Abdominoplasty

The procedure is performed under narco-analgesia assisted by local anesthesia and lasts about three to four hours.

The incision is then made in the lower part of the abdomen.

• Dr. Bernier can then lift all the skin to the ribs. To be able to pull the skin, it is necessary to release it from the belly button. The latter remains in its original location but is exposed through a new opening during the surgery.
• Then, the relaxed muscles will be brought closer together with stitches that will tighten them and allow them to be functional once again.
• Finally, Dr. Bernier will pull the skin from the abdomen down and remove excess skin and fat. Stretching the skin also makes stretch marks less visible. At the same time, it is also possible to perform liposuction of the lower abdomen.

The main scar will run horizontally along the lower abdomen so that a panty can hide it. There will also be a small scar around the belly button.

Abdominoplasty is for healthy people whose excess weight is not critical (not exceeding 15% of their normal healthy weight) or whose fat accumulation in the abdomen area is not the first source of a prominent abdomen. This procedure may also be contraindicated if the patient has already undergone surgery that has left scars in the upper abdomen area.

Contrary to popular belief, patients cannot undergo this procedure as soon as they start having sagging abdomen skin or a prominent belly. It is important to distinguish what the surgery can achieve from unrealistic expectations some patients may have.

The majority of women who undergo this procedure are those who have had one or more pregnancies and have flaccid skin on their abdomen (sometimes with stretch marks), excess fat and, on occasion, loose abdominal muscles.

In any case, only a proper medical evaluation by Dr. Bernier will allow us to conclude whether or not abdominoplasty is right for you. If this is not the case, Dr. Bernier will guide you to other options such as liposculpture, a weight loss diet or a strength training program.

• In the first few days, Dr. Bernier will prescribe the necessary medications to relieve the pain resulting from the procedure. Since this surgery tightens the abdominal muscles, you can expect more acute pain than when a simple adjustment of the excess skin is performed.
• A work leave of two to three weeks as well as restricting physical activity are mandatory to allow tissues to settle properly. This will also prevent the accumulation of fluid under the skin.
• For a few days, a semi-seated position will be recommended to reduce tension on the abdomen. Wearing abdominal support for about a month will be added to the measures to be taken.
• Finally, the lower part of the abdominal wall may be hard and show signs of numbness for a few months. The duration of this side effect varies from one individual to another. Dr. Bernier will tell you when you can return to work and when you can resume physical activities.

• As a preventive measure, it is necessary to avoid taking aspirin, anti-inflammatory medicines and other coagulation-influencing medication for two weeks before and one week after the procedure to avoid bleeding during and after the procedure.
• To maximize the chances of avoiding complications, Dr. Bernier will insist that the patient quit smoking at least four weeks before and after the procedure to promote better blood circulation. During the same period, hormonal supplements will also be banned. Alcohol must be stopped two weeks before and after. 

Any surgical procedure involves risks. However infrequent they may be, they do exist, hence the importance of drawing up a non-exhaustive list here. It should also be noted that the presence of a seroma (accumulation of a liquid under the skin) is both the most frequent and the most common complication.

Early complications 

• Seroma: Fluid can accumulate under the skin. In this case, several visits to the doctor may be required to vacuum this liquid by a puncture in a non-sensitive area. Drainage is necessary to allow the different layers of tissue to remain in contact and thus better merge.
• Bleeding: It is normal for the dressing to be soiled during the first few days. If the bleeding remains severe after some time, surgical treatment may be necessary.
• Infection: It is uncommon. Drainage, dressings or antibiotics may then be necessary.
• Skin necrosis: This poor skin circulation is rather rare. Smokers and people with abdominal scars are at higher risk of this type of complication.
• Fat necrosis: Sometimes fat lobules liquefy and a yellowish discharge may persist for several weeks. Smokers and obese people are more likely to experience this type of side effect.
• Wound dehiscence: It is quite rare that the wound does not heal properly and opens up on its own. In this case, it may be necessary to perform a second procedure to close the wound.
• Phlebitis: This inflammation of the veins in the lower limbs is very rare. It is important to move the legs and calves after the operation to avoid this problem. This is the reason why hormones must be stopped. 
• Pulmonary embolism: This is an extremely rare complication. To avoid it, it is important to move your legs and calves after the procedure.
• Bad scar or vicious scar
• Painful scar
• Belly button deformation
• Persistent numbness in the lower abdomen
• Persistent edema (swelling) in the lower abdomen.

Will I have scars?

Incisions are necessary to access and tighten the abdominal muscles, as well as to remove excess skin. Scars are, therefore, inevitable. The scars will be located around the belly button and all over the lower abdomen. Long scars are, however well hidden under Bikini panties.

Scar healing is an individual physiological process that takes place in depth over several months, even a year or more. The scar can be fine, enlarged, pigmented or not.

The scar’s final appearance has little to do with the surgeon. However, certain factors such as smoking, alcohol, bleeding and diet can affect the quality of a scar.

Should I lose weight before the procedure?

Prior weight loss is preferable if an accumulation of fat in the abdominal cavity is suspected so that the tissues can be optimally stretched and the muscle girdle tightened if necessary.

Are the results permanent?

No one can counter the effects of time and ageing, which are the leading causes of tissue sagging. Nevertheless, good weight control, a healthy lifestyle and regular physical exercise remain your best guarantees of success to maintain and preserve the results achieved by a tummy tuck.

Dr. Bernier does not recall having to do a second abdominoplasty. 

Is sunbathing beneficial to the scarring process?

No, because sunbathing does not heal a wound any faster. Sun exposure of scars that are less than three to four months old can even alter these scars, which would then become redder or darker. Dr. Bernier will tell you when it will be possible to expose yourself to the sun without consequences.

Can I see “Before/After” photos?

Dr. Bernier thinks this is a good idea and can be reassuring, but more importantly, it shows the quality of the results and/or the limitations.