Abdominal wall reconstruction
This operation is meant to improve shape, volumes and function of the abdominal wall. Severe laxity of the abdominal tissues might follow pregnancy or be consequence of excessive weight loss. Furthermore the abdominal wall can be relaxed due to surgical procedures incidentally interesting fascial and adipose tissues. The tissue removed in the operation allows to improve body shape and to bring circumferences back to more pleasing proportions. The intervention is planned to leave the least possible scars that will be easily camouflaged by the fabric of underwear and bathing suits. The amount of cutis, subcutis and fat pad to be removed is decided time by time and determines how long the scar will be. In case of pre-existing scars, one will discuss with the patient whether or not they should be used as an access to deeper planes.
The operation provides that the natural umbilical depression is recreated. When abdominoplasty concerns a large lozenge of tissue, the belly button will have to be transposed upwards to avoid its descent towards the pubis, as a consequence of tissue stretching. According to the tonicity of the abdominal wall, the muscular plane functionality will be corrected double-folding and suturing the recti muscles along the median line. In some cases one can resort to biocompatible patches, meant to reinforce the muscle fascia. Special care must be taken in the presence of fissures within the muscle wall, consequence of previous operations or spontaneous tissue relaxation. In theses cases the abdominal wall will have to be restored to avoid any herniations.
The scar may or not show depending on the surgeon, on the patient, but mainly on the volume and area of the removed tissue. It can be represented by a very fine line or be more evident. Anyway the scar tends to get much lighter within 4-5 months and eventually will hardly be distinguished from the surrounding skin, but the process takes time, even up to one whole year.