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1. For whom?
An abdominal wall correction is a solution for women who had multiple pregnancies: the skin has been stretched and striae has formed. Striae cannot be fully removed because they also appear above the belly button. Only skin below the navel will be removed with abdominal wall correction. The navel is then repositioned. In case the navel does not need repositioning then it is a mini abdominal correction. The skin above the navel has to be sufficiently elastic (and the fat layer not too thick) in order to get good results. If the fat layer above the navel is too substantial I will advise to lose weight first. Abdominal wall correction is often combined with liposuction.
2. Protruding abdomen (mommy make over)
If you have a protruding abdomen or people ask you “Are you pregnant again?”. than the muscles running vertically have been stretched during pregnancy which is the reason why you have a hollow back and more prominent belly. Sometimes this will cause back complaints. During the abdominal wall correction these muscles can be tightened. The abdomen will flatten, your posture will improve and existing back complaints will disappear. Often this can be done through a mini abdominal wall correction. In the United States this procedure is called a “mommy make-over”.
A belly that is not flat can also be the result of overweight and is then caused by internal fat layers. In this case an abdominal wall correction is not possible and I will advise then to lose weight first.
3. Mini tummy tuck
With this technique only part of the skin below the navel will be removed without touching your navel. For a good result the navel should not be positioned too low and the skin surplus should not be too substantial. Sometimes this technique is used to correct the scar of the caesarian scar. The tummy tuck is cosmetically superior and if possible I will recommend this technique.
4. Belly button correction
Correction of the navel or an umbilical hernia correction can be a part of a mini abdominal corrrection. An umbilical hernia correction as an individuel treatment can be performed under local anesthesia.
5. Correction of the mons pubis
The cause of a voluminous of bulky mons pubis can be congenital, weightloss, or a less successful abdominal wall correction.
Correction is possible by means of liposuction, a mini abdominal wall correction, or a redo abdominal wall correction.
The abdominal wall correction is often combined with liposuction. Not to correct overweight but to improve the body contour at the sides and/or to make the skin of the upper abdomen more flexible, which enables loosening a smaller amount of skin.
7. Before the surgery
Smoking will almost definitely cause complications. With the loosening of the skin and fat tissue many blood vessels are cut. The blood has to pass to the skin via a different way and with smoking you jeopardize the blood flow. Smoking narrows the blood vessels and could fully endanger the already decreased blood flow. My advice: stop smoking three months prior to surgery.
Other than that I recommend my patients to take 3 to 4 weeks off from work because of limited mobility after the abdominal wall correction. For a mini abdominal wall correction 1 to 2 weeks will be sufficient. For the first 8 weeks after surgery (mini abdominal wall correction 4 weeks) you will receive shapewear pants prior to the operation. My assistants will measure the right size.
The operation will take one-and-a-half to two hours and will take place under general anesthesia or by means of epidural anesthesia. I will mark the scar with a marker. After that I will detach the skin with its fat layer from the abdomen, remove the part below the navel and stich the skin in the bikini line. With the extended abdominal wall correction the navel will be replaced (usually moved upwards) to its new position in the tightened skin. There will be a scar in the navel. With the mini abdominal correction the navel will not be moved and thus there will be no scar.
9. After the surgery
You will wake up with gauze that is held by foam tape and runs from one side of the belly to the other. The drains come out through the bandages. They will drain (both) the excess blood and wound fluid. The drains will be removed after 1 or 2 days; stiches after 2 weeks. Total recovery time varies between 4 and 8 weeks. After the abdominal wall correction, but also after the mini abdominal wall correction it is advisable to wear tight fitting shapewear pants.
10. Not a small procedure
Sometimes people tend to underestimate this procedure. There is a difference whether it concerns an extended or mini abdominal correction. The mini abdominal wall correction sometimes can be done in day treatment, but with the extended version day treatment would increase the risk of complications. Rest is vital; preferably a few days in hospital and after that with good care at home.
The issue is that the tightened skin attaches itself again to the underlying abdomen. If you would move around too much, then there is not enough time for the skin to stick to the under layer. The result is excessive fluid and a delay in recovery.
11. Possible complications
There is a realistic possibility of bruises because of the large area involved. You can imagine that if the bruising is substantial that this needs to be surgically removed. Other than that there can be a disturbance of the blood flow of the tightened skin and fat layer. Smoking can be the cause of that. With careful planning and performance of the surgery the chances of these complications are limited.
A simple complication is fluid accumulation under the skin. During the check-ups after surgery we will then drain the fluid a few times. Too much strain and too soon can cause this complication, so you can prevent this by restraining your activities. Finally it is important to realize that the sense in the skin just above the mons venus will slightly decrease.
Dr. Erik J.F. Timmenga
13. Patient review
"impressively responsive and reassuring"
Saw Dr. Timmenga for abdominoplasty with muscle repair in August 2017. Really happy with the quality of care. His team went above and beyond to schedule me in quickly for surgery and all pre-op and follow-up appointments were on time and very convenient. Care in hospital when staying overnight was very good, comfortable, and private. Dr. Timmenga’s bedside manner is excellent, he was able to answer all of my questions in English and was impressively responsive and reassuring on a Sunday afternoon when I had a question about how my incision was healing and had sent him a quick photograph and he got back to me in just a couple hours. As someone who has limited Dutch as a second language I can say that receiving care from Dr Timmenga and his team worked very well. Paperwork is of course in Dutch but everyone spoke with me in English whenever needed as long as I spoke up, asked questions, and advocated for myself with any needs around follow-up, complications, or pain management. I couldn’t be more pleased with the results, everything looks very natural and I feel like myself again. Costs were also very reasonable and well disclosed up-front. Highly recommend!
From: Zorgkaart Nederland - Score 9,7