The Avelar Abdominoplasty Procedure

The traditional abdominoplasty procedures (full tummy tuck, mini-tummy tuck and dermolipectomy) are associated with a relatively high complication rate because of the required significant undermining of the anterior abdominal flap that involves extensive trauma and compromises the blood supply of the abdominal flap. General anesthesia or heavy twilight sedation is frequently needed to complete the surgery because of the extensive tissue dissection and manipulation.

We adopted a revolutionary minimally invasive approach to tummy tuck that can be safely and effectively perform as an office procedure totally under local tumescent anesthesia. The technique called Abdominoplasty combines two procedures: liposuction of the abdomen and tummy tuck. By avoiding the use of general anesthesia or heavy sedation (and complications associated with this type of anesthesia), this new procedure offers an improved postoperative recovery.

In the past, traditional teaching held that performing abdominal liposuction at the same time of tummy tuck would further disrupt the blood supply, creating a significantly greater risk of necrosis of the inferior end of the flap.

Recent studies clearly demonstrate that such a belief was erroneous. It is well established now that when one performs limited liposuction, the blood vessels remain intact and functional even though the fat is removed. The removal of the fat by liposuction leaves essentially an empty space, thereby eliminating the need to undermine. Because the skin overlying this empty space remains extremely mobile, we can remove as much skin as, or more than, that removed during a standard tummy tuck without the danger of losing blood supply.

The management of the belly button is identical in both procedures. The skin incisions and the amount of skin removed are also similar. Tightening of the muscles also can be performed with either procedure. However, with the technique used by Dr. Byrd the amount of fat one can remove is greater. This improves the abdominal contour by thinning the fat layer considerably more than one can with the traditional tummy tuck while decreasing the risks of skin necrosis because the blood supply remains intact. Our approach doesn’t require the routine use of suction drains – a standard requirement in traditional tummy tuck.

Additional benefits over the traditional tummy tuck:

• Minimal bleeding due to the vasoconstriction created by the tumescent anesthesia. Traditional tummy tuck can be associated with profuse bleeding and even the need for blood transfusions and requires meticulous hemostasis throughout the procedure using electrocautery (which by itself creates blood vessel and tissue heat damage).

• The patient is wide awake and can ambulate, eat and drink during the surgery. That is virtually unheard of with standard tummy tuck. Following liposuction and before the tummy tuck, the patient is assessed while standing and the shape and size of the skin to be removed is drawn on the abdomen. This step eliminates guessing and improves the odds to achieve the desired body shape, contour line, and a symmetrical incision. When the surgery is performed under general anesthesia or heavy sedation, the patient must remain in a lying position throughout the surgery. This forces the surgeon to guess the shape and size of the skin to be removed.

• The operating time is significantly reduced because there is no bleeding.

• The technique eliminates puckers of skin on either end of the scar (dog ears) because liposuction allows the creation of similar fat thickness in the superior and inferior borders of the flap.

• The postoperative period is similar to that of the standard liposuction of the abdomen. The patient is able to stand up from the operating table, walk and dress her-/himself at the end of the procedure. This quick recovery is virtually unheard of with a standard tummy tuck under general anesthesia or heavy sedation. Due to its long lasting effects, tumescent anesthesia offers a minimum of 12 hours pain control following the surgery.

• In our hands the abdominoplasty totally under local tumescent anesthesia with no undermining results in a shorter, more aesthetically pleasing scar when compared with the scar from traditional tummy tuck.

• This new approach creates a more youthful abdominal silhouette and more harmonious results while avoiding complications and the prolonged recovery time associated with the traditional tummy tuck.

To learn more about Dr. Byrd's Tummy Tuck contact Byrd Aesthetic Today!

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