Abdominoplasty or lipectomy
The abdomen sometimes presents a significant variation in volume over the course of life. Pregnancies in women, excessive weight gain or major weight loss often leave significant consequences. These sequelae particularly affect the skin, which loses its elasticity and can present significant stretch marks. The abdominal wall can also be permanently damaged by multiple pregnancies, especially if there are twin pregnancies. This procedure only removes the stretch marks present on the skin that will be resected. It is particularly suitable for people who have sagging abdominal skin that does not improve with exercise or diet.
The intervention
The intervention consists of resecting the skin under the umbilicus in order to put the remaining skin under tension. It can also be performed at the same time a plasty on the distended muscle wall or a suction of excess abdominal fat. The horizontal scar on the lower part of the abdomen can be longer or shorter depending on the size of the excess skin to be removed. At most this scar extends between the two hips. It is sometimes necessary to make a vertical scar under the umbilicus. The procedure is usually performed under general anesthesia. Sutures are generally absorbable threads hidden in the scar. At the end of the operation, a drainage system is put in place to collect the fluids and prevent the formation of a collection.
The initial consultation
The initial consultation allows you to jointly think about the different types of treatment according to your wishes and the surgical possibilities. The amount of excess fat, the scars, the quality of your abdominal strap can modify the surgical procedure. You will also be asked to evaluate a possible tobacco intoxication which may in certain cases contraindicate the intervention. The consultation will also be an opportunity to check whether your intervention can be covered by your health insurance. The intervention may be postponed due to excess weight, and will only be possible after dieting.
Complications
Lipectomy is a heavy intervention but the consequences are generally simple. Any surgical procedure, even carried out competently in conditions of maximum safety, carries a risk of complications. There are risks of bruising, infection or reaction to anesthesia. It should be noted that the anesthetic techniques, the products used and the monitoring methods have made immense progress. They offer optimal safety, especially when the intervention is performed outside the emergency room and in a healthy person, but they can nevertheless involve risks of serious complications.
The most feared complication is the migration into the bloodstream of a clot from a vein in a lower limb (phlebitis) into the lungs (pulmonary embolism). This complication can, when it is massive, lead to death. Wearing varicose veins, getting up early and taking anti-coagulant therapy can prevent this risk. Exceptionally, skin necrosis may appear around the scar which will have aesthetic consequences. These necrosis are very often secondary to persistent tobacco intoxication. It is imperative to stop smoking at least two months before the operation.
A decrease in abdominal sensitivity may be noted during the first few months. A return of the sensitivity is generally observed between the 6th and the 18th month. The evolution of scars is unpredictable and can be unfavorable with the occurrence of pigmentations, hypertrophy (red and inflammatory scar) or even keloids (hard and purplish rim). These scarring complications can compromise the aesthetic appearance of the final result. If an early complication appears, close monitoring is necessary and compliance with the instructions imperative.
Before the intervention
The anesthetist will be consulted less than a month before the operation. Tobacco must be completely stopped at least one month before the operation. No medication containing aspirin should be taken in the 10 days preceding the operation.It is imperative to remain fasting (do not eat or drink anything) 6 hours before the operation. Just before the operation and the two previous days, an antiseptic soap will be used for the shower.
After the intervention
The postoperative effects are generally not very painful. Hospitalization is two to five days. The first dressing is usually done on the day of discharge. The drain will be removed at this time. The sutures are generally absorbable hidden in the scar and do not need to be removed. A compression sleeve will be worn the month following the procedure. A work stoppage lasting 8 to 15 days is generally necessary.
A 3-month suspension from any sporting activity is recommended. It is important not to expose the scar to the sun for at least 6 months and to protect it with a full screen after this period. Dark scars at the beginning will gradually lighten and take on their final appearance after 24 months. They are generally little or not visible.
Important information
This text provides basic information on the principles and procedure of a lipectomy. A more detailed information sheet will be given to you during your consultation. A good understanding of the course of the intervention and the expected result is essential before considering this intervention. It should be emphasized that the goal of this surgery is to bring improvement and not to achieve perfection. If your wishes are realistic, you will be satisfied with the result.
