How frequently is a surgery performed? What is the most most common complaint from the person seeking the surgery?
A drainless tummy tuck is essentially a lipoabdominoplasty which was originally described by Avelar as well as Osvando Saldanha, a Brazilian plastic surgeon who first started lecturing on this technique back in the 1990s.
This is a departure from the typical type of abdominoplasty in which an abdominal flap was separated from the underlying muscle fascia all the way to the rib cage and then the redundant skin is pulled down and removed from its base and the umbilicus is then translocated on an umbilical stock.
The problem with this procedure is that approximately 80% of the blood supply to the skin flap is lost as these are cut in raising the flap and liposuction of the abdominal flap is not advised as to the strain on the already tenuous blood supply that is left with using this technique.
In the case of a lipoabdominoplasty, extensive liposuction is done to the entire anterior abdomen until an abdominal flap of desired thickness is obtained, preserving the blood supply to the abdominal flap. During the dissection, the sub-Scarpa fat or the deep fat is retained below the umbilicus as the lymphatics are contained in this fatty layer. and allows for a drainless procedure. Above the umbilicus, only the diastases recti is uncovered during the surgery leaving the vast majority of the abdominal flap adherent to the abdominal wall. In my practice I routinely put in drains and leave them in for approximately 4 – 5 days because this greatly speeds up resolution of postoperative firmness and swelling and speeds recovery.
Patients primarily complain of either redundancy of skin and fat and the inability to obtain a flat “stomach” despite hours of workouts in the gym due to the fact that the muscle bellies of the rectus muscle are separated which is known in medical terms as a diastases recti. These complaints are aptly addressed in an abdominoplasty.
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