EL-ROUBY-CLINIC

Abdominoplasty (Tummy tuck, Lipectomy or Apronectomy)

What is Tummy Tuck or Abdominoplasty?

Tummy tuck, or abdominoplasty, can help individuals to reduce or remove the appearance of a protruding abdomen leaving the area looking flatter, firmer and tighter as well as a high defined waist. This is achieved by removing excess skin and fat from the abdominal area, and having the muscles tightened.

Historically, the greatest efforts have been made to reduce a woman's waist line. Boned corsets were used for several centuries, but during the twentieth century these were mostly replaced with more flexible foundation garments. Where corsets are used for waist reduction, it may be temporary reduction by occasional use or permanent reduction by people who are often referred to as tight-lacers. Liposuction and tummy tuck are the common surgical methods of reducing the waist size.

The protruding abdomen can be the result of stretching the abdomen to a point where dieting and exercise have no effect on changing its appearance. Whether stretched by factors such as weight gain, weight loss, pregnancy, etc., the abdomen frequently fails to return to its original shape. Stretched beyond the capacity to return to normal, abdominal tissues don't always respond to various exercise and diet programs.

In such cases, a tummy tuck may provide a highly effective, immediate solution in the treatment of stubborn abdominal areas.

While the degree of improvement varies significantly depending on the magnitude of the abdominoplasty surgery, other factors contribute to the surgical outcome such as the patient's skin tone, body build, and the individual healing process. Aside from these issues, most patients are happy with the results offered through abdominoplasty and maintain a more favorable body image following the surgery.

There are options to the traditional tummy tuck procedure; a mini tummy tuck, or simply liposuction can gain the appearance of a firmer abdomen.

A mini tummy tuck is designed to help those who are dissatisfied with their abdominal appearance below the navel (umbilicus). Liposuction removes just the fat from the abdominal area to gain a flatter appearance.

With the increasing popularity of various cosmetic surgery procedures, it is imperative that the prospective patient research and understand different issues like what the procedure can and cannot treat, inherent risks, costs, and so on. When considering any form of cosmetic surgery, it is important to have a good understanding of the procedure before making a decision. Take some time to view the introductory information we have provided on tummy tuck or abdominoplasty. While the information contained in this website will provide you with a basic understanding of the procedure, it may not answer all of your questions. To get complete answers to the questions you are seeking, we recommend that you contact us.

Body Shapes and Hip-Waist Ratio:

There are 7 basic categories of "body shapes" or "0, O, A, 8, H, I, V frames":
(1) The Pear Shape: "0 frame" Wide hip
(2) The Apple Shape: "O frame" Wide waist
(3) The Bell shape: "A frame" Wide hip and waist
(4) The Hourglass Shape: "8 frame" Narrow waist. The ideal one that we all wish we were
(5) The Brick Shape: "H frame" Straight throughout ("boy-shaped")
(6) The Column Shape: "I frame" Thin and tall
(7) The Cornet Shape: "V frame" Wide chest and narrow waist and hip

Distribution of excess weight, indicated by body shape, is important. Apple-shaped (top-heavy) bodies indicate that extra weight is centered around the waist; pear-shaped (bottom-heavy) bodies indicate that extra weight is centered on the hips and thighs.

The Apple-shaped bodies are more troublesome because they are associated with greater risks for medical diseases like heart disease, high blood pressure, diabetes and stroke.

The Pear-shaped bodies are thought to have more difficulty than Apples in changing their shape by dieting and exercise.

The size of an individual’s waist can be a reflection of both total and abdominal fat. Studies tell us that waist sizes greater than 40 inches (102 cm) in men and 35 inches (80 cm) in women are associated with apron abdomen.

Waist-hip ratio:

The waist-hip ratio (WHR) is a person's waist measurement divided by the hip measurement. Notwithstanding wide cultural differences in preferences for female build, scientists have discovered that the waist-hip ratio of any build is very strongly correlated to the perception of attractiveness across all cultures.

Women with a 0.7 WHR (waist circumference that is 70% of the hip circumference) are usually rated as more attractive by men from European cultures. In other cultures, preferences vary, ranging from 0.6 in China, to 0.8 or 0.9 in parts of South America, Africa and Arab countries and divergent preferences based on ethnicity, rather than nationality, have also been noted.

WHR has been found to be a more efficient predictor of mortality in older people than waist circumference or body mass index (BMI).

Changes to body shape:

The aging process has an inevitable impact on a person's body shape. A woman's sex hormone levels will affect the fat distribution on her body. Concentrations of estrogen will influence where body fat is stored.

Before puberty both males and females have a similar waist-hip ratio. At puberty, a girl's sex hormones, mainly estrogen, will promote breast development, and until menopause a woman's estrogen levels will cause her body to store excess fat in the buttocks, hips and thighs, but generally not around her waist, which will remain about the same size as it was before puberty. These factors result in women's WHR being lower than for males.

During and after pregnancy, a woman experiences body shape changes. After menopause, with the reduced production of estrogen by the ovaries, there is a tendency for fat to redistribute from a female's buttocks, hips and thighs to her waist or abdomen.

