400 Newport Center Drive, Suite 500. Newport Beach CA 92660.                                         Phone: 949-644-2442

Abdominoplasty history
Ideal abdominal aesthetics
Types of abdominoplasty
Typical patients
Consultation
Where will your procedure be performed?
Details of your procedure
Your recovery
Your results
Relative contraindications
Surgical risks and potential complications

Everyone would like to have an abdomen that is tight, firm, flat and well-contoured. As we age, that goal may not be simply achievable by weight loss or exercise. People of normal weight can still develop an abdomen that protrudes, or is loose and sagging.

The combined effects of aging, gravity, fluctuations in weight, pregnancy, gastric bypass surgery, and loss of skin elasticity can all contribute to lax abdominal muscles and soft tissue. Pregnancy and weight gain stretch and separate the two main abdominal muscles that are responsible for the six-pack look, rectus abdominus muscles. These muscles form two vertical bands down the abdomen that are joined at the midline by connective tissue. Also, the abdominal skin may be stretched beyond its biomechanical capability and result in breakage of the deeper dermal layer of skin. After delivery of the baby or significant weight loss, the stretched out skin is now unable to spring back and contract. The degree of deeper skin damage, visible as stretch marks, dictates the ability of the skin to retract to its initial elastic form. Thus, the abdominal deformity presents as excess skin and fatty tissue, and laxity of the abdominal wall musculature. Often there is surplus skin and underlying fat in both the upper and lower abdomen. The most significant changes are, however, noted around and below the umbilicus, where excess soft tissue can hang over the groin area. Apart from bulging of the abdomen, the flanks (love handles) are frequently full with excess fatty tissue.

A flat and well-toned abdomen is something many of us strive for through exercise and weight control. Stretched beyond the capacity to return to normal, abdominal tissues don't always respond to various exercise and diet programs. In such cases, abdominoplasty, also known as tummy tuck, may provide a highly effective, immediate solution in the treatment of stubborn abdominal areas. Abdominoplasty is a surgical procedure to remove excess abdominal skin and fat from the abdomen and to tighten the underlying muscles of the abdominal wall. As an added benefit of the tummy tuck, not only will the abdominal region be firmer and flatter, but the waist will be smaller as well. While the degree of improvement varies significantly depending on the magnitude of the abdominoplasty surgery, other factors contribute to the surgical outcome such as the patient's skin tone, body build, and the individual healing process. This operation is done on both men and women alike. Following tummy tuck surgery, many patients experience an immediate improvement in their self-esteem and discover greater self-confidence. In addition, many also find greater access to different clothing styles and fashions and are less self-conscious at the gym, around the pool, or at the beach.

Abdominoplasty is a very popular procedure when it comes to plastic surgery and can produce satisfactory results for many people. According to the American Society for Aesthetic Plastic Surgery's 2004 Cosmetic Surgery National Data Bank, the number of abdominoplasty procedures performed has increased 344% in the last 7 years.

Abdominoplasty is frequently combined with liposuction in the form of the new technique of lipoabdominoplasty. It may also be performed after another surgery, such as hysterectomy or other gynecologic surgery. A pre-existing C-section scar on the lower abdomen can often be removed during an abdominoplasty.

Although the results of an abdominoplasty are considered permanent, weight fluctuations after surgery can cause the abdomen to protrude again. Patients who intend to lose a lot of weight should postpone the surgery until they have reached their weight goals. Also, women who plan future pregnancies should wait until they are finished having children so the results of an abdominoplasty are not undone.

Because smoking can increase the risk of complications and delay healing, smokers should stop at least 3 weeks before surgery and remain smoke-free for 3 weeks after surgery.

