant sub-umbilical region, are frequently observed: normal sensitivity usually returns within 3 to 12 months with the waning of the tummy tuck.
• Finally, it can be observed, especially in patients whose skin is very scarred or injured, the phenomena of delayed healing that prolong the postoperative course.
GENERAL CONCLUSION ON PLASTIC SURGERY BEAUTY AND THE ABDOMINAL WALL
Plastic and cosmetic surgery of the abdominal wall has made breakthroughs that allow today, in many cases, to provide a technical and a suitable therapeutic strategy to solve this, either by a simple liposuction or by mini-abdominoplasty (tummy tuck localized) or more intervention (extended abdominoplasty), the main aesthetic problems abdomen..
In total there should not overstate the risks, but just be aware that surgery, even seemingly simple, still a small share of hazards. The use of a qualified Plastic Surgeon ensures that it has the training and knowledge required to avoid these complications, or effectively treat if jurisdiction.
These are the pieces of information that we wanted to bring you in addition to the consultation. We recommend that you keep this document, read it again after the consultation and reflect "a clear head." This reflection may raise new questions for which you wait for additional information. We are available to talk during the next consultation, or by phone, or even on the day of surgery when we meet in any way before anesthesia.
Phone : + 33344282959
7 impasse de la Passerelle 60300 SENLIS
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