Various strategies are sometimes employed to temporarily or permanently alter the shape of a body. The most common include dieting and exercise. However, the protruding abdomen is the result of stretching the abdomen to a point where dieting and exercise have no effect on changing its appearance.
Therefore, Tummy Tuck will be the only solution.
In addition, breasts can be surgically enlarged using breast implants or reduced by the systematic removal of parts of the breasts.
Also, buttock augmentation surgery may be used to increase the size of hips and buttocks and to make them more rounded.

Who Would Best Represent an Ideal Candidate for a Tummy Tuck?

There are several important factors one must consider in determining whether or not abdominoplasty is the appropriate procedure for them. During the consultation visit, it is recommended that the patient ask if he is a good candidate for abdominoplasty. In determining one’s readiness for abdominoplasty, the patient should:

- Be realistic with the tummy tuck expectations.
- Be 18 years of age or older.
- Be mature enough to fully understand the procedure.
- Be in relatively good physical condition.
- Be in good psychological health.
- Not be pregnant or planning on becoming pregnant within a year.
- Not be severely overweight (BMI is less than 45% for woman and 47% for men).

In short, a tummy tuck may dramatically tighten the abdominal muscles as well as remove sagging, excess skin and accumulated fatty tissue. As an added benefit of the tummy tuck, not only will the abdominal region be firmer and flatter, but the waist will be smaller as well.

How is the Tummy Tuck Performed?

In an effort to achieve the best tummy tuck result, several different surgical techniques are available. The most appropriate technique will be selected based on the condition of the patient, the extent of the procedure as well as the patient/surgeon preference. Contingent on the patient's desired outcome, as well as their pre-operative status, the surgeon may recommend that either a partial or full tummy tuck be done in conjunction with Liposuction.

- Most tummy tuck procedures are performed under general anesthesia especially "a full tummy tuck procedure". However, Mini-Abdominoplasty, "partial tummy tuck" or "Apronectomy" could be done under local anesthesia with sedation.
- While many tummy tuck procedures are performed in a hospital setting, some are done in an office surgical suite.
- The procedure takes 2 to 3 hours.

Full Tummy Tuck or "Lipectomy":

- a surgical incision is made across the lower abdomen right above the pubic area. Following the creation of this initial incision, a second incision is made around the patient's belly button as a means of loosening the surrounding skin.

- Next, the patient's skin is separated from the wall of abdomen.

- Then, we pull the loose abdominal muscles from the left and right flanks and sutures them together.
This action results in:
- tighter abdominal muscles,
- a stronger, firmer abdominal wall,
- a smaller waist.

- Directly after the tightening and suturing of the abdominal muscles, excess skin is removed and a new opening is made in the correct position for the belly button.

- Any remaining incisions are closed with sutures (stitches) and/or staples. A drain could be used to avoid postoperative accumulation of blood or fluids under the skin flap.

- Lastly, surgical gauze is placed over the incision area in an effort to keep the abdominal region clean and free from infection. A pressure garment or abdominal binder should be applied for three months.

- Liposuction is frequently incorporated into those tummy tuck cases where additional fat deposits need to be removed from the hips, resulting in more rejuvenated, dramatic body contour. Occasionally, liposuction alone may offer the best results.

Partial Tummy Tuck, "Mini-Abdominoplasty" or "Apronectomy":

- This procedure was designed to treat problem areas existing below the belly button.
- This less invasive form of abdominoplasty is frequently performed on an outpatient basis and typically requires a local form of anesthetic.
- a surgical incision is made across the lower abdomen right above the pubic area.
- Following the creation of this initial incision, an elliptical excess skin tissues are excisied.
- The wounds are closed with sutures (stitches) and/or staples.

What to Expect on recovery period after abdominoplasty?

- Depending on the extent of the tummy tuck, an overnight stay in a hospital is common. This allows for the patient's recovery process to be monitored by trained medical staff. If the treatment area is minimal, the patient may return home the same day.

- While it may take most tummy tuck patients several weeks to feel completely back to normal, those patients who are in good physical condition will experience faster recovery times within one week. Additionally, some tummy tuck patients are able to return to work after two weeks, others will require up to four weeks to recuperate.

- Early light exercise following surgery is important to reduce swelling, decrease the possibility of developing blood clots and enhance skin tone. However, vigorous exercise, such as lifting heavy objects, etc., should be put off until it may be done comfortably and the surgeon has provided their consent to do so within 3 months.

- We will provide additional instructions for various activities such as showering, changing the surgical dressings and walking.

- Stitches and sutures are typically removed within two weeks following surgery. Deeper sutures with ends that protrude through the skin, those used at deeper levels under the skin, will come out in two to three weeks.

- As with most surgical procedures, scars do result from tummy tucks. Typically, surgical scars appear to worsen during the first few months following a tummy tuck - this is normal. In some tummy tuck cases it may take up to a year before most scars flatten out and lighten in color. While scars never disappear completely, tummy tuck scars are placed in areas that will subsequently be covered by clothes, bathing suits.