ABDOMINOPLASTY HISTORY

Over the past several decades, abdominoplasty has undergone a significant evolution. In 1899, Kelly, attempted to correct excess abdominal skin and fat using a horizontal incision. Since then, many variations and incisions have been suggested. In 1924, Thorek, described a procedure that preserved the umbilicus. In 1967, Pitanguy published a report of 300 abdominoplasties, and in the same year, Callia, described a low incision that extended below the groin crease. Later, in 1972, the W-technique for abdominoplasty was described and in 1973, the bikini line incision. When the Saint Tropez bikini (with a very low waistline) was fashionable, the abdominoplasty incision was nearly horizontal in order to be concealed under such a garment. When the French-line bikini (with a very high leg cut) was popular, the abdominoplasty incision had to be converted from a nearly horizontal line to an incision line that paralleled the groin lines. Since the turn of the century, bikinis with very low waistlines have become more popular again. Therefore, proper adjustments in techniques are again necessary to achieve a tailor-made abdominoplasty.

IDEAL ABDOMINAL AESTHETICS

The ideal abdominal contour as seen frequently in lingerie models and athletes follows certain features that define an aesthetically beautiful and healthy figure. These include a well defined rectus abdominus silhouette with or without six-pack indentations. A narrow indentation defines the mid-abdominal line in between the two rectus muscles. The trunk follows an hour-glass look with deep waist concavity. The navel is vertically oriented and the abdominal tissue over the rectus muscles is full with obliquely oriented depressions on the outer aspect of the muscles. The upper thigh tissue is firm and smooth.

TYPES OF ABDOMINOPLASTY

There are many types of abdominoplasty that Dr. Agha performs routinely. In addition to these, Dr Agha has developed his own signature abdominoplasty that he calls "Contoured Abdominoplasty" since it refines the 3-dimensional contour.

1) Mini-abdominoplasty- The mini-abdominoplasty is performed through a smaller incision and thus, it is useful if you only have a small amount of excess skin and fat above the pubic area.

2) Full Abdominoplasty- In this technique, an incision is made from one hip bone to another. Unlike, many surgeons, Dr. Agha places his incision very low, so that it is well hidden by underwear or a bikini. Dr. Agha is able to remove most of the excess abdominal skin and fat from the pubic hair line all the way to the belly button, in most patients. He then tightens the loose abdominal muscles as needed.

3) Extended Abdominoplasty- This technique is reserved for those patients that have moderate excess of the hip areas. In addition to the steps performed in a full abdominoplasty, Dr. Agha extends the abdominoplasty incisions around the hip area on each side and removes skin and fat from these regions. This results in a more concave hour-glass contour of the hips and also lifts the outer aspect of the thigh on each side.

4) Circumferential Abdominoplasty- Also known as "belt abdominoplasty" is reserved for those patients who present with lower body laxity. This typically occurs after significant weight loss or ageing. The typical patient is unhappy with the looseness of her/his abdomen, thighs and buttocks. The circumferential abdominoplasty places incisions that go all the way across the patient's lower back. Through these incisions, the excess abdominal tissue, hip tissue and lower back tissue are removed. The buttocks and outer aspect of the thighs are elevated, followed by completion of the abdominoplasty procedure. This procedure is often performed as part of a lower body lift.

5) Inverted-T or Fleur-de-lis Abdominoplasty- This procedure is best suited for those rare patients who have lost significant weight and need substantial quantity of skin and tissue removed. The patients often present with both vertical and circumferential abdominal tissue laxity and lose their hour-glass look due to fullness of their sides. Fleur-de-lis abdominoplasty combines the use of a horizontal incision over the lower abdomen with a vertical incision on the abdomen, forming an "inverted-T" pattern.

6) Reverse Abdominoplasty- A reverse abdominoplasty removes excess skin and fat in the area above the navel. It is a relatively uncommon procedure that can be used in conjunction with breast reduction or mastopexy (breast lift) or an upper body lift. In this procedure, the incision is made along the crease underneath the breasts, and the skin is pulled upward.

