Abdominoplasty Surgery

Abdominoplasty Surgery Bangalore is a procedure done to shape the tummy which is sagging and has lost the muscle tone (firmness).

The tummy, sags due to many reasons. The most commonest is after pregnancy. The next most common cause for sagging is obesity, significant weight loss. Another cause could be that the person has lax muscles due to dietary deficiencies and lack of exercise.

Let us discuss about a sagging tummy post pregnancy. During pregnancy , as the baby grows within the uterus, the tummy begins to show up i.e grow bigger. In doing so, there are many layers of the tummy wall i.e the abdominal wall that are put onto a stretch. This is to emphasize that just tightening the skin using heat or lasers or ultrasonic energy does not solve the problem of a sagging tummy. The skin, muscle and rectus sheath peritoneum are put on a stretch. This stretch is gradual , but at the same time it is constant and continues over a period of 9 months. This continuous and gradually increasing pressure on the abdominal wall weakens the wall and while stretching it causes thinning of it. After delivery, once the baby is born, there is a sudden relaxation of the pressure that was there on the abdominal wall along with sudden release on the stretch that had been there for few months. This make the abdominal wall loose and it begins to sag. This sagging can be more pronounced if it is a twin pregnancy or a big baby or hydramnios. Good news is that, if proper exercises ( tummy tightening abs) are resumed after delivery ,accompanied by good protein in the diet as well as supplementation with micronutrients ( if there is existing deficiency), then there can be resumption of nearly 80 to 90 % of the pre-existing( before pregnancy) muscle tone ( tightness) of the abdominal wall( tummy).

But if the existing musculature of the mother is weak due to protein deficiency, lesser protein intake in the diet, micronutrient deficiency, sudden weight loss before marriage in an attempt to lose weight before marriage , then the chances of sagging are even more . In such cases, it will not be easy to get back pre-existing tightness of the tummy, leading to a sagging lax abdominal wall. In such cases if one wants to have a flat tummy as before, then abdominoplasty ( tummy tuck ) is the answer.

Similarly when a person who is obese loses significant weight, there will be laxity in the abdominal wall . The degree of sagging will vary depending on the amount of weight loss in kilograms, duration taken to lose the weight, age of the patient ( determining skin elasticity)type of obesity- central or generalised. As the degree of obesity increases, fat starts creeping into the muscle planes making the muscles very weak. As a person loses weight, fat in these muscle planes disappears, leaving the muscle lax and loose. Good news is that all this can be avoided and reduced to a significant degree if during weight loss a person does focussed exercise on the tummy as well as ensures to have good protein not only through diet, but also additional protein supplements will be required. This must be done not after the weight loss , but during the weight loss.

By now , it is crystal clear that a good nutritious diet, rich in proteins along with focussed exercise is pivotal in regaining abdominal wall tone ( tummy toning).
But, if for reasons, this is not possible and there is a residual sag in the abdominal wall, the answer is abdominoplasty (tummy tuck). By now you know that many layers of the abdominal wall are stretched leading to sagging, so it will not be difficult for you to understand that tummy tuck or abdominoplasty is not just cutting of the sagging or extra skin.

Abdominoplasty involves taking care of all the layers that were under pressure or stretch or weakened. These layers are the skin, muscles and rectus sheath. The abdominoplasty can help give a flat tummy by cutting the excess skin and tightening the inner layers. An incision( cut) is taken over the skin crease in the bikini line ( to hide the hair line Scar). A flap is raised above and below named as upper and lower flaps. The upper flap is to be raised upto the costal margin, remembering to leave the umbilicus in place. When one cuts the excess skin, there is a high chance that the umbilicus ( navel) comes to a lower position making it look very awkward. Hence, the skin around the navel is cut and the same( navel) is positioned in a new place ensuring the the umbilicus ( navel) is central in position, maintaining normal anatomy. Considering the laxity of the muscles and the sheath, depending on the degree of laxity, a decision is taken whether a mesh is required or not along with muscle tightening to get a taut look of the tummy.

The tightening of the muscles and sheath is done in one or two layers. This decision is taken by the surgeon during surgery, depending on the laxity and the requirement. In some cases, the muscles are not only weak and thinned out, but also get separated. This in medical terms is called divarication of rectii. In these cases, just dealing with the muscles is not enough, a supporting mesh is required . the mesh is of an adequate size covering the entire tummy and is fixed to the underlying sheath with non absorbable sutures. This mesh acts as a shield giving strength to the abdominal wall, thus giving a flat tummy. Once this is done, the skin is stretched and with necessary markings and calculation, the excess skin is excised. After excising the excess skin, the umbilicus is then placed in a proper position and fixed with absorbable sutures. The upper and lower flaps of the skin are stitched together using subcuticular stitches ( under the skin). Hence the scar is a fine line and is cosmetic.

It is preferable to place a drian under the abdominal wall so that there is no collection of serosanguinous fluid which in turn can lead to infection. This drain can be removed as soon as the secretion decreases. The only care one needs to take is to wear an abdominal corset to give an additional touch to enhance the look and healing of the new flat tummy. One can get back to work within a week and the corset needs to be worn for 6 to 8 weeks.
In some, who have a little bit of excess fat around the hips ( love handles) or upper abdomen, it would be wise to combine the procedure of abdominoplasty with liposuction of the excess fat in those areas. However there could be a temporary loss of sensation over the flaps which returns over a few months

To conclude, abdominoplasty surgery in Bangalore( tummy tuck) is a procedure that is safe and it can give you the desired flat tummy.

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