Here  in  Brazil,  we  call  the  Tommy-Tuck surgery as Abdominoplasty. This cosmetic procedure  treats loose or sagging abdominal skin, leading to a protruding abdomen that typically occurs after significant weight loss. The ideal candidates for abdominoplasty are individuals in good health who have one or more of the above conditions and who have tried to address these issues with diet and exercise with little or no results.

Women  who  have  had  multiple  pregnancies  often  seek abdominoplasty as a means of ridding themselves  of  loose  abdominal  skin.  While  in  many  cases  diet and exercise are sufficient in reducing  abdominal  fat  and  loose  skin  after  pregnancy, in some women these conditions may persist.

Another common reason for abdominoplasty is to remove excess skin from a person who has lost a large amount of weight or is obese. A  large  area  of  overhanging skin is called a pannus. Older patients   are at an increased risk of developing a pannus because  skin  loses  elasticity  as  one ages.  Problems with hygiene or wound formation can result in a patient who has multiple hanging folds of abdominal skin and fat. If a large area of excess tissue is removed, the procedure is called a panniculectomy.

The patient is usually placed under general anesthesia for the duration of surgery. The advantages to general anesthesia are that the patient remains unconscious during the procedure, which may take from two to five hours to complete; no pain will be experienced nor will the patient have any memory of the procedure; and the patient’s muscles remain completely relaxed, lending to safer surgery.

The  skin  will  be  lifted off the abdominal muscles from the incision up to the ribs, with a separate incision being made to free  the  umbilicus  (belly button).  The vertical abdominal muscles may be tightened by stitching them closer together. The skin is then stretched back over the abdomen and excess skin and fat are cut away. Another incision will be made across the stretched skin through which the umbilicus will be located and stitched into position.  A temporary drain may be placed to remove excess fluid from beneath the incision (for 1 week).  All  incisions  are then stitched closed and covered with dressings.

Additional Procedures

In some cases,  additional      procedures   may   be     performed   during   or   directly   following abdominoplasty.  Liposuction,  also  called  suction  lipectomy  or  lipoplasty, is a technique that removes fat that cannot be removed by diet or exercise. During  the  procedure,  which is generally performed in an outpatient surgical facility,  the  patient  is anesthetized and a hollow tube called a cannula is inserted under the skin into a fat deposit. By  physical  manipulation,  the  fat deposit is loosened and sucked out of the body. Liposuction may be used during  abdominoplasty  to remove fat deposits from the torso, hips, or other areas. This may create a more desired body contour.

Some   patients   may   choose   to   undergo   breast   augmentation,   reduction,  or  lift   during abdominoplasty.  Breast augmentation  involves  the insertion  of  a  silicone-filled  implant into the breast, most often behind the breast tissue or chest muscle wall.   A  breast  reduction  may  be performed on patients who have large breasts that cause an  array of symptoms such as back and neck pain. Breast reduction  removes  excess  breast  skin  and fat and moves the nipple and area around the nipple (called the areola) to a higher position. A breast  lift, also called a mastopexy, is performed on women who have low, sagging breasts, often  due  to  pregnancy,  nursing,  or aging. The surgical procedure is  similar  to  a breast reduction, but only excess skin is removed;  breast implants may also be inserted.

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