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Case presentations on Total Abdominoplasty with Umbilical Translocation (surgical ‘tummy-tuck’) |
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Warning! The following pictures are highly graphic in nature. They show the actual operation in steps. Viewer discretion is required. If you are faint hearted, please do not view them. |
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First case is of a 37 yrs old woman of African origin. She presented with |
- A midline vertical caesarean scar
- Loose and hanging belly skin folds
- A protruding belly due to weak and stretched abdominal muscles following multiple deliveries.
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| SURGICAL PLAN: |
Pre-operative markings: the area within the marked ellipses will be removedThe incision line will fall within the ‘panty-line’.
The lower line represents the ‘cut’ Whole abdominal skin from just above the navel and encircled by the elliptical markings will be removed.
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Infiltration of Tumescent Local aesthesia.
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This will make the entire area numb and close the blood vessels so that there is no bleeding during the surgery. |
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| Liposuction is done for the sides of the waist line first on both sides
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| Liposuction of the belly is done to reduce fat in the middle area of the upper belly
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| The umbilicus (navel) is detached from the skin and allowed to fall inside.
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| It will be brought out later on during umbilicoplasty. |
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| A very low cut is made usually one cm inside the pubic hair line. Therefore the final scar will be well hidden inside the panty line. You will notice that the cut is practically bloodless. There is virtually no bleeding during the incision.
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| The whole of abdominal skin is lifted up from the pubic area right up to the rib cage. As you will see there is no bleeding. The lifting is accomplished in a bloodless manner. The detached navel is seen in the centre.
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| The abdominal muscles are tightened in the midline from the ribs to the pubic bone. Patient experiences abdominal tightening and narrowing of waist line while it is being done. |
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| Excess skin flaps are now evident. The triangle of skin flap marked preoperatively will be removed. If necessary, more skin may be removed. |
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| The ‘original’ navel is now being brought out from the stretched skin. The navel is designed to be placed in its normal anatomical position which is usually at the level of crests of Hip bones.
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| Shown here is the opening in the abdominal skin through which the navel will be brought out (the opening is shown by an instrument passing through the hole) |
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| Navel has been positioned and fixed with ‘stay’ sutures. ‘Umbilicoplasty’ or re-designing of navel has been done. |
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| Deep layer closure of the incision line has been done. Drains have been put in place and brought out from the pubic area.
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| Top layer skin closure being done |
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| Incision closed. Drains put in position. Navel |
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| Surgery complete. Dressing done.
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As seen before and after 10 days of Total Abdominoplasty |
(These results are very early, just after 10 days. After few months, the results are even better and scars are like very thin lines) |
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SIDE VIEWS |
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FRONT VIEW |
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Before surgery |
Pre-op markings |
After just ten days |
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