American Medical Association Family Medical Guide - American Medical Association [785]
Abdominoplasty
To remove excess abdominal skin and fat, the surgeon makes a continuous incision that extends from one hip to the other. He or she then separates the skin from the underlying tissue up to the ribs and folds it out of the way (left). After removing excess fat, the surgeon pulls the abdominal skin back down and trims off the excess. A new opening is cut for the navel, and the skin is stitched into place along the incision lines (right).
After Surgery
In the first few days after surgery, your abdomen will be swollen and painful. Your surface stitches can be removed in 5 to 7 days, but the deep sutures (the ends of which stick out through the skin) on your abdominal muscles will not come out for 2 or 3 weeks. Once your dressings are removed, you may have to wear an elastic support garment.
It will take several weeks or months before you feel completely back to normal. In general, the stronger your abdominal muscles were before the surgery, the faster you will recover. You can go back to work in 2 to 4 weeks, depending on the extent of the surgery. Light exercise, such as walking, during the first month or two will help you heal faster and help prevent blood clots from forming in your legs. Avoid vigorous exercise until your surgeon tells you it’s OK.
Your scars will remain red and may even seem to get more noticeable for the first 6 months. It will take 9 months to a year before they fade into inconspicuous lines, but they will never disappear completely. You may have numbness for up to 2 years.
Complications from abdominoplasty are rare but can include bleeding, infection at the surgical site or in the lungs (pneumonia; see page 660), excessive scarring, irregularities in the shape of the abdomen, and blood clots that can travel to the lungs and cause sudden death.
The results of an abdominoplasty are long-lasting if you maintain your weight by eating sensibly and exercising regularly.
Hair Replacement Procedures
Hair loss (see page 1075) usually occurs in people who have a family history of baldness. More than 30,000 surgical hair replacement procedures are performed every year nationwide to fight hair loss. Most of these procedures are performed on men. Women can sometimes take advantage of hair replacement surgery but, because they lose hair from the entire scalp rather than just from the front and crown, hair replacement in women is more difficult and the outcome is often less successful. The most common surgical procedures used for hair loss are hair transplantation and scalp surgery, including tissue expansion, flap surgery, and scalp reduction surgery.
Hair Transplantation
Hair transplantation is the surgical transfer of grafts of skin from a hair-growing part of the scalp to a bald part. The process requires multiple sessions interspersed with months of healing. The entire process can take up to 2 years to complete. Common transplant methods include circular punch grafts that each contain 10 to 15 hairs, minigrafts of 2 to 4 hairs, micrografts of 1 or 2 hairs, slit grafts inserted into slit incisions in the scalp, and strip grafts, which are longer slit-type grafts. Surgeons may combine one or more of these techniques to achieve the best results.
Successful hair transplantation requires full, healthy hair growth at the back and sides of the head from which the surgeon can take the grafts. Because women generally experience uniform hair loss