Body Cosmetic Surgery | Munare Clinic

BODY COSMETIC SURGERY

Sagging, loose, or non-firm abdominal skin can be corrected by surgically removing the excess abdominal skin and tightening the abdominal muscles to restore firmness. This improves the condition of the abdominal muscles and sagging skin to a state close to their original form, resulting in a well-shaped waistline and a firmer, more toned figure.

Technique 1: Mini Lipectomy

This is a surgical method focused on tightening only the lower abdomen, below the navel. It works well for patients who have never been pregnant or who have looseness caused by weight loss, where only skin and fat need to be removed. The incision scar will be shorter than in the full technique, and there is no need to reconstruct the navel. Surgery takes about 2–3 hours.

If performed on a patient with diastasis recti (separation of the abdominal wall muscles), it will only tighten the lower abdomen; the upper abdomen (epigastric area) may still protrude, leading to less optimal results. For patients with looseness in the upper abdomen as well, this technique may not be sufficient. It can be performed under general anesthesia or local anesthesia.

Technique 2: Full Lipectomy

This addresses looseness or stretch marks across the entire abdomen. Patients who have been pregnant often require this technique for the best results. The incision scar above the pubic area will be longer than in the mini technique, and navel reconstruction is required, as the skin above the navel will be pulled down to the pubic area. The skin between the navel and the pubic area will be entirely removed.

The surgery takes approximately 2–4 hours. This method can significantly improve abdominal contour since a larger amount of skin can be removed.

Technique 3: Modified Lipectomy

This technique is used in patients who are not candidates for a full lipectomy. It is suitable for those with mild skin laxity and early looseness above the navel, along with some muscle laxity above the navel. The muscles are tightened more firmly, or in cases where existing abdominal scars limit how much the abdomen can be tightened.

More skin is removed compared to a mini lipectomy, and muscle tightening can be performed in the upper abdomen. The navel may be lowered slightly without creating a scar around it. More skin under the navel can be removed than in a mini technique.

Technique 4: Lipectomy Combined with Liposuction (Suction Assisted Lipectomy and Full Lipectomy)

This involves removing abdominal fat in combination with liposuction. It can be done as either a mini or full lipectomy. Before closing the incision, liposuction may be performed in the flank area for patients with excess fat on the sides.

Preoperative Examination

During consultation, a physical examination is performed while standing to assess abdominal fat thickness and skin tension.

Ideal candidates for lipectomy are those with sagging or stretch marks in the lower abdomen without very thick fat layers, as this surgery improves tightness and waist contour but does not significantly reduce fat thickness.

Key factors to assess before surgery

Lower Abdominal Laxity
- If there is significant excess skin and looseness, surgery can provide great tightening.
- Skin tension is assessed by pulling the skin together while bending forward.
- In patients with thick fat, diabetes, or smokers, excessive tightening should be avoided due to a higher risk of wound separation or infection.
Upper Abdominal Laxity
- In a full lipectomy, skin above the navel is pulled down to the pubic area.
- Stretch marks above the navel will be relocated to just above the pubic area.
- In cases of severe looseness and muscle laxity above the navel, more upper skin may need to be removed.
Abdominal Muscle Laxity
- In some patients, abdominal wall bulging is due to muscle laxity rather than skin looseness.
- Lipectomy will involve muscle tightening to reduce abdominal wall protrusion.
- Care must be taken in patients with respiratory problems.
Liposuction Considerations
- In patients with thick side fat, liposuction may be required to improve contour.
- Caution is needed when performing liposuction in the upper abdomen, as blood supply to the lower abdominal skin must be preserved.
Existing Abdominal Scars
- Previous scars may affect surgical planning and increase the risk of complications if excessive fat removal is done.

Pre-Surgery Consultation Checklist

Amount of fat to be removed
Whether liposuction is required
Most suitable surgical technique
Desired navel appearance
Expected scar length and placement

Preoperative Preparation

Stop NSAIDs (e.g., aspirin), smoking, and certain supplements like garlic or fish oil at least 2 weeks before surgery.
Plan for 10–14 days off work.
Check for any underlying medical conditions.
No food or water for 6 hours before surgery.
Shave abdominal or pubic hair before hospital arrival.
Eat light meals the day before surgery.
Shower before surgery.
Arrange for someone to accompany you.
Do not bring valuables to the hospital.
Patients with heart disease or hypertension must consult their physician first.
Wear loose clothing for the trip home.

Surgical Steps

Incision is made above the pubic area along a horizontal line.
Fat is separated from the abdominal muscles up to the epigastrium.
Abdominal muscles are tightened by suturing them together to enhance waist contour.
Excess abdominal skin is pulled downward and removed.
Navel repositioning may be required if large amounts of skin are removed.
Skin is sutured and drains are inserted.

Postoperative Care

Stay in the hospital for 2–3 days.
For the first 1–2 days, lie in a bent position with a urinary catheter in place.
Begin walking slightly bent at the waist for 1–2 weeks before standing fully upright.
Drains are removed on day 3; bathing is allowed afterward.
You may return home on day 4 if you can walk.
Bandages can be removed within 1–4 days; drains and urinary catheter are removed within 2–4 days.
The scar will be visible at first but will improve over 1–2 years.
Avoid getting the wound wet until cleared by the doctor.
Eat high-fiber foods and drink plenty of water to avoid constipation.
Avoid alcohol for 3 weeks to prevent fluid retention in the wound.
Avoid smoking for at least 2 weeks to promote healing.
Report any unusual swelling or redness to your doctor immediately.
Sleep with your head and knees elevated.
Massage the scar gently for 10 minutes twice daily to reduce thickness.
Wear compression garments for 1 month to reduce swelling and improve contour.
Avoid heavy lifting and intense exercise for 6 weeks.
Use baby powder for itching but avoid the incision area.
Ensure compression garments are smooth without folds.
Continue wearing compression garments for at least 6 weeks.
Take medications as prescribed; avoid aspirin-based painkillers.
Begin light walking once pain subsides to reduce swelling.
Avoid lifting over 2–5 kg for 6 weeks.
Avoid abdominal exercises like sit-ups for about 6 weeks.
Shower only after 2 days following drain removal.
Apply sunscreen SPF 30+ before sun exposure.
Avoid soaking in baths until stitches are removed.
Resume normal diet but avoid dairy products.
Stitches are removed on days 10 and 14; scar tape should be worn for about 4 weeks.
Monthly checkups after surgery; steroid injections may be given for thick scars.
Swelling peaks within the first 3 days, improves in 2–4 weeks, and resolves fully in 3 months.
Scars will gradually improve over 1–2 years.