How Much Pain is Associated With a Tummy Tuck?

- For the first few days following an Tummy Tuck, expect some degree of swelling in the abdominal region. Furthermore, it is likely that the patient will experience some pain and discomfort which may be controlled by various pain medications.

- In an effort to reduce any pain and discomfort associated with a tummy tuck, it is common that two to three days of bed rest is recommended. During this time, the patient should keep his legs slightly bent at the hips to reduce the amount of strain placed on the abdominal muscles.


What Are The Risks and Limitations of a Tummy Tuck?

All surgical procedures, including the tummy tuck, have potential risks associated with their performance. Basic risks include, bleeding, potential reaction to the anesthetic, and infection.
Some scaring is to be expected with a tummy tuck. As mentioned earlier, scars will become lighter and flatter with time.
Smoking may increase the risk of complications and may delay healing. Furthermore, smoking could potentially lead to larger scars. Most risks and complications associated with the tummy tuck may be reduced significantly by closely following any and all of our instructions.

What is The Long-Term Effect of a Tummy Tuck?

For most tummy tuck patients, the long-term results associated with the procedure are excellent. Issues such as keeping one's weight relatively constant, eating a healthy diet, exercising regularly, and carefully following our instructions regarding physical activity, etc., determine the overall effect associated with a tummy tuck. However, the results are permanent.

What Are The Typical Costs Associated With a Tummy Tuck?

Often the price says nothing about the quality of the work. Most multicenter clinics charge much more than private doctors — their advertising budget is more and the owner of the clinic has to take his 20% or 30% off the top. In my opinion, you are less likely to get a quality procedures at these multi-center locations.

Although price is a factor when deciding on surgery, the most important factor is that you feel you are getting a good quality, natural-looking result from the procedure.

Tummy tuck procedure costs are variable according to the BMI, previous surgeries, associated conditions and the used technique. Usually the cost is ranging from 1500 to 2500 U.S. dollars. Most medical insurance providers do not cover the procedure.

Frequently asked questions from patients when considering undergoing Tummy Tuck?!

Q - What is the type of anesthesia, and when I can return to normal life?
A - According to your preference and the procedure. General anesthesia is the formal. However, Local anesthesia with sedation usually could be used, and you can practice your normal life within 2 days up to few weeks.

Q - What are the symptoms that may occur in the first five days after abdominoplasty procedures?
A - Soreness which could be managed by pain killer’s medications and there may be edema or swelling.

Q - What are the guarantees that the success of the process?
A - There is no doubt that the followers of the medical instructions and close follow up visits are the main factors for the success of any surgical procedure. If not, the process to achieve the agreed outcomes before, the process repeats at reduced cost. The procedure may needs refine touch after 8 months.

Q - When can we get the final results?
A - The final results is achieved within the first three months.

Q - If I gain weight again, may fat accumulate again?
A - No. But other non-treated areas could be.

Q - What is the maximum amount of fat to be removed?
A - Up to 20 Kilograms.

Q - What is ideal age for Abdominoplasty?
A - It could be done at any age above 18 years old.

Q - When could I get pregnancy after Abdominoplasty?
A - After one year you are allowed to get pregnancy but with close follow up by Gynecologist.

Q - If you are not Egyptian, What is the minimum period for follow up?
A - 3 weeks.

Q - What are the contraindications of Lipectomy procedures?
A - There are no absolute contraindications but the patients should inform their surgeons about any allergies, serious medical conditions, medications they may be taking, previous operations and family history of any medical problems. Smokers should stop smoking 2 weeks before surgical procedures to promote the healing process.

Q - Where will the Tummy Tuck procedures be performed?
A - In hospital or may be in outpatient bases (clinic).

Q - In my case, what is most appropriate procedure in helping me achieve my cosmetic goal? liposuction technique or tummy tuck? In my case, would a "partial abdominoplasty" work as well or better than a "full abdominoplasty"?
A - It depend on the your age, skin redundancy, distribution of body fat and your preference.

Q - How much does apronectomy procedure cost and what elements factor into that cost like hospital fees, anesthesia, and so on?
A - Ranging from 1500 to 2000 U.S. dollars per area. Medical insurance dose not cover these procedures.

Q - What is the surgeon’s level of experience in performing tummy tuck procedures?
A - Consultant or Doctoral in Plastic surgery.

Q - What percentage of patients experience complications with tummy tuck?
A - 6 - 11%

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Summary of Tummy Tuck (Abdominoplasty) Procedures:

The time of the procedure: from two to three hours.
Type of anesthesia: General anesthesia or local anesthesia +/- sedation.
Location: hospital with postoperative one day hospital stay.
Expected Side effects: Temporary swelling, ecchymosis and pain.
Recovery time: return to work after one week and the final outcome within 3 months.
Cost: according to procedure and treated area: 1500 to 2500 U.S. dollars, or 7500 to 11,000 Egyptian pounds.
Results: Permanent.

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