7) Lipoabdominoplasty- is a newer technique that was described by the Brazilian Plastic Surgeon, Dr Saldengo, several years ago. It employs liposuction in conjunction with abdominoplasty, thus called tummy tuck liposuction. This procedure involves use of the liposuction to sculpt the upper abdomen and the flanks. This is followed by tightening of the abdominal muscles and excising the loose lower abdominal skin and tissue. The procedure should be performed by those who have experience in this technique. Lipoabdominoplasty and contoured abdominoplasty are the two main types of tummy tucks performed by Dr. Agha.

8) Contoured Abdominoplasty- This procedure is developed by Dr. Agha and is his signature abdominoplasty. Dr. Agha will recreate an hour-glass contour of your abdomen, applying many of the aesthetic features of ideal abdomen: defined rectus abdominus silhouette with oblique lateral indentation and depressions, and vertically oriented navel in a narrow midline depression. The procedure uses liposuction t sculpt the upper abdomen and the flanks.

TYPICAL PATIENTS

	This mother presented to Dr. Agha for a Mommy Makeover, including a tummy tuck and breast augmentation and lift.
	This patient presented to Dr Agha for a tummy tuck after multiple pregnancies.
	This patient presented to Dr. Agha for a lipoabdominoplasty and body contouring surgery.
	This patient presented to Dr. Agha after open gastric bypass surgery for a circumferential abdominoplasty and lower body lift.

Abdominoplasty can be performed on adults of any age who are in good health; close to their ideal weight; good physical and psychological health and not severely overweight. Often, these people have managed to control their weight through nutrition and exercise but still have excess skin or fat on their abdomen. Other patients have lost skin elasticity in their abdomens after one or more pregnancies.

There are certain people for whom a tummy tuck is not an ideal choice. If you are planning on becoming pregnant in the future, or are trying to lose a large amount of weight, it may be best to wait until later to undergo abdominoplasty. In both cases, the benefits of a tummy tuck may be undone by changes in skin and muscle tone.

CONSULTATION

During your initial consultation, Dr. Agha will inquire about your general physical and mental health status, pre-existing health conditions, prior surgeries, your medications, allergies, and smoking habits. Relevant questions in the history include:

1) Pregnancies and their effects on the abdomen

2) Previous surgical procedures (including laparoscopic procedures)

3) History and method of weight gain and loss

4) Future plans for pregnancy

5) A detailed history of current medical and psychological problems, e.g. heart disease, diabetes, and a history of thromboembolic disease, connective tissue disorders and wound healing problems

It is important that you be thorough when providing the requested information as this will allow Dr. Agha and staff to proactively address medical and psychological concerns.

When asked about medications, be sure to include any diet pills, vitamin or herbal preparations, since some vitamins and herbal medications can affect your blood pressure and clotting ability. Honesty regarding your smoking and alcohol use is also very important, as these will have a profound impact on your recovery period and your ability to heal following your procedure.

After reviewing your medical history, Dr. Agha will discuss your concerns, priorities and motivations for pursuing plastic surgery. Dr. Agha will then proceed with examining you and assesses your abdominal tissue laxity. He will assess multiple factors including, the degree of abdominal muscle weakness and separation, abdominal tissue excess, skin laxity and damage, and distribution of the excess fat in flanks and upper abdominal regions. Also, the locations of all scars are noted and presence of an abdominal hernia is ruled out.

Each of these components will determine which procedure is best for you. With only mild fat excess and good skin elasticity, you may be benefit best from liposuction alone. For mild tissue and skin excess confined to the lower abdominal region, you may be a candidate for a mini-abdominoplasty with or without liposuction. For more skin and fat excess, as well as patients who have muscle weakness or laxity, you will most likely require a full abdominoplaty or contoured abdominoplasty to achieve the best results.

Dr. Agha will subsequently provide you with information on different options and will explain the advantages and disadvantages of the each procedure to you. You will then be provided with information regarding the potential risk and complications of each surgery. Finally, considering your input, Dr. Agha will plan an appropriate procedure to best suit your anatomy, and likewise meet your desires and expectations.

