PEER-REVIEW | PREGNANCY AND AESTHETICS |
involves the removal of excess skin and fat from the middle and lower abdomen in order to tighten the muscle and fascia of the abdominal wall. Abdominoplasty operations vary in scope and are frequently subdivided into categories, depending on the extent of the surgery. There are different variations on the technique dependent on which tissues are sagging and if there is associated weight loss or residual fat to be removed. The first variant is whether a partial or a complete abdominoplasty is required30
.
■ Complete abdominoplasty can take from 1 to 5 hours. During this procedure, an incision is made from hip to hip just above the pubic area and another is made to free the navel from the surrounding skin. The skin is then detached from the abdominal wall to reveal the muscles and fascia to be tightened
■ Partial abdominoplasty (mini-tuck abdominoplasty) can be completed between 1 to 2 hours. During this technique, a smaller incision is made and the skin and fat of the lower abdomen are detached in a more limited fashion from the muscle fascia. The skin is stretched down and excess skin removed
■ Extended abdominoplasty includes a lateral thigh lift. The operation allows for complete abdominal contouring as well as smoothing the contour of the upper lateral thigh
■ High lateral tension abdominoplasty (HTLA) tightens abdominal muscles in a vertical line. This method, in addition to vertical-line tightening, tightens muscles horizontally. The final result with this technique is a dramatically flat abdomen with significantly better-defined waistline31
■ Floating abdominoplasty or FAB technique (also known as an extended mini-abdominoplasty) allows for tightening and shaping through a smaller incision that isn’t placed around the belly button. Through this smaller incision, excess skin is removed and the belly button is temporarily detached, floating above the muscles during this process. The muscles are tightened and reshaped from sternum to pubic area.
■ Combination abdominoplasty includes a lower body lift done in conjunction with another procedure such as breast reduction, breast lift, hysterectomy or liposuction contouring.
Abdominoplasty carries certain risks that
may be serious or life-threatening. When making the decision to undergo such a procedure it is recommended to compare the benefits with the potential risks and complications. Hence, all patients must be informed of all the risks they are exposing themselves to32
thromboembolic disease (relative); morbid obesity (BMI >40); and unrealistic patient expectations. Combined aesthetic and gynecologic surgery is an attractive option for both patients and surgeons. A popular name for breast enhancement procedures performed in conjunction with an abdominoplasty after pregnancy is now called a ‘Mommy Makeover’.
Stretch marks
occur during pregnancy and are caused by rapid stretching of the dermal tissue of the abdomen during the distension and weight gain of pregnancy.
Breast atrophy Solution: Breast implants and hyaluronic acid This is one of the most obvious places to see the difference between a ‘pre’ and ‘post’ pregnancy body type. During pregnancy, the ovaries and the placenta produce estrogen and progesterone. These hormones stimulate the 15 to 20 lobes of the milk-secreting glands in the breasts to develop. It is widely accepted that most breasts seem to undergo a ‘deflationary’ change in the weeks and months after weaning. The reason that this occurs is due to the fact the ratio of fat tissue to gland tissue in a women’s breast actually changes with the new requirements of the body. Most women tend to regain their normal cup size post natally but many do not, especially if they have breast fed. The body has underwent a physiological redistribution of fat and when the breast gland tissue regresses there is less fat and the breast may shrink, especially in the upper poles. Ptosis of the breast is the medical term for drooping or sagging female breasts. Many women and medical professionals mistakenly believe that the breast itself offers insufficient support and that wearing a bra prevents sagging. Many also believe that nursing increases sagging. Society is hard on mothers and very few magazine pictures display this new physiotype as anything to be proud of. One of the most popular treatments for breast atrophy remains breast implants. There are three general types of these devices, defined by their filler material: saline solution, silicone gel, and composite filler. The saline implant has an elastomer silicone shell filled with sterile saline solution; the silicone implant has an elastomer silicone shell filled with viscous silicone gel; and the alternative composition implants featured miscellaneous fillers, such as hyaluronic acid, soy oil and even polypropylene string33
. When .
These combination techniques mean the patient is under anaesthesia for a longer period of time, increasing the mortality risk. Contraindications to abdominoplasty include right, left, or bilateral upper quadrant scars (relative); severe comorbid conditions (eg, heart disease, diabetes, morbid obesity, cigarette smoking); future plans for pregnancy (relative); a history of
60 ❚ March 2015 |
prime-journal.com
compared to the results achieved with a silicone-gel breast implant, the saline implant can yield acceptable results of increased breast-size, smoother hemisphere-contour, and realistic texture; yet, it is likelier to cause cosmetic problems, such as the rippling and the wrinkling of the breast-envelope skin, accelerated lower breast pole stretch, and technical
problems, such as the presence of the implant being noticeable to the eye and to the touch34
. Women with breast implants may have functional
breast-feeding difficulties; mammoplasty procedures that feature periareolar incisions are especially likely
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