Abdominoplasty and Tummy Tuck Surgery in Montreal
A tummy tuck or abdominal lift is a surgical procedure that involves removing excess skin and underlying fat from the middle and lower abdomen by tightening the muscles of the abdominal wall. In some cases, it helps to repair hernias or separated muscles. The procedure is very effective in changing the appearance of your abdomen. The incisions are hidden in the folds of the body or by the underwear.
Get the flat stomach you’ve always dreamed of!
Classical abdominoplasty - Transposition of the umbilicus
The classic abdominoplasty or also called abdominal lift with transposition (displacement) of the navel is commonly practiced at the private clinic of Dr. Chen Lee in Montreal.
This technique is intended to tighten the skin of the abdomen, tighten the muscles of the abdominal wall and reposition the belly button up.
Surgery can be done with two methods of incisions: a long and a short. Both incision methods also include the incision around the belly button so that it can be placed in a good position. Obviously, “little scar” says “small result” for abdominal surgery. As a result, the results are more visible and satisfactory with the long incision because the quantity of skin removed is greater.
Moreover, with the long incision, the skin is peeled up to the level of the thorax leaving the navel attached to the muscular wall. Once the exposed muscle wall Dr. Chen Lee tightens the muscles by joining them at the vertical centerline, this makes your abdominal muscles firmer and your waist closer. To finish, the top of the skin, which is of better quality, is drawn to the pubis to close the incision. The umbilicus (navel) came out at the same initial level through the skin that was stretched.
The “Mini” abdominoplasty involves removing excess skin and tightening the lower muscles of the abdomen ie the abdominal wall below the belly button.
During surgery, the navel stays in the same position, it is not detached and transposed, so there is no incision in the navel. Surgery of “Mini” Abdominoplasty or “Mini” Abdominal Raising can be done with two methods of linear incision: long incision or shorter incision.
The best candidates for this technique are people with excess skin only in the lower abdomen.
The incision is made above the pubis, as low as possible and extends on each side along the line of a “bikini panties”
Less commonly practiced Techniques of Abdominoplasty
FAB Abdominoplasty - "Floating" Umbilicus Mini Abdominoplasty
This new procedure helps to shape the tummy and tighten the abdominal muscles throughout a small incision in the lower abdomen and without any incisions around the belly button.
With this low abdominal incision, excess skin is removed and the belly button is detached and elevated from the inside, under the skin, causing it to “float” over the muscles. The muscles of the abdomen, or the right muscles, can then be patterned and tightened from the sternum to the pubic area. Very often, an endoscope or a special camera is used to facilitate this repair because the incision in the lower abdomen is very short.
Since during surgery, the skin is stretched down and the navel “floats”. If there is not enough space between the navel and the pubic line, after the surgery the navel may be too low. As a result, the results are generally not satisfactory.
"Fleur de Lys" or inverted "T" Abdominoplasty
Abdominoplasty surgery “Fleur de Lys” or also called “T” inverted refers to the forms of incisions. This technique is often used on people who have undergone bariatric surgery for weight loss. After a significant loss of weight and excessive amount of skin excess Abdominoplasty “Fleur de Lys” is the alternative treatment to “Classic” Abdominoplasty. If you have a significant amount of skin removed in the upper and lower abdomen, Dr. Chen Lee recommends the “Fleur de Lys” Technique.
This surgery requires an additional vertical incision, from the navel to the horizontal incision, located on the pubic line. Sometimes even another vertical incision always from the belly button up to the top of the abdomen. This surgery is very similar to “Classic” Abdominoplasty except that the skin on the upper abdomen is also removed leaving a vertical scar in the middle of the abdomen. The skin of the lower abdomen is also removed. Since this surgery is more complex it is quite possible that Dr. Chen Lee poses drains during the surgery. The surgery is performed under general anesthesia and lasts between 3 and 4 hours. It is recommended to spend a night at the surgery center. After the surgery, you must wear a compression abdominal sheath.
