Abdominoplasty in former obese patients

ABDOMINOPLASTY (Abdominal Dermolipectomy) IN FORMERLY OBESE PATIENTS

  ABDOMINOPLASTY (Abdominal Dermolipectomy) IN FORMERLY OBESE PATIENTS

Patients who have undergone significant weight loss, whether through diet, diet and medication, or bariatric surgery, may have a large excess of skin in the abdomen, known as an apron belly, as their main complaint. Besides being aesthetically unpleasing, it can cause dermatitis (skin infections) and cellulitis, mainly due to difficulties in personal hygiene.It is considered a RECONSTRUCTIVE surgery, which is why it is covered by insurance companies and health plans, and should also be performed within the Unified Health System (SUS), but obtaining authorization and release can be difficult.It is a surgery performed on both men and women.It can be associated with the correction of midline hernias (epigastric hernia, umbilical hernia, incisional hernia), as well as the correction of rectus abdominis diastasis (separation of the muscle bellies) and the correction of previous scars.Furthermore, it can be combined with liposuction and other surgeries for formerly obese patients (arms, breasts, and thighs),* but due to its extent and the patient's other conditions and comorbidities (diabetes, hypertension, etc.), the surgical time should be faster to reduce the risk of complications such as bleeding, deep vein thrombosis (DVT), infection, and others.
What are the conditions for performing an abdominoplasty after bariatric surgery?

• The patient is expected to be in their best clinical condition at the time of surgery, meaning existing diseases are controlled.
• Patients who have undergone bariatric surgery, such as Sleeve gastrectomy and Gastric Bypass, may present with nutrient and vitamin deficiencies, as well as iron deficiency anemia.
• Weight stability for at least 6 months is recommended.

Where are the scars located in abdominoplasty?

Scars:Depends on the location of the excess skin, previous scars, and the choice made by the surgeon together with the patient. It can be anchor-shaped, longitudinal, transverse, or crescent-shaped.Navel: the existing scar can be used or a new navel (neoomphaloplasty) can be created.

What type of anesthesia is used for abdominoplasty?

Anesthesia:Anesthesia can be general, spinal, or epidural.

What is the hospitalization like for abdominoplasty?

Hospitalization:It can be performed as a DAY HOSPITAL procedure with discharge on the same day in a few cases, but discharge on the following day is preferable for patient observation and only if the patient is in good condition.

What is the post-operative period for abdominoplasty like? 

Post-operative / Recovery: Normally, the patient can return to activities in 2 to 3 weeks. An elastic garment must be worn for at least 1 month. The use of drains may be necessary.

What are the main complications in an abdominoplasty? 

The main complications are: Bleeding, hematoma, seroma, infection, unaesthetic scar, thrombosis, dehiscenceSource:http://www2.cirurgiaplastica.org.br/http://www.amato.com.br

https://youtu.be/OETRgX4HLro Description

Dr. Fernando Amato (CRM 133826) talks about abdominoplasty or abdominal dermolipectomy. Abdominoplasty consists of the aesthetic treatment of the abdomen, mainly involving the removal of excess skin and fat. Classic abdominoplasty involves the removal of skin and excess skin and fat below the navel, resulting in a scar at the location of a C-section and slightly larger. But there is also the anchor abdominoplasty, which is a surgical option for patients who have experienced significant weight loss, that is, they have lost a lot of weight.

Transcript

Hello, I'm Dr.

Fernando Amato and today we will talk about abdominoplasty
or abdominal dermolipectomy.

Abdominoplasty consists of the aesthetic treatment
of the abdomen, mainly with the removal

of excess skin and fat.

It can be classic abdominoplasty, which
is the removal of skin, excess skin

and fat below the navel and resulting in a
scar at the location of a C-section and a little

larger.

There is also anchor abdominoplasty,
which is a surgical option for those

patients who have had significant weight loss,
meaning, they have lost a lot of weight, either with diet

or with bariatric surgery and, in this case,
there will be a final anchor-shaped scar,

with a vertical and a horizontal scar.

There is inverted abdominoplasty or reverse abdominoplasty,
which is an option and is rarer,

to treat excess skin only above
the navel.

In addition, there is the famous mini abdominoplasty, which
is only called “mini” because it has a slightly smaller incision

than classic abdominoplasty, and in this
surgery, a procedure is performed to treat the entire

musculature, that is, with a small incision,
it dissects up to here, corrects umbilical hernia

when present, and this results in a slightly smaller
scar and removes

much less skin.

In addition, there is lipoabdominoplasty,
which is a combination of liposuction

in the abdomen and abdominoplasty.

It's a little different from when liposuction
is performed on the body and abdomen; in this

case, liposuction is performed on the abdomen
itself.

In all these surgeries, the treatment of
hernias that are in the midline is performed; the

most common is the umbilical hernia and the treatment
of rectus abdominis diastasis, which

is the separation that occurs in the musculature.

Many patients ask about the navel:
how the navel looks after these surgeries.

There are techniques that preserve the navel and
reinsert it into the new abdomen, and there is a scar

at the union of the old navel with this new abdomen;
depending on the case, it is even possible to leave it without a scar.

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