Introductory information on abdominoplasty
Sometimes the skin of the abdomen can loosen in the lower quadrants, as after pregnancy, and take on a relaxed, sagging appearance. This is quite frequent in people with obesity and can also occur after significant weight loss. The procedure that can remedy this condition is abdominoplasty.
Prof. Bracaglia has refined abdominoplasty surgical techniques, which have been published in international scientific journals and made available to colleagues in the international scientific community via the “National Institutes of Health” and the “National Center for Biotechnology Information” (USA).
When abdominoplasty is needed
When the skin and subcutaneous fat of the abdomen become flaccid, overabundant, and slide downward, they take on a pendulous appearance in front of the pubis — the so-called “pendulous abdomen” or “apron belly”. This may appear in adulthood or old age, and sometimes even in youth.
A pendulous abdomen can cause significant discomfort because it looks unnatural, lax, and drooping, sometimes worsened by the presence of stretch marks.
In more advanced cases, the abdominal skin may hang so low in front of the pubis that it creates a wide fold covering the genitals and the upper thighs. At the base of this deep skin fold, chronic irritation can develop, often worsening in summer when sweat macerates the skin.
All these situations can be effectively treated with abdominoplasty.
Abdominoplasty: how it works
With abdominoplasty (or dermolipectomy), the excess skin and fat are removed and, if necessary, the tone of the abdominal muscles is restored by addressing the rectus and oblique muscles, which make up the abdominal wall.
The classic cosmetic abdominoplasty or dermolipectomy always acts on superficial planes: the surgeon does not open the abdominal cavity and remains in the plane between the muscles and the skin. The outcome is an abdomen with a firmer, leaner, and more compact appearance.
The procedure involves a horizontal suprapubic incision whose length varies according to the amount of skin to be removed. The incision can be shorter in milder cases or extend toward the iliac crests in more severe cases.
In minor cases, the navel is not touched, whereas in major cases the umbilicus is repositioned in its correct location on the abdomen.
When indicated, abdominoplasty may be combined with liposuction.
If excess skin is confined to the lower abdomen between the pubis and the navel, the defect can be corrected with a more limited procedure known as mini abdominoplasty.
Scars
In most cases, the scar remains hidden below the edge of underwear or swimwear. If the abdominal wall muscles are lax, they can be brought together to restore physiological continuity and strength, and the rectus muscles are approximated to their proper position.
At the end of abdominoplasty or dermolipectomy, the excess skin and subcutaneous fat are removed.
Anesthesia
Abdominoplasty or dermolipectomy is performed under general anesthesia. Hospitalization lasts 2 days.
Post-operative course
After surgery, pain is usually mild and short-lived, and can be managed with common analgesics. In some cases, it is absent.
Complications such as infections, significant blood/serum collections, or wound reopening (dehiscence) are uncommon. Carefully following the surgeon’s pre- and post-operative instructions significantly reduces risk.
Recovery
People with diabetes or heavy smokers who did not stop smoking before surgery may experience slower healing after abdominoplasty. For otherwise healthy individuals, recovery is generally quite rapid.
Convalescence typically lasts at least 10–14 days; during this period, wearing a compression garment (abdominal binder) is required.
