For patients where a liposuction is not enough to solve their aesthetic problem, plastic surgery has one of the most complete operations that exist, the abdominal Dermolipectomy or Abdominoplasty.

What does it involve?

It consists of the removal of excess skin and abdominal fat and the correction of the muscular flaccidity. With the abdominal dermolipectomy one can get a flatter and stronger abdomen and a narrower waist. It is a technique that sometimes combines with the liposuction to get better aesthetic results. It is often needed in patients who have had weight gain and later loss, women who have had several pregnancies or simply due to the passage of time. It is advisable to have this operation when one has decided not to have more pregnancies, since the gestation could undo the reconstruction. However, the contradiction regarding pregnancy is only aesthetic. From an organic point of view, a possible pregnancy does not pose any risk for women. According to the importance of the abdominal problem, a mini abdominal dermolipectomy can be performed, when the surplus is moderate and requires less cut  of the skin, or also a complete abdominal dermolipectomy in cases in which both the excess fat as the skin is more important. With this surgery the abdomens that are bulging, hanging, having  stretching marks below the navel and the scars of possible previous births by cesarean section are solved.

Patient’s Assessment  

It is very important in the first visit to consider three fundamental aspects: the skin, the fatty tissue and the muscle wall. This first analysis allows you to indicate the type of dermolipectomy that each patient requires and the need to use an additional technique (liposuction).
A complete medical history will be carried out to gather essential information prior to the operation such as the previous surgical background of the abdominal wall. A full preoperative consult will be required and pictures will be taken of the patient for the medical history.

What type of anesthesia is used?

The anesthesia used for a dermolipectomy is the general anesthesia. The operation lasts about two to three hours, depending if it is combined with another type of surgery or not. It requires a full day of recovery, and therefore, the patient spends the night in the clinic.

Surgical Technique

The abdominal dermolipectomy is carried out through an incision above the pubis, horizontally, making a curve. In this way we can reach the most important muscles in the abdomen, the abdominal rectum and the external oblique, centering them and causing as a result a tension. In fact, it forms a kind of natural belt that gives back to the abdomen its original appearance (muscular sutures). These muscles that are tensioned and united provide a firmer abdominal wall and a narrower waist. The separated skin is stretched towards the pubis and the skin, together with the excess of fat removed. The navel is placed in its new position. By eliminating the excessive skin, the possible stretch marks disappear and, if it is the case, the scar due to a precedent delivery by cesarean section.

Does it leave scars?

There is a thin linear scar above the pubis, longer than a cesarean section, but that will always be covered with a swimsuit, no matter how small. We have to wait a few months so that the scar flattens and lightens, then if the patient heals well it will not be very visible. Anyway, it is not something to worry about, above all to patients with stretch marks and previous scars, because it compensates for the elimination of all other visible scars for another that would be hidden above the pubic hair.

Is the operation painful? What cares are necessary?

The post-operative pain of an abdominal dermolipectomy is mild or moderate, disappearing almost entirely after three or five days after the operation, meanwhile, the patient may take anti-inflammatory and analgesics for his convenience.
As in a liposuction, it is required that you wear an abdominal bandage for approximately one month. When they remove the sutures after a few days you may start with the lymphatic drainage sessions, which help to remove the inflammation.
During the first days it is normal to feel a swollen abdomen and some tension in the lower abdomen. During the following week it is advisable to avoid physical effort and at first it may be somewhat difficult to walk. A good moisturizing of the abdomen skin is recommended. The results of an abdominal dermolipectomy shall be always final if accompanied by a balanced diet and regular exercise.

How to distinguish when there is a need for a liposuction or an abdominal dermolipectomy?

One can be treated with liposuction when there is no excess of skin, sagging skin, there is only fatty tissue to be eliminated and the abdominal wall is not relaxed. Then the liposuction is able to give an aesthetic figure proper to the abdomen wall.
If the abdomen is sagging, or globular, with stretch marks and excess of skin the only aesthetic solution to get a flat belly and an accentuated waist will be the dermolipectomy or abdominal abdominoplasty.