At the completion of your consultation, you will be given a written estimate of the cost of your procedure. At this time, you will also have the option to schedule your procedure if you so choose. You are encouraged to bring your spouse, significant other, family member, or a friend to your consultation.

The cornerstone of Dr. Agha's approach is to customize treatment to your specific needs and circumstances, and to ensure that you have an adequate understanding of the procedure so that you are able to make a fully informed decision. This will help you achieve the appearance you desire with the least invasive procedure available.

Prior to surgery, you may be asked to obtain specific lab tests and a medical evaluation.

WHERE WILL YOUR PROCEDURE BE PERFORMED?

Dr. Agha has been granted staff privileges at several local hospitals and outpatient surgery centers. In the interest of the safety of his patients, he only performs surgery in fully accredited facilities with the proper services and staff.

DETAILS OF YOUR PROCEDURE

Tummy tuck surgery usually takes two to five hours depending on which type of abdominoplasty is being performed and how much correction of the abdominal contour is desired and practical. Mini-abdominoplasty takes 1 to 2 hours, and full or contoured abdominoplasty takes 2 to 3 hours- depending on the extent of work required. After you have changed into a gown and had your intravenous line started, Dr. Agha will mark certain landmarks on your abdomen and flanks in the preoperative holding area. The location, length and direction of these incision lines will be dictated by the type of abdominoplasty being performed. This ensures proper planning for the site of abdominoplasty incision and liposuction. He will also review the entire operative plan with you including potential complications. You will then be given a dose of intravenous antibiotics as a precautionary measure.

What happens during abdominoplasty surgery?

Step 1 - Anesthesia

Abdominoplasty is usually performed under general anesthesia. After initiation of anesthesia in the operating room, Dr. Agha will inject a solution of local anesthetics known as "tumescent solution" at the intended incision site, the surgical site, as well as sites that are marked for liposuction. The injection solution consists of a low concentration of lidocaine and epinephrine. The lidocaine will numb the surgical site and the epinephrine causes constriction of the blood vessels at the surgical site, reducing your potential for bleeding and bruising.

Step 2 - The incision

Dr. Agha will next make the incisions necessary for removal of excess skin and fat. He will place your incisions low so that it can be well hidden in a two piece bathing suit. For a mini-abdominoplasty, the incision will be limited to the width of the pubic hairline. For the full or contoured abdominoplasty, the incision may extend all the way from hip bone to hip bone. The shape and length of the incision will be determined by the degree of correction necessary. A second incision is made to free the navel from its surrounding tissue. After the incision has been made, Dr. Agha elevates the skin and fat off of the underlying muscles of the abdominal wall. These muscles are then tightened by pulling them close together with stitches in a seam down the center of the abdomen. This provides a firmer abdominal wall and narrows the waistline. Excess fat, tissue, and skin are removed and the remaining abdominal tissue is re-draped over the underlying muscles. A new opening is then created for your belly button. Your belly button is then pulled through and sutured in its correct position.

Step 3 - Closing the incisions

The incisions are carefully closed to minimize your scar. Dr. Agha places all his sutures beneath the skin where they are gradually absorbed by your body. Not having to undergo suture removal has improved patient comfort and satisfaction. One or more drains may be placed beneath the incision. These slender, rubber tubes assist in draining any fluid that may accumulate beneath the incision and delay your healing.

Step 4 - Dressings

A sterile dressing is applied to the incisions, and a compression garment or abdominal binder is placed over your abdomen. This compression garment or binder helps support your abdominal wall during healing, decreases postoperative swelling, and helps decrease any bruising that may occur.

YOUR RECOVERY

Tummy tuck surgery may be performed as an outpatient procedure, or you may choose to stay in the hospital overnight. If you choose to go home, you will recover in the recovery room for approximately one hour or two prior to being released in the company of a friend or family member. We also have a private duty nurse available to care for you in the comfort and privacy of your own home if you so choose. Some patients may need to stay overnight in the hospital, this will depend on many factors, including how extensive the operation is.

