Complicaciones y dolor después de una abdominoplastia
Complications and pain after a tummy tuck
The tummy tuck also known in medical terms as abdominoplasty, is a plastic surgery procedure designed to improve the appearance of the abdominal area in patients with skin sagginess. The unsightly appearance of the tummy can be caused by many factors, including multiple pregnancies, considerable weight fluctuations, and even the natural aging process. The skin loses elasticity in time skin folds can occur on the lower abdomen that is not pleasant to look at and alters the overall appearance of the body.
The tummy tuck is a complex surgical procedure that should be performed only by an experienced, board-certified plastic surgeon in a hospital or accredited medical facility. Patients interested in undergoing the tummy tuck should be aware of the complications that can occur and also the level of pain to be expected during the recovery period.
In this article, we will discuss how the tummy tuck is performed and post-op complications that are possible.
Tummy tuck: best candidates and surgical plan
To be a good candidate for any type of plastic surgery procedure, the patient should be in good health and emotional condition. The procedure is performed on an elective basis, and even something as simple as a cold can determine a delay in the date set for the surgery. A patient who is prepared and in good health will be able to recover faster and also avoid certain complications that might occur.
While severe heart, lung and blood conditions are a contraindication for the procedure, patients with chronic conditions such as diabetes can still undergo the tummy tuck. However, it is important for the plastic surgeon to be fully aware of the health condition of the patient, current medication, and allergies to decide on the best surgical plan to be followed.
Good candidates for the abdominoplasty often present skin folds and sagginess on the lower abdomen, sometimes associated with loose abdominal muscles and an excess of fat on the tummy. The procedure should be performed on patients with a normal weight as it is not a cure for obesity and is not to be used as a weight loss method.
Abdominoplasty often requires general anesthetic for the comfort of the patient. The surgeon will make an incision on the lower part of the abdomen on the suprapubic area. The skin on the tummy is detached from the muscles of the abdominal wall up to the sternum. Abdominal muscles are strengthened with sutures if they have become distended due to multiple pregnancies, and umbilical hernia is also corrected if present. After this, the skin is re-draped on the muscles and the excess skin is removed surgically. The incision is then sutured and dressings are applied. Compressive garments or a girdle are mandatory to be worn after the tummy tuck.
Potential complications that can occur after a tummy tuck
Infection is a risk present in all cases of surgical procedures. An experienced plastic surgeon will perform the tummy tuck with the patient receiving antibiotics through the IV and will also prescribe antibiotics treatment for five days post-op. The patient also needs to be very careful when changing the dressing after the surgery and looking after the surgical incisions until they fully heal. Common signs of infection are high fever, intense pain, and pus coming from the incision sites. If you notice any of these signs or a combination of them, make sure to get in touch with the plastic surgeon or your doctor as soon as possible.
– Delayed wound healing
This complication is more common for patients who don’t give up smoking. The recommendation from the plastic surgeon is to quit smoking three to six weeks before the procedure and stay smoke-free for the same amount of time post-operatively. The low levels of oxygen in the blood due to smoking can interfere with the healing process and cause delayed wound healing.
– Lack of sensitivity on the incisions
Often, changes in sensitivity occur on the operated areas. These changes usually disappear within the first few weeks after the procedure and in rare cases, they can become permanent. The lack of sensitivity is not generalized to the whole abdominal area, and mostly it is just the incisions that can suffer from a lack of sensitivity.
– Seromas and hematomas
These are collections of blood or other fluids that occur on the operated area. They often occur shortly after the procedure and don’t require specific treatment if they are small in size. To prevent blood and fluids from accumulating at the incision site, plastic surgeons often insert drain tubes on each side of the abdomen so the fluids can drain from the body. If the seroma or hematoma that develops is of considerable size, the plastic surgeon might decide to perform a procedure to treat it. The fluid can be extracted with a syringe. The use of compressive garments and girdles can prevent the development of hematomas and seromas.
– Unsightly scars
The scars that occur after the tummy tuck need time to heal. Patients might find it difficult to understand that it can take up to one year or more for the appearance of the scar to be final. During the first few weeks and months after the procedure, the scars will go through different healing stages and their appearance might look unsightly. However, after the cicatrization process is complete, unsightly scarring is possible in few and rare cases. Unsightly scars can be caused by the patient’s natural tendency for abnormal scarring (keloid and hypertrophic scars) or because of a lack of proper care of the incisions during the recovery period. Again, make sure to follow the plastic surgeon’s recommendations to the letter, don’t apply products on the incisions not prescribed by the plastic surgeon, and wear the girdle.
Our body is not perfectly symmetrical, and after the tummy tuck, there might be slight differences or asymmetry in the abdominal area. In some cases, the belly button might not be positioned exactly in the middle of the abdomen due to the stretching of the tissues that occurs during healing. To prevent asymmetry after the tummy tuck, make sure to select a highly experienced plastic surgeon to play out your procedure.
– Skin or umbilical necrosis
When complete tummy tucks are performed, the navel needs to be repositioned after the excess skin is removed. If the tissues don’t heal properly, umbilical necrosis can occur, and this might deem an additional procedure to be performed to reconstruct the navel. Skin necrosis can also occur on incisions as well, but only in rare cases. Skin and umbilical necrosis that can occur after the tummy tuck can often be avoided if the patient quits smoking before the procedure and remains a non-smoker during the recovery period.
Pain after the tummy tuck
Patients planning to undergo the procedure are wondering about the level of pain to be expected during the recovery period. It is common for patients to experience pain during the first few days after the procedure, but the pain is not intense and can be alleviated with antalgic medication. The intensity of pain depends from patient to patient, so if you have a low tolerance to pain, make sure to discuss this issue with the plastic surgeon.
Results after the tummy tuck
For most patients, the tummy tuck delivers impressive results, but it is important to be aware of the risks and limitations before scheduling the procedure. The results of the tummy tuck are easily sustainable in time if the patient will manage to keep a constant weight. Gaining weight or losing weight after the abdominoplasty can result in the alteration of the aesthetic results achieved with the procedure. Moreover, keep in mind that an ulterior pregnancy can have the same effect as gaining weight (if not more considerable) due to the excessive stretching of the muscles on the abdominal wall that can cause diastasis recti and hence an unsightly appearance of the tummy.
Just like any other part of the body, the abdominal area is affected by different changes that occur with aging or pregnancy. The appearance and tonus of the skin changes with time and this might trigger skin sagginess on the tummy. To correct the unsightly appearance of the tummy, abdominoplasty can be performed. A certain level of pain is normal after the tummy tuck and certain complications can occur, just like any other surgical procedure.
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