Abdominal and torso reconstruction after massive weight loss
In recent years, obesity has developed into a true epidemic. The statistics are striking: over 60% of adults in the United States are considered overweight, while more than 30% are classified as obese. Although the situation in Greece is not at such dramatic levels, the adoption of a “Western” lifestyle is gradually worsening the figures here as well.
The presence of a large, overhanging abdomen is a common problem for both women and men following massive weight loss. The appearance is almost always similar: accumulation of fat in the lower abdomen, protrusion of the abdominal wall, skin laxity with unsightly folds, and the development of stretch marks due to loss of skin elasticity.
Abdominal reconstruction after massive weight loss is a procedure designed to restore the natural contour of the abdominal wall by eliminating unsightly folds, tightening the abdominal muscles, and addressing stretch marks located in the lower abdomen.
How is abdominal reconstruction after massive weight loss performed?
The procedure is performed under general anesthesia or epidural anesthesia with sedation and lasts approximately 3 hours. An incision is made between the two iliac bones, just above the pubic area, along the so-called “bikini line,” where it can be concealed by underwear or swimwear.
The skin and fat of the lower abdomen are then elevated up to the level of the navel. An incision is made around the navel so that it remains in its original position, and the dissection continues upward to just below the ribs.
The abdominal muscles, which have become lax, are tightened and sutured together along the midline, restoring the strength of the abdominal wall and refining the waistline.
Finally, the excess skin and fat are removed along with the stretch marks located below the navel. The navel is repositioned through a small opening, and the abdominal flap is pulled downward and closed with internal absorbable sutures. Usually, two small drains are placed on either side and remain in place until fluid production stops (approximately 3–5 days).
What should I expect after surgery?
As mentioned, the procedure lasts approximately 3 hours. After surgery, you will need to remain in the clinic for 1–2 days. Pain is generally mild to moderate and is managed with oral or intravenous analgesics. On the day of surgery, you will mostly remain in bed with your legs slightly bent. From the day after surgery, you will begin getting up for short walks. The drains are usually removed after 3–5 days. During the first few weeks, you will also need to wear a special abdominal binder to support the abdominal wall and prevent fluid accumulation beneath the skin.
The sutures are usually internal and absorbable, so they do not require removal. The scars will initially appear red and slightly firm; gradually, they will soften, turn pink, and eventually fade to a lighter color, leaving a fine scar that is concealed by underwear or swimwear.
When can I return to my activities?
During the first week after surgery, you should remain at home with limited activity. Walking is encouraged, but household tasks are not permitted. From the second week onward, you may gradually increase your activity level, and after two weeks you may return to light work. Full return to normal activities is expected after 4–6 weeks.
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