• Day of Surgery- When you wake up from your procedure, you will be in the recovery room and will be wearing an abdominal binder. You should plan to wear the abdominal binder or compression garment for four weeks following surgery.
• Care Giver- When patients leave the surgery facility to go home, they are usually groggy for about 12 hours or overnight. That is why it is very important to have someone who can assist you with getting around and taking your medications for at least the first 24 hours.
• Nausea- Most people are nauseated during the first 24-48 hours. To reduce this, we suggest that you take your nausea pill one hour before taking your pain pills or antibiotics.
• Sleep- During the first week after abdominoplasty, attempt to sleep on several pillows on your back. Also, keep your legs slightly bent at the hips. This ensures that the tension on your incision line is minimized, reducing pain and resulting in a thinner scar during the initial healing process.
• Painkillers- You're likely to feel sore for a few days, but you should be up and around in 24 hours. Most of your discomfort can be controlled by the prescribed painkillers.
• Q-pain Pump- Alternatively, you may also be a candidate for a revolutionary new product for the management of postoperative pain, called the On-Q Post-Operative Pain Pump. Be sure to ask Dr Agha about this during your consultation if you think you might be a good candidate for this system.
• Shower- Remove your dressing, sponges and gauze pads on the third post-operative day. You may now take a shower. After showering, simply pat your incisions dry and replace your abdominal binder.
• First Post-operative Visit- Dr. Agha prefers to see you on day 5 for your first post-operative visit. At this time, he will remove the drainage tubes.
• Swelling- Any swelling in your abdomen and flanks may take three to five weeks to subside.
• Driving- It is not safe to drive a car within twenty-four hours of taking pain medication, as your reflexes and alertness may be altered.
• It is important that the surgical incisions are not subjected to excessive force, abrasion, or motion during the time of healing.
• Walking- You will probably be unable to stand up fully upright for 7 to 10 days after a full or contoured abdominoplasty. Even if you can't stand straight, it is still important to start walking as soon as possible, usually the evening of surgery. This is the best way to reduce the chance of getting a blood clot in the legs.
• Light Exercise- Dr. Agha recommends light exercise to reduce swelling and prevent clotting. Light exercise includes walking, stretching, moving arms and legs while sitting. If you should feel pain or pulling from the scar area, cease the movement.
• Activities- During the first week after surgery, you want to avoid activities that raise your blood pressure. This could cause bleeding at the operative site, which could result in a hematoma (collection of blood).

  Walking is the safest exercise, especially during the first week. Avoid exercises which directly stress the area of your surgery for a full four weeks. After this period, cardiovascular activities such as riding a stationary bicycle or brisk walking can be initiated. Running at this point may be premature.

  Avoid heavy lifting, contact sports and jogging for up to 6 weeks. By the time you are at six weeks post-operatively, you will be nearing your pre-operative level. The reason to avoid pull at the surgical area has to do with healing and scarring. During the early phase of healing, one must avoid irritation around the operative site, as this can worsen swelling and fluid accumulation. This could cause development of a seroma (fluid collection) or cause problems with the wound (dehiscence or opening of the suture line, or widening of the scar). Even though the skin is closed, there are many activities taking place beneath the skin.

• Healing- You will need a few weeks to recover and heal from a tummy tuck procedure. The typical healing time is at least one to two weeks before returning to work.
• Scarring- Every person's body is different, and many factors contribute to scar healing. Your scars will be firm and pink for about six weeks. Non-smokers and those who follow the Enhanced Recovery Nutritional Supplements have a better chance of having rapid healing and thinner scar. Expect to wait at least nine months before your scars lighten in color and become as flat as the rest of your skin. Although they will never disappear completely, abdominal scars will not show under most clothing, even bathing suits.
• Follow-ups- Regular checkups protect against complications.
• Emergencies- Some discomfort is expected following your surgery; however, be sure to tell us if:
  • There is an increase in swelling, pain, redness, drainage or bleeding in the surgical area.
  • You develop fever, dizziness, nausea or vomiting, or a general ill feeling.
  • If you experience shortness of breath, chest pains, or unusual heart beats, seek medical attention immediately. Should any of these complications occur, you may require hospitalization and additional treatment.