Day of Surgery
Dr. Chen Lee is a regular practitioner at the Montreal Metropolitan Surgery Center. Surgeries always start early in the morning and you come out in the afternoon. Before the intervention, the experienced medical staff will welcome you and make you comfortable during the preparations for surgery.
The surgery lasts approximately 1h30 to 3h00 depending on the technique you chose during your consultation with Dr. Chen Lee. The surgery of the abdomen ends with the installation of an abdominal compression (compression) sheath.
When you wake up, you will be taken to a rest room so that you can recover and recover your spirits. Patients stay about 4 to 6 hours before they can go home. This is so that you can go home safely and safely. However, it is imperative that someone come to the surgery center and take care of you the first days after the tummy tuck.
Our team will contact you by phone the two days following your surgery to ask you some questions about your state of health and make sure that your convalescence goes well. In addition, we will answer all your questions or concerns following your surgery of the abdomen. Your first follow-up appointment will take place approximately 6 to 10 days later.
- Keep a sitting or semi-sitting position as much as possible to reduce tension on the skin. Sleep with pillows behind the back and below the knees for the same reason.
- Keep the sheath in place, adjust it for your comfort.
- Take a short walk inside your home, move your legs and ankles to prevent phlebitis.
- Vacuum the pear of the drain regularly. Note the drainage volumes.
- Take the medications as prescribed.
- Keep the abdominal sheath as long as Dr. Chen Lee recommends.
Contact us immediately if:
- Operative pains increase a lot.
- You do a lot of temperature. On the other hand, a slight fever the first days postoperatively is often normal.
- One of your legs swells a lot and becomes painful.
Scar “Ear of Dog”
You will experience pain and discomfort due to the swelling of your abdomen. Take the medication as prescribed by Dr. Chen Lee, it is important to follow all the indications of Dr. Chen Lee so that your convalescence is going as well as possible. Dr. Chen Lees is always available after the surgery and if you have any concerns and the clinic is closed you can always send him a text message and he will call you back the same day as soon as possible. Your abdominal sheath must be worn at all times, 24h / 24h 7 days / 7 days. However, it is important to open it from time to time and close it again. If you are afraid to ask a loved one to do it. The abdominal sheath is Velcro just open it for 2 to 5 min and close it.
Make sure the sheath is tight enough (not too much), it should not float. Compression is important so as not to worsen the swelling. At your follow-up appointments, Dr. Chen Lee will tell you when you can remove it.
During the first days, you must rest and make no physical effort except to walk to the bathroom for example. It is important to walk at regular intervals. Dr. Chen Lee recommends a convalescence of 4 to 6 weeks. The scar will gradually fade, during your appointment 1-month post-op, we can recommend a silicone gel to improve and reduce the color of your scars. The final result of Abdominoplasty is 1 year after surgery.
However, there may be a small revision needed to improve the corners of “dog ear” scars. During your follow-up appointments, Dr. Chen Lee always examines the healing of the scar.
Complications related to abdominoplasty are relatively rare. On the other hand, they are more frequent in patients who are still obese or who have a very large surplus of skin and fat.
It occurs at seven to ten postoperative days with pain and redness that begins in the incision and has a tendency to spread with significant fever. However, it should be remembered that a mild fever, the first two days postoperatively, is often normal. In addition, a light yellowish-transparent flow in the umbilicus or incision is frequent at two weeks postoperatively and represents the resorption of sutures. If a serious infection occurs, it is treated with antibiotics. In rare cases, if an abscess is formed, surgical drainage may be required.
It is the abnormal accumulation of blood between the skin and the muscular wall. This accumulation is rare since it is prevented by the use of a drain and the compression of the abdominal wall by a sheath.
It is the gradual accumulation of fluid between the muscle wall and the skin that occurs in the days and weeks after removing the drains. If the accumulation is slight and not very symptomatic, the fluid resolves spontaneously. If it is a significant accumulation, the liquid is evacuated by a puncture.
