Personal Observations from a Feminine View:
Depending on the patient, I sometimes ask that she wear a corset prior to the Abdominoplasty, this is so that her internal abdominal organs can begin to get used to the new tighter position which will occur after the tightening of the abdominal musculature.
Liposuction of the abdominal flap
Since the year 2000 I have been doing liposuction of the abdominal flap which is being submitted to Abdominoplasty. This paper regarding this work was presented at the 37th Brazilian Congress of Plastic Surgery.
Because of scientific analysis and through patient follow-up, I am convinced that this procedure does not harm the blood-vessels that provide nutrition to this region.
Today, this procedure is has been accepted by a large number of plastic surgeons. I have made a number of presentations at congresses regarding this method, which demonstrates credibility by the Brazilian Plastic Surgery Society. You can see further information within my Curriculum.
Binding of the oblique muscles
I normally offer patients that are wide at the waist the possibility of approximating the oblique muscles so that the waist can be smaller. There is no woman who does not want to have a thinner waist. The binding of the abdominal muscles has become a routine in practically all stomach plastic surgery.
The routine that I follow is to apply liposuction to the regions near the stomach in order to obtain a greater aesthetic harmony in this region. I believe that it is a waste to just undergo plastic surgery of the stomach if there still is an excess of fat at the waist, the hips, sides of the ribs, etc. Without it, the aesthetic result will be incomplete. All women who undergo Abdominoplasty would like to look in the mirror and see that their body structure really improved.
I also suggest the grafting of sections of the patient’s own fat into regions of the gluteus, which helps provide a better projection to the buttock region. We provide a special treatment to the graft to avoid when possible the reabsorption of this fat. I normally use a little bit more fat, in a way to compensate the natural body absorption process.
A new belly-button
As a woman who wears a bikini at the beach, I know how important it is to have a nice belly-button. For this reason, I take very good care in creating a new belly button with the scars hidden, which looks natural and pleasing to the eye.
Marking the patient
The day before the surgery I draw a pattern on the patient’s skin with a special marker. This marking is done standing-up and in front of a mirror, looking at photographs that the patient may have brought (of a younger period).
Important for when making these marks is that the patient bring with them a bikini as a reference. This is so that I can make sure that the resulting scar will remain hidden by the bathing-suit.
This is a technique that I normally use to maintain the scars as small as possible. Each patient is instructed as to how she can place. The scar will undergo a special treatment that uses generally available medical tape (flesh colored works best) during the six months after the surgery.
Taping is a way to provide counter-tension to the scar during its forming process. Remember that any stitch and resulting scar will have a natural tendency to spread apart; specially, the ones located in areas of the body that are in movement. I have found that consistent taping, daily, during six months, greatly reduces the possibility of creating a wide scar.
The scarring process is individual to each person genetics; some persons will create scars that are better looking than others. Taping helps the normal scaring process but will not stop the formation of keloidal scars, if the patient has this tendency.