ABDOMINOPLASTY WITH TRANSPOSITION OF THE UMBILICUS

Body surgery

Changes in body weight, pregnancies and ageing are the three main factors which may negatively act on the aesthetic appearance of the abdomen.
There are various techniques of abdominoplasty whose choice will depend on the anatomy of each patient and his requirements.

The abdominoplasty with transposition of the umbilicus enables to deal with the lower abdominal apron and to restore the tension of the abdominal skin above the navel. The latter is re-positioned in its anatomical position at the end of the procedure.

Procedure steps

  • Dr. Petit will begin with questioning your medical and surgical histories (abdominal hernias, bariatric surgery: by-pass, gastrectomy sleeve, gastric ring), gynecological antecedents (number of pregnancies), your weight and your size, as well as your tobacco consumption.
  • He will listen to your discomfort and to your requirements relating your stomach.
  • Dr Petit will carry out an abdominal clinical examination in order to estimate your excess skin but also your rectus abdominis muscles (“the abs”). The spacing of these muscles, especially after pregnancies, can entail a weakening of the abdominal wall which slackens, and can give the stomach a protruding appearance.
  • He will carry out a more global examination of your silhouette (the hips, the bottom, jodhpur thighs), in order to suggest the most appropriate surgical strategy adapted to your anatomy and to your requirements.
  • Dr. Petit will provide information on the scar positioning, treatment process and procedure limits, post-operative recoveries as well as main risks, so as to make an informed decision.

Procedure limits

  • The abdominoplasty with transposition of the umbilicus does not treat a round stomach if it is due to an intra-abdominal fat excess (around the viscera) relating to an excess weight. This is the reason why it is important to be at your ideal weight before planning the procedure.
  • The abdominoplasty with transposition of the umbilicus does not treat the stretch marks located above the navel.
  • The abdominoplasty with transposition of the umbilicus does not act on the excess fat located in the upper and lateral areas of the abdomen (beneath the breasts). these ones will require an upper body lift.

Good candidates for an abdominoplasty with transposition of the umbilicus are those

  • Having a lower abdominal apron covering more or less the pubis.
  • Having a cutaneous slackening in the subumbilical region of the abdomen.
  • Accepting the scarring price.
  • And having understood the procedure limits.

General pre-operative instructions relating to aesthetic surgery

  • Smoking cessation 1 month before and after the procedure.
  • Discontinuation of medicines which increase bleeding 10 days before and after the procedure: aspirin, anti-inflammatory and anticoagulant medicines, vitamin E.

Specific pre-operative instructions relating to the silhouette surgery

  • To be at your stable and ideal weight for 6 months at least.
  • Discontinuation of the oral contraception 1 month before the procedure in order to reduce the risk of thrombo-embolism (phlebitis and pulmonary embolism).
  • Purchase of a compression garment.

Procedure stages

Pre-operative markings are performed by Dr. Petit before the intervention.

This one is performed under general anesthesia and requires a hospital stay of one night at the clinic.

The procedure usually starts with a liposuction of the abdomen. Then, it consists in removing all the excess skin between the navel and the pubis, and to tighten the subumbilical abdominal skin as well as the pubis. The umbilicus is re-positioned properly at the end of the operation. In case of associated slackening of the abdominal muscles, a firming of theses muscles will be performed in order to tighten your abdominal wall and to refine your waist. This gesture is known as cure of diastasis of the rectus abdominis muscles.

Two scars are necessary:

  • 1 low scar concealed in the underwear, located above the pubis and extending from on hip to the other.
  • 1 scar around the umbilicus.

The cutaneous closure is performed with sub-cutaneous dissolving sutures.

A dressing modeling the abdomen is performed at the end of the procedure.

What to expect after surgery

The abdominoplasty with transposition of the umbilicus is a moderately painful procedure in the absence of gestures relating to the muscles of the abdominal wall. Pains are well soothed by analgesics.

Ecchymosis (bruises) are classical and subside within 2 to 3 weeks after the operation. An oedema (swelling) is constant and of variable duration, gradually subsiding within a few months.

Daily nursing care after your shower with a soft soap are necessary during 15 days.

Three preventive measures against phlebitis are established after the procedure: the affected leg elevated as well as the walk, the wearing of compression stockings and the daily injection of an anticoagulant (medicines which thin the blood) over 15 days.

The wearing of a compression garment is recommended during 4 to 6 weeks in order to reduce the post-operative œdema, and to protect the suture of the muscles when it has been performed.

The progressive resumption of daily activities is possible the day following the procedure, provided you avoid carrying heavy loads during 4 to 6 weeks.

The resumption of professional activities is variable (2 to 3 weeks) and depends on the operative gesture performed and the work of the patient.

The resumption of sports activities can be done within 6 weeks following the operation.

Procedure risks

The complications of an-abdominoplasty with transposition of the umbilicus are weak and will be mentioned by Dr.Petit during the consultation.

Main risks are the following:

In the first hours following the surgery:

  • A haematoma (blood pooling), a rare complication requiring a revisionary process in order to drain it.

In the post-operative month:

  • Healing problems, resulting in one or several localized disunities (opening of the scar) requiring a directed healing.
  • A seroma (collection of fluid), requiring a drainage in consultation.
  • Transitory troubles of skin sensitivity.
  • An infection, a cutaneous necrosis: rare complications.
  • A phlebitis, a pulmonary embolism: exceptional complications with the preventive measures established previously.

In the long term:

  • A scar expansion, requiring a revisionary procedure.
  • A pathological scarring (hypertrophic scars or keloids).

Long-term result

The final result of a mini-abdominoplasty is obtained between 3 to 6 months after the procedure, when the post-operative oedema has disappeared.

The scars initially are inflammatory (red and swollen) the first months, then they will fade gradually without disappearing. The final aspect of de your scar is not predictable and will be known at the end of the scarring maturation (between 1 and 2 years after the procedure).

The result is long-lasting except in case of significant changes in body weight or pregnancy.

Notez cet article