Delayed wound healing and skin necrosis:
In rare cases, blood flow in the abdominal skin flap may be compromised. This can produce skin loss along the incision line and the opening of the surgical wound (skin dehiscence). These types of complications are more often seen in obese patients or smokers. The treatment consists of regular washing of the wound and application of dressings until complete closure. Subsequently, if the residual scar is too apparent, it can be improved by surgical revision.
As mentioned at the beginning, the price to pay to tighten the skin of the abdomen is a relatively long scar. It is, therefore, necessary to have a large skin surplus to justify this scar. If the skin is elastic and it is a surplus mostly greasy, isolated liposuction can be considered to avoid any scar. The tummy tuck scar is always red and conspicuous for three to four months postoperatively and then progressively fades in the first year. With time, it becomes very little apparent but never completely disappear. On the other hand, in some people, the residual scar may remain too apparent, either related to necrosis and earlier healing time is simply related to the individual skin healing characteristics of the person. After the complete maturation of the scar (one year of evolution), surgical revision of the scar may be considered. This is a simple procedure done under local anesthesia that does not require convalescence.
Am I a good candidate for surgery?
Applicants must be in good health, have no serious or active illnesses, no pre-existing medical conditions, and must have realistic expectations of the outcome of the surgery. If you are planning to become pregnant or lose a significant amount of weight, you must discuss these plans with Dr. Chen Lee before surgery.
Tummy tucks are not a treatment for obesity or a substitute for good nutrition and exercise. Individuals intending to lose weight should delay their abdominal surgery until they have reached a stable weight.
How to prepare for surgery?
You must follow Dr. Chen Lee’s instructions carefully before surgery. These include guidelines on eating, drinking and smoking, taking or avoiding vitamins, iron tablets and certain medications. If you develop influenza or infection of any kind, especially a skin infection, the surgery may be postponed. Take care of yourself. In addition, avoid exposing your belly to the sun before surgery, and do not start a severe diet, otherwise, it may be difficult for you to heal after surgery.
What are the risks and side effects of surgery?
Initial healing may take 5 to 10 days, and you will have some swelling and some discomfort that can be controlled by the medication. It will be difficult to keep straight at first, but you will have to start walking as soon as possible to avoid blood clots and other complications. The stitches are removed as soon as the incisions are healed, so you are able to return to work and your normal activities (although you should not engage in excessive lifting or vigorous exercise for 6 weeks).
What to do if I get pregnant?
It has happened to many women to get pregnant and carry their pregnancy to term without any difficulty after a tummy tuck. The skin is an elastic organ capable of being stretched over time. Some of our patients did not need surgery after their pregnancy because the skin is wonderfully well replaced. Nevertheless, Dr. Chen Lee strongly recommends having a tummy tuck after you have had all your children. There is no guarantee that the skin will recover after pregnancy following your tummy tuck.
Will I gain weight again?
The portion of the skin and the fat that is removed will never be back. However, if you do not watch what you eat and neglect exercise, it is very likely that you gain weight. The fat cells are forming again. You may start taking fat from other parts of the body before the abdomen. There is a permanent reduction of the skin and subcutaneous tissue, however the tummy tuck may not be permanent.
Will I have the abdomen completely flat?
Perhaps. Remember, if you are overweight, there is always a residual amount of fat under the abdominal skin after surgery that will not allow you to have a flat stomach. Even patients who are within their weight limit can not have a “completely” flat stomach because their expectations exceed the possible outcomes of the surgery. Also remember that even thin people in a sitting position have some skin and fat hanging on them.
Will my stretch marks go away?
If your stretch marks are below the umbilicus (navel), the likelihood is very high that the tummy tuck will remove them. However, if the stretch marks are above the umbilicus or on the hips, unfortunately they will still be there after the surgery. With a tummy tuck, the stretch marks above the umbilicus will be near the pubic area after your surgery.
Why Liposuction is Often Coupled With Tummy Tuck?
Liposuction can be performed during the abdominoplasty or before / after separately. The abdominoplasty will treat the excess of skin in the abdomen. Some areas such as love handles still retain fat deposits, they require liposuction to obtain a satisfactory result.