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Abdominoplasty – Tummy Tucks Complications and Risks
So think about abdominoplasty (tummy tuck) what are the possible complications of abdominoplasty (tummy tuck)? If they are easily avoided I am not telling you these complications to make you afraid of abdominoplasty (tummy tuck) but because technically I always prefer the patient to be aware of the complications and the steps of his surgery.
Here is the list of possible complications of abdominoplasty (tummy tuck)
This is the reaction during surgery due to anesthesia
Death of the navel:
More common in smokers occurs due to failure of healing of 2 surgical scars
Hematoma (risk is 3-4%)
Infection (risk is less than 1%)
It is not usual, since the surgeries are done in septic conditions
Skin lesions in which the skin is wrinkled
Skin necrosis or dead skin (more likely with smokers)
Serious complications after a tummy tuck are rare. However, there are risks with any surgery and specific complications associated with this procedure.
Complications such as infection and blood clots are rare but can occur. The infection can be treated with drainage and antibiotics, but it will prolong your recovery. You can minimize the risk of blood clots by moving as soon as possible after surgery (immobility allows blood to pool and form a clot that can travel to the lungs, heart or brain causing a pulmonary embolism, a heart attack or stroke).
If wound problems develop, it can delay healing for several weeks or even months. Areas of skin can die and peel off (this complication is more common among smokers). This will cause a delay in healing and may require a skin graft. Although rare, it is possible for the fat to liquefy and drain through the incision. Additional surgery may also be necessary.
One of the most common problems after a tummy tuck is the collection of fluid under the skin after the drains have been removed. Your surgeon may aspirate the fluid with a needle. Drainage stops within a month and will not affect the final results.
Surgical scars – as a complication of abdominoplasty (tummy tuck) – are permanent. There will be a long scar that stretches from hip to hip. However, the incisions are usually placed below the swimsuit line, so they usually won’t be seen. In fact, the scars may get worse for the first three to six months as it heals, but this is normal. It usually takes 9 months to a year for the scars to flatten and lighten.
Complication of protein deficiency
Abdominoplasty (tummy tuck) is a metabolic surgery designed to produce malnutrition. Energy deficit occurs due to low food intake, food intolerance and poor absorption of nutrients. Abdominoplasty (tummy tuck) aims to achieve malnutrition to lose weight but without complications.
Protein deficiency can occur after abdominoplasty (tummy tuck). The ratio of fat mass to fat-free mass loss is approximately 4:1 in non-restrictive operations such as RYGB.12 It is probably even more severe after biliopancreatic bypass (BPD). The literature is not clear. Some report severe protein-calorie malnutrition13, although others have described low incidences.
Protein deficiencies manifest initially with fatigue and loss of muscle strength, especially with greater than expected weight loss as in patients with gastrojejunal anastomotic strictures. Progression of protein deficiency is predictable with continued weight loss with further development of hair loss, poor wound healing, wasting, emaciation, kwashiorkor and marasmus.
Protein deficiencies should be promptly addressed with supplementation. Although the normal protein requirement for the average individual is 1 g/kg body weight/day, this formula does not work for morbidly obese individuals weighing 200 kg plus. Most abdominoplasty (tummy tuck) surgeons aim for 60-90 g per day for their postoperative patients – Abdominoplasty (tummy tuck) – but, in fact, there is little evidence for this guideline. Protein deficiency can be assessed by checking serum albumin levels at regular intervals, but it is not a reliable measure. We have seen virtually normal albumin levels in severely malnourished patients that fall to extremely low values when supplemental nutrition is provided. It almost seems that patients lack the enzymes to use albumin, creating stores of albumin that cannot be used.
The approach is to proceed quickly by supplementing these patients with one or two cans of a high-protein, high-vitamin liquid preparation, such as Ensure Plus, if they are able to tolerate an oral diet. This approach rarely fails, but it can take weeks to restore patients to euproteinemia. However, if patients are unable to eat or drink, total parenteral nutrition should be started promptly with an emphasis on slow rather than rapid correction. In our experience, malnourished patients should be corrected slowly; they are unable to handle large sudden nutrient loads when first seen.
Complication due to carbohydrate deficiency
Carbohydrate deficiency, manifested as episodic hypoglycemia, is probably quite common. Many patients admit to experiencing episodes of feeling “shaky and dizzy” during the day, usually about 2 hours after meals. When our gastric bypass series was about 1000 cases over 16 years, we found 47 patients in our practice who developed documented glucose levels in the range of 30-40 d/mL. Hypoglycemia appeared to be independent of age, sex, race, original weight, and degree of weight loss and could occur as late as 14 years postoperatively. Fortunately, all our patients were treated well with candy taken at the first “aura” of hypoglycemia, ie weakness, tremors, sweats, etc. All cleared up within a year of symptom onset. A recent report of nesidoblastosis requiring pancreatic resection suggests that refractory cases exist possibly due to the development of secondary tumors.
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