The abdomen skin can slacken till it assumes a flabby, saggy aspect in front of the pubes.
This is particularly frequent in obese people or in whoever has undergone a significant loss of weight, or after a pregnancy. In the cases of some young obese subjects, the relaxation of the abdominal skin occurs precociously even due to a family predisposition.
The abdomen cutis and the subcutaneous panniculum become flabby, redundant and slide downwards, assuming a pendulous aspect in front of the pubes, almost as an apron, named “pendulous abdomen” or “abdominal apron”.
This phenomenon can occur both in adult and elderly age, but sometimes even in young people. The pendulous abdomen causes a strong feeling of uneasiness because an unnatural, saggy, pendulous aspect is assumed, sometimes worsened by a myriad of stretch marks.
In the worse cases, the abdomen cutis might hang so loosely in front of the pubic area that it duplicates, forming a large fold, which covers the genitals and the higher part of the thighs. At the bottom of this crease a chronic irritation can occur, which tends to worsen during the summer period, when perspiration macerates the skin. Such a situation also causes difficulty in movements in normal social life.
With the abdominoplasty or dermolipectomy surgery, excess skin and fat are removed and, when necessary, the tone of the abdomen muscles is recreated through the appropriate operation on the vertical and oblique muscles, which constitute the structure of the abdominal wall. In some people, who used to be obese, or after a pregnancy, these muscles might have parted, progressively collapsing.
When the abdominoplasty or dermolipectomy operation is a cosmetic procedure, all the surgical steps are limited to the superficial layers; the abdominal cavity, where the viscera are located, is never opened.
The result obtained after an abdominoplasty or dermolipectomy operation is an abdomen that looks more tonic, tight and compact. During surgery, a horizontal incision above the pubic area is performed, the length of which varies according to the quantity of skin that has to be removed: it may be shorter in less conspicuous cases or from hipbone to hipbone in the more serious cases. In most cases, the scar is hidden by the edge of the underwear or bathing suit. Whenever needed, the abdominal muscles are pulled close together to recreate the continuity of the muscular system. At the end of the abdominoplasty or dermolipectomy surgery, the exceeding subcutaneous skin and fat are removed and the rectus abdominis muscles are pulled back together in the right position.
In minor cases the navel remains untouched, while in major cases the operation is concluded by repositioning the navel in its original seat, where it is stitched to the abdomen skin.
When indicated, it is possible to associate a liposuction to the abdominoplasty or dermolipectomy operation. Sometimes, the excess skin is present in the lower part of the abdomen, between the pubic area and the navel. Such a defect can be corrected with a more limited operation, called “mini abdominoplasty”.
The abdominoplasty or dermolipectomy surgery is performed under general anaesthesia. Hospitalization lasts 2 days. In the post-operation phase pain is modest and temporary, easy to control with a common pain-killer. In some cases, pain is completely absent.
Complications, such as infections or major blood or serum stagnation, or the re-opening of wounds (dehiscence), seldom occur. The risk of complications can be reduced by closely following the pre- and postoperative instructions provided by the surgeon. After an abdominoplasty or dermolipectomy surgery, recovery may be slower with diabetic people or strong smokers who do not stop smoking before the operation. In healthy people, the recovery phase is quite fast. According to the case, convalescence at home lasts at least 10-14 days and during such a period a support garment needs to be worn.