Abdominal Lift Surgery

Definition and Why Is It Done?

Abdominal stretching surgery (abdominoplasty)is an aesthetic operation in which sagging skin and excess adipose tissue in the abdomen are surgically removed, loosened abdominal muscles are tightened. Especially in women who have had multiple pregnancies or people who experience a large amount of weight loss, the abdominal skin can lose elasticity and sag, and the abdominal muscles separate (rectus diastasis), resulting in a protruding appearance in the navel area. Abdominal stretching surgery is an effective solution for these problems that cannot be eliminated by diet and exercise. The goal of surgery is to achieve a flatter, tighter and aesthetically smooth abdominal profile. This operation is not a slimming method, but a procedure to correct existing excess skin and deformation; therefore, it is usually close to their ideal weight and suitable for individuals with regional deformity in the abdomen. After abdominal stretching surgery, patients can observe positive results, such as a decrease in pants and clothing sizes, an increase in self-esteem, and the acquisition of a more proportional body contours.

How Is It Done?

Abdominal stretching surgery is performed under general anesthesia in hospital conditions and according to the scope of the procedure performed is approximately 2-3 hours can last. The surgeon makes a long incision in the lower abdomen (usually slightly below the line where the cesarean scar passes), which runs from the hip bone to the hip bone. This incision is planned so that it remains within the underwear or swimsuit line. If there is sagging in the entire abdomen, including the top of the navel (full abdominoplasty), a second incision is made circularly around the navel, so that the belly button is kept in its normal place while removing excess skin, and the new stretched abdominal skin is removed. In more limited sagging (mini abdominoplasty), an incision may not be made around the belly button.

Following the incisions, the skin and subcutaneous fatty tissue are carefully removed from the abdominal wall towards the ribs. If there is relaxation or detachment of the abdominal muscles, the muscles are tightened by placing stitches on the connective tissue on the membranes of these muscles in the middle line (this procedure helps to thin the waist and flatten the abdomen, creating an internal corset effect). Then the excess parts of the abdominal skin, which are pulled upwards, are measured and removed. At this time, the umbilical hole, previously left in its position, is pulled out through a small newly formed opening on the stretched skin and fixed around it by stitching. Thus, the belly button is reshaped in its natural position, with the stretched skin around it.

The surgeon can fix the abdominal skin to the abdominal wall with internal sutures (this procedure can be done to reduce the risk of edema and seroma). One or two pieces to remove serum fluid accumulated under the skin drain are inserted; these thin silicone tubes prevent accumulation by draining fluid outflow in the first few days after surgery. After the incisions are closed with aesthetic stitches, a wide printed bandage or corset is put on the abdomen. When the patient is awakened from anesthesia and taken to his room, a feeling of tension in the abdomen is normal. In the first days, the patient is usually carried out in a slightly tilted position forward, thereby reducing the tension on the seam line.

Who is it suitable for?

Abdominal stretching surgery is a suitable option for people who experience significant excess skin and sagging in the abdomen, who cannot correct this condition with diet and exercise. Suitable candidate profiles include:

• Those Who Have Abdominal Deformation After Pregnancy: In women who have had one or more pregnancies, the abdominal skin may loosen and crack, the abdominal muscles may separate. Abdominal sagging, which cannot be eliminated by postpartum exercise and weight loss, is corrected by abdominal stretching. (Note: It is important for those planning surgery to share this with their surgeon if they are thinking of getting pregnant again in the future, as pregnancy may somewhat reverse the results of surgery.)
  
  
• People Who Experience Sagging After Major Weight Loss: In people who have undergone obesity surgery or lost a lot of weight on a diet, sagging skin in the form of an “apron” can form in the abdomen. These skin folds can also prepare the ground for diaper rash and fungal infections. In people who have completed the weight loss process and whose weight has remained stable for some time, this sagging skin is removed with abdominoplasty.
  
  
• Middle-aged Individuals with Disproportionate Fat Accumulation and Decreased Skin Elasticity: With the progression of age, metabolism slows down, and fat may increase in the abdomen. If skin elasticity is also impaired, this regional greasiness and slight sagging, which cannot be given by diet, can be corrected with a combination of mini-abdominal stretching and liposuction in appropriate cases.
  