YOUR RESULTS

You will notice an improvement in your abdominal contour immediately. A tummy tuck will result in a flatter, firmer abdominal contour that is proportionate with your body type and weight. The final results may be initially obscured by swelling and your inability to stand fully upright until internal healing is complete. Within a week or two, you should be standing tall and confident with your new, slimmer, contoured profile.

For most patients, the long-term results associated with tummy tuck procedure are excellent. However, long-term results are dependent on keeping one's weight relatively constant, eating a healthy diet, and exercising regularly.

RELATIVE CONTRAINDICATIONS

1. Severe comorbid conditions (eg, heart disease, diabetes, morbid obesity, cigarette smoking);
2. Expecting future pregnancy
3. Thromboembolic disease (blood clotting disorders)
4. Morbid obesity (BMI >40)
5. Unrealistic patient expectations
6. Upper abdominal scars
7. Patients who tend to form keloids or hypertrophic scars

SURGICAL RISKS AND POTENTIAL COMPLICATIONS

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All surgical procedures, including the tummy tuck, have potential risks associated with their performance. The decision to have abdominoplasty or other body contouring surgeries is extremely personal and you'll have to decide if the benefits will achieve your goals and if the risks and potential complications are acceptable.

In this section, you will find further information regarding the potential risks associated with various abdominoplasty procedures.

Possible risks of abdominoplasty include:

• Surgical anesthesia: Both local and general anesthesia involves risks, which will be discussed by your anesthesiologist on the day of surgery.
• Unfavorable scarring: If the sutured area doesn't heal properly or if the area takes too long to heal, the scars that are a result of the abdominoplasty may be thicker than normal. If the patient heals relatively quickly, minimal scarring results. Scars will take years to fade, but they are permanent. Despite the best effort by Dr. Agha, scar appearance and healing are not fully predictable. The scars may be uneven, excessively wide, and/or asymmetrical. Scars may be unattractive and of different color than surrounding skin. Excessive, hypertrophic and keloid scarring are uncommon. Additional treatments including surgery may be necessary to treat abnormal scarring.
• Bleeding/Hematoma: Bleeding may result if the sutured areas do not heal correctly or if there is improper coagulation after the tummy tuck procedure. If a patient notices any unusual bleeding after an abdominoplasty, they need to contact Dr. Agha immediately. Do not take any aspirin or anti-inflammatory medications for ten days before surgery, as this will increase the risk of bleeding. Non-prescription "herbs" and dietary supplements can also increase the risk of surgical bleeding. Hematoma is a blood collection that can form under the skin and enlarges as a tender bulge.
• Infection: Major Infection with fever and large areas of red skin (cellulitis) is unusual after this type of surgery. Should a serious infection occur, treatment including intravenous antibiotics or additional surgery to remove dead tissue and drain abscesses may be necessary. Minor wound infections, accompanied by exposed and "spitting" sutures can occur and are usually easily dealt with by limited debridement, antibiotics, and dressing care. There is a greater risk of infection in smoker, in those with diabetes and with multiple procedures.
• Fluid Accumulation (Seroma): Drains are often placed at the surgical site at the end of the operation to collect seepage of fluid. After their removal in about 5 to 7 days, body fluids (serum) occasionally accumulate underneath the skin. Should this occur, it may require aspirations. If that fails to cure the seroma then the patient will need to be seen either in the office or operating room for insertion of new drainage tubes and removal of seroma cavities. This is very rarely necessarily.
• Poor Wound Healing: Individuals that have a slower than average healing rate or those who are smokers may find that they do not heal properly; or that the sutured areas reopen easily; or that they are more prone to infection. Smokers should avoid smoking three weeks prior and after the procedure so that their body's natural healing process is not hindered.
• Wound Dehiscence: In general, your skin closure is in multiple layers. Separation of the superficial, deep and/or both layers may occur any time during your first post operative month. Suture breakage, knots untying, sutures tearing through an excessively tight closure, too much movement or bending by the patient, skin necrosis (death) are some of the recognized causes of dehiscence. Breakage of suture in the superficial layer of skin may be sutured closed or allowed to heal secondarily, at the judgment of Dr. Agha.

