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Two weeks prior to your operation,
you will need to discontinue medications which can lead
to surgical complications. You will meet with Dr. Parker
and his nurse for a second visit, during which any remaining
questions regarding the operation are answered. You
will then be asked to sign a surgical consent which
gives the doctor your permission to carry out the procedure
of abdominoplasty, and allows for an Anesthesiologist
to administer a general anesthetic.
Photographs will be taken of your
abdomen and any other areas upon which Dr. Parker will
be operating. You will be asked to sign a photographic
consent prior to having any photographs taken.
A general physical examination will
be done to ensure that no ongoing medical problems are
present which might interfere with the success of the
operation. IT IS IMPERATIVE THAT YOU REPORT ANY POSSIBILITY
THAT YOU COULD BE PREGNANT.
Specific instructions regarding the
date and time of your procedure will be given to you
in writing. You will need to arrange for an escort to
drive you to and from the surgical center on the day
of the operation and for the first postoperative visit.
You should wear loose fitting clothing that will wash
easily in the event they are soiled. Do not wear jewelry,
contact lenses, or bring valuables to the operating
room. Remove all body jewelry from pierced body parts;
this can interfere with the procedure and may represent
a safety threat to you because of the use of electrocautery
during the procedure. DO NOT SHAVE OR WAX your abdomen
prior to surgery; this may increase your risk of infection.
Appropriate shaving will be done on the morning of your
procedure.
Finally, Dr. Parker will write prescriptions
for preventative antibiotics to decrease your risk of
infection and a narcotic analgesic for postoperative
pain relief.
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On the day of your procedure, you will meet with Dr.
Parker’s nurse and have your vital signs checked.
The doctor will place skin markings on your abdomen
to direct him during the procedure. The anesthesiologist
will review your medical history and he or she will
then administer an anesthetic known as a general anesthetic.
This implies that you will be completely unconscious
during the operation, and will feel no pain whatsoever.
A full abdominoplasty usually takes 2-3 hours, depending
on the extent of the work involved. During the procedure,
the lower abdominal skin and fat are excised or removed.
This tissue is discarded and will not return. The abdominal
skin above the level of the navel is then lifted off
the underlying muscle up to your lower rib cage, like
lifting an apron. A cut is made around the navel , which
is left alone.
The vertical abdominal muscles are then tightened with
heavy sutures from your xiphoid (solar plexus) to your
pubic bone. This provides a firmer abdominal wall and
a narrower waistline. The skin apron is then pulled
down to the pubic area and after a new opening is made
for the navel, the skin is stitched. Drain tubes are
placed under the skin apron to evacuate any fluid which
may ooze after the operation. The drains exit in the
area of the pubic hair through tiny holes and are stitched
in place. These drains are removed approximately a week
after surgery. The closure of the skin is done with
dissolving-type suture material, which does not require
removal.
An elastic belt or binder is placed to support your
abdomen and provide comfort during the postoperative
period. Almost always, patients are ready to be discharged
from the recovery room an hour or two after the conclusion
of their procedure, but it is necessary to have an escort
to drive you home. Patients cannot be discharged to
the company of a minor or to a taxi service. If you
have no one to provide you with assistance, our office
can make arrangements for medical transport at an additional
charge. Out-of-town patients should plan to stay locally
for approximately 7-10 days.
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For
the first few days, your abdomen will be swollen and you
are likely to feel discomfort which can be controlled
with medication. We will provide you with instructions
for hygiene and activity. It is important for you to rest,
but at the same time it is also important to begin walking
as soon as possible to avoid complications such as deep
venous thrombosis and/or pulmonary emboli. Occasionally,
patients will be sent home with a Foley (urinary) catheter
in place for their convenience, and for close monitoring
of their fluid balance. This is placed after you are under
anesthesia, and is usually not uncomfortable in any way.
If used, the catheter is removed in 1-2 days.
You will be seen back in the office
in 1-3 days, at which time the wound is checked, dressings
changed, and if necessary, the urinary catheter is removed.
On the next visit, usually at 7 days, sutures around
the navel and the drainage tubes are removed. Most people
return to work shortly after this, but in some instances,
work cannot be resumed for 3-4 weeks. This depends on
the occupation of the patient, and their individual
pain tolerance and healing characteristics.
The abdomen does not usually feel
"normal" for several months after surgery.
There may be some temporary numbness, particularly just
above the incision in the middle, that may stay permanently
numb. The abdomen feels very tight, and one feels occasional
twinges of pain from time to time during this later
healing phase. The scars take at least a year to mature
and fade, and may require additional treatment to optimize
their appearance. While they will never disappear completely,
the scars will not show under clothing, even bathing
suits.
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