  
• Those with good overall health and realistic expectations: Abdominoplasty is a serious surgical intervention, so the candidate should not have a significant health problem (uncontrolled diabetes, serious heart disease, etc.). Candidates who smoke are asked to stop smoking for at least a few weeks before surgery, as smoking is one of the most important factors that impair wound healing. In addition, candidates should know that a permanent scar will remain after surgery (usually hidden in underwear) and have realistic expectations about the appearance of the new abdomen.
  
  

People who meet the above criteria and are uncomfortable with the appearance in the abdominal area may be eligible for this surgery as a result of an evaluation with a plastic surgeon.

Possible Risks and Complications

Although abdominal lift surgery is generally a safe procedure, it involves certain risks, like any surgical intervention. It is important that patients are informed about these risks and intervene quickly if they occur:

• Infection: Infection may develop at the wound site or under the skin after surgery. Redness, swelling, increased pain and discharge may be signs of infection. In this case, antibiotic therapy is started and, if necessary, wound care is reorganized. A serious infection is rare, but if it does occur, follow-up in the hospital and sometimes a small surgical cleaning may be required.
  
  
• Hemorrhage and Hematoma: Since the large area in the lower abdomen is studied during abdominal stretching, there is a risk of blood accumulation (hematoma) under the suture line in the first days after the operation. To prevent this, drains are installed at the end of the operation. When signs of bleeding (sudden swelling, bruising, excessive pain) appear, the accumulated blood is drained by drainage or surgical intervention.
  
  
• Seroma (Fluid Accumulation): It is one of the most common complications. In the space under the skin, tissue fluid can accumulate and form swelling. Drains are usually kept for 3-7 days and removing fluid to reduce the risk of seromas, but small seromas can also form within weeks after the drain is removed. Light seromas are absorbed by the body, while in the case of noticeable fluid accumulations, your doctor will treat this fluid with the injector by withdrawing this fluid. The probability of seroma formation is around 10-20%, especially in extensive stretching procedures.
  
  
• Scar and Skin Healing Problems: The scar that will remain after stretching the abdomen is initially red-pink, although it fades and becomes indistinct over time, it does not disappear completely. Some patients may develop fluffy, hard scars called hypertrophic scars or keloids due to genetic predisposition. In this case, scar massage, silicone gel application or advanced treatments (such as laser, cortisone injection) may be required. In addition, especially in smoking or diabetic patients, there may be late healing or slight skin losses due to a circulatory problem in one area of the incision line. These wounds heal most often on their own with dressing, rarely additional intervention may be required.
  
  
• Sensory Changes: Loss of sensation or numbness may occur in the abdominal skin, especially in the sub-umbilical region, due to nerve cutting during surgery. This is usually expected, and feeling gradually returns over months with nerve reconstruction, although some patients may have permanent slight loss of sensation in a small area.
  
  
• Suture Separation and Flap Necrosis: In rare cases, there may be separation in the skin seams in the first days after surgery for reasons such as overstrain or infection. Small separations are followed by dressing, while large separations may need to be re-stitched. Again very rarely, especially in severe smokers or in cases with impaired circulation, some parts of the skin-flap tissue removed from the abdominal wall may not be able to provide adequate blood supply and small areas of skin death (necrosis) may appear. This, in turn, is managed by local debridement (cleaning of dead tissue).
  
  
• Aesthetic Dissatisfaction or Asymmetry: Although abdominal stretching is meticulously planned, it can sometimes be difficult to achieve complete symmetry. Conditions such as a slight excess on one side after surgery, minor disturbances in appearance or a longer scar than expected can be noticed by the patient. In such cases, at least 6-12 months are usually expected, since it takes time for the tissues to fully soften and allow maturation. If after this time a noticeable problem persists, correction can be done with a minor revision surgery.
  
  
• General Surgical Risks: As with any major surgery, serious but very rare risks such as anesthesia-related reactions, deep vein thrombosis (a clot in the leg vessels), and pulmonary embolism also apply to abdominoplasty. To reduce these risks, careful monitoring, early mobilization and appropriate prophylactic measures are taken during and after surgery.
  
  

Patient compliance with doctor's instructions before and after surgery plays an important role in minimizing these risks. Especially since smoking seriously increases infection and wound healing problems, it should be stopped before surgery and should not be used during the period recommended by your surgeon.

Healing Process

After abdominal stretching surgery, recovery proceeds step by step. Immediately after surgery, the patient may have tension and moderate pain in the abdomen, which is controlled with painkillers. On the first day, feeding with liquid foods usually begins, and the patient is encouraged to get out of bed and take short walks with the help of the medical team. Walking with a slight lean forward reduces the load on the seam line and increases comfort. The drains in the operating area are kept in place for 2-7 days until they reach the level to be removed; the drains are taken when the amount of fluid removed daily drops below a certain level.

