Abdominoplasty known more commonly as a "Tummy Tuck", is a surgical procedure to remove excess skin and fat from the middle and lower abdomen and to tighten the muscles of the abdominal wall. The procedure can dramatically reduce the appearance of a protruding abdomen and make it flat. But it does produce a permanent scar, which can extend from hip to hip but is hidden in the bikini line.   The best candidates for Abdominoplasty The best candidates for Abdominoplasty are men and women who are in good health but are bothered by loose abdominal skin or a protruding abdomen which does not respond to dieting and exercise.   The procedure is especially helpful for women who through multiple pregnancies have stretched the skin and muscles to such a degree that it cannot return to normal.   Patients who are likely to lose significant amount of weight in the near future should postpone the surgery. Women whose childbearing is not complete should postpone the surgery as the abdominal muscles which are brought together during surgery will again separate during the pregnancy.   Uncertainty and risk Abdominoplasty when done by a qualified plastic surgeon is generally a safe procedure, with good results. However, like any surgery, it does carry a certain risk and some complications related to the procedure.   Infection and blood clot formation are two complications related to the surgery. Infection is prevented by meticulous technique and use of antibiotics but in the rare instance of infection occurring, antibiotics are used to treat the infection. Blood clot formation is reduced by insertion of drainage tubes and early mobilisation. Poor healing can lead to conspicuous scars and may require second surgery. Smokers should quit smoking to ensure good healing. Planning the surgery In the first consultation, the surgeon will evaluate your health, determine the extent of fat deposits in your abdominal region, and carefully assess your skin tone. Be sure to tell your surgeon if you smoke, and if you're taking any medications, vitamins, or other drugs.   If the fat deposits are limited to the area below the navel then a less complex procedure called partial abdominoplasty or mini tummy tuck can be done. Liposuction done along with the procedure can treat the bulges on the sides. Liposuction alone may be done when there is good skin tone and no skin laxity. The surgeon after the examination will decide which surgical procedure suits you the best.   Preparing for surgery Your surgeon will inform you about the dos and don'ts prior to the surgery including diet, smoking and what medications to avoid.You should also discuss and be informed about the anaesthesia which will be used for the surgery.   Anaesthesia Most often, abdominoplasty is done under general anaesthesia where the patient sleeps throughout the surgery.   Surgery For the first few days, the abdomen will probably be swollen and there is some pain and discomfort which can be controlled by medication. Depending on the extent of the surgery, the patient may be released within two to three days or may have to remain hospitalized for seven to ten days.   The tubes come out after 3 to 4 days.   Though it may not be possible to stand straight at first, walking can be started as soon as possible.     Stitches will be removed in five to seven days. The dressing on the incision may be replaced by a support garment   Getting back to normal It may take you weeks or months to feel absolutely normal again. Some people return to work after two weeks, while others take three or four weeks to rest and recuperate.   Exercise will help healing. Even people who have never exercised before should begin an exercise program to reduce swelling, lower the chance of blood clots, and tone muscles. Vigorous exercise, however, should be avoided until you can do it comfortably.   Scars may actually appear to worsen during the first three to six months as they heal, but this is normal. Expect it to take nine months to a year before scars flatten out and lighten in colour. While they'll never disappear completely, abdominal scars will not show under most clothing, even under bathing suits.   Abdominoplasty, whether partial or complete, produces excellent results for patients with weakened abdominal muscles or excess skin. And in most cases, the results are long lasting if you follow a balanced diet and exercise regularly.   If you're realistic in your expectations and prepared for the consequences of a permanent scar and a lengthy recovery period, abdominoplasty may be just the answer for you.       Message All rights reserved 2007@ Dr. Shrirang Purohit