  Deep dehiscence may require return to the operating room for closure under anesthesia. These healing problems may require frequent dressing changes, extra office visits and further surgery to remove the non-healed tissue. Open wounds may take weeks to heal or secondary closure may be appropriate. Wounds allowed to heal on their own usually benefit from secondary scar revision. Smokers have a high risk of skin loss and wound healing complications. Do not smoke for 3 weeks before and after your surgery.

• Suture Granuloma: Some surgical techniques use deep sutures. These items may be noticed by the patient following surgery. Sutures may spontaneously poke through the skin, be visible, or produce irritation that requires removal.
• Numbness in Skin Sensation: Post-operative diminished (or loss of) skin sensation (numbness, pins and needles sensation, burning or itching), and/or pain in the lower torso may be temporary or very rarely permanent.
• Contour Irregularities: Contour irregularities and depressions may occur after these procedures. Visible and palpable looseness and wrinkling of skin can also occur. On occasion, asymmetrical fullness, bulges, and depression may be present.
• Asymmetry in Scar Placement or Contour- On occasion, asymmetry may occur after a tummy tuck. Although this is not typical, it is a risk associated with the abdominoplasty procedure- every body and every patient is different.
• Pain that may persist: Chronic pain may occur very infrequently from nerves becoming trapped in scar tissue after surgery.
• Nerve damage: If improper healing occurs, the patient may have some nerve damage. The possibility of nerve damage should be discussed with the physician before the procedure. Nerve damage can result in over sensitivity or it can result in a lack of sensitivity in certain areas where the thigh lift was performed.
• Allergic Reactions: In rare cases, local allergies to tape, suture material, or topical preparations have been reported. Systemic reactions which are more serious may occur to drugs used during surgery and prescription medicines. Allergic reactions may require additional treatment.
• Loss of Umbilicus: mal position, scarring, unacceptable appearance or loss of the umbilicus (navel) may occur.
• Residual deformity- Despite best efforts to obtain tight abdominal contour, a small degree of residual deformity may persist or develop months after the surgery.
• Need for revisional surgery: The practice of medicine and surgery is not an exact science. Should complications occur, or some aesthetic expectations remain unmet, additional procedures or other treatments may be necessary. Other complications and risks can occur but are even more uncommon.
• Suboptimal Aesthetic Result: You may be disappointed with the results of surgery. Under treatment with residual laxity and looseness or over treatment with excessive tightness of skin can occur with flattening of regional contours and widening or thickening of scars. Considerable judgment is used to achieve the optimum shape but for a variety of reasons the ultimate aesthetics may be suboptimal. At times, it is desirable to perform additional procedures to improve your results.
• Deep Vein Thrombosis (DVT) and Pulmonary Complications: Deep vein thrombosis is rare but worrisome complication of plastic surgery. It represents formation of blood clot in the deep veins of the legs during anesthesia and surgery. Although a sequential compression device will be used to reduce the risks, few patients may still develop DVTs. Pulmonary complications may occur secondarily to migration of the vein blood clots into the lungs (pulmonary emboli) or partial collapse of the lungs after general anesthesia. Should either of these complications occur, you may require hospitalization and additional treatment. Pulmonary emboli can be life-threatening or fatal in some circumstances.
• Long Term Effects: Subsequent alterations in body contour may occur as the result of aging, weight loss or gain, pregnancy, or other circumstances unrelated to the above procedures.

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