The patient is usually after surgery 1-2 days is discharged inside. At home rest, regular use of a special abdominal corset during the period prescribed by the doctor (usually 4-6 weeks) is very important. This corset supports the abdominal area, helping both to reduce puffiness and to smooth tissue adhesion. In the first weeks it is necessary not to lift heavy, avoid sudden movements. Supporting the abdominal area by hand, even when coughing or sneezing, is a measure that can be applied by the patient.

The first two weeks: Although walking during this period is free, it should not be fast-paced. Usually, at the end of 10-14 days, stitches are removed (if there are external stitches that need to be removed). In this process, slight retractions and a feeling of tightness in the abdomen are normal. The time to return to work depends on the work performed by the patient; those who do desk work can start working after 10-14 days, while work that requires physical exertion may require a longer rest.

2-6 Weeks: A significant part of the swelling gradually descends during this period, the abdominal contour begins to appear more clearly. The patient now becomes able to walk more upright. Nevertheless, intense abdominal exercises and heavy lifting should be avoided. The use of corsets can be discontinued or reduced at the end of this period according to the doctor's recommendation. It is usually allowed to start light exercises (eg brisk walking) after 4-6 weeks; but usually for movements that strain the abdominal muscles 8 weeks and is expected after.

Week 6 and Beyond: Restrictions in everyday life are largely lifted once your surgeon gives approval. Activities such as swimming, low-paced jogging can be done around 6-8 weeks. It is recommended to stay away from contact sports, where there is a risk of a direct blow to the abdominal area, for a few more months. During this period, the body has now adapted to the appearance of the new abdomen; the patient can move much more comfortably than before the operation and feels free in the choice of clothes. The trace care is continued; massage applications with silicone sheets or creams promote faster fading of the scars.

Complete recovery and final results are approximately 3-6 months lasts. During this time, the remaining light swellings dissolve, the scars mature and soften. In order for the results of abdominal stretching to be permanent, patients are advised to pay attention to weight control and, if necessary, continue to strengthen the abdominal muscles with regular exercise. Since significant weight changes or a new pregnancy can negatively affect the results obtained with surgery, ideally postoperative weight fluctuations should be avoided.

Abdominal Lift Surgery at Central Hospital Istanbul

Abdominoplasty operations at Central Hospital Istanbul are performed by experienced plastic surgeons in the field of aesthetic and reconstructive surgery using modern surgical techniques. Before surgery, our patients undergo a detailed evaluation; the condition of the abdominal skin, muscle structure, fat distribution and overall health profile is analyzed and the optimal surgical approach is planned. Abdominal stretching, when deemed necessary, liposuction In combination with (fat removal), better shaping of the waist and abdomen is achieved. Our surgeons talk extensively with patients before surgery about their expectations, drawing a realistic picture of the surgical scar and outcome.

In abdominoplasty operations performed in fully equipped operating rooms of our hospital, patient safety and comfort are paramount. All necessary preventive measures are taken against the risks that may develop during surgery (for example, the formation of clots); the patient is fitted with leg compression devices and prophylactic blood-thinning drugs are administered. Our anesthesiologists carefully monitor the patient's vital functions during surgery and plan post-operative pain control.

After surgery, close follow-up by our specially trained nursing team begins when the patient is taken to the room. From the first day, the patient is helped in such matters as giving positions, conducting, feeding. The care and measurement of drains is done with care; they are kept sterile for the risk of infection until the day they come out. When our patients are discharged, they are provided with special corsets and are told how to use them. In addition, detailed information is provided on wound care, bathing process, nutrition and movement restrictions.

At Central Hospital Istanbul, regular check-ups are organized to facilitate the recovery process of our patients who have undergone abdominal stretching surgery. During the first week, the first month and the third month, our surgeon evaluates the incision healing, the shape of the abdomen and the general condition. Recommendations for massage or scar treatment are recommended if necessary. If any problems develop, problems are solved without growth with rapid intervention.

In abdominal lift surgery, which is part of plastic surgery, the satisfaction and safety of our patients is our primary priority. While patients who have completed abdominal lift surgery in the comfortable environment of Central Hospital Istanbul and with a team of reassuring specialists enjoy their new appearance, we are proud to be a partner in their happiness.

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