There are several different abdominoplasty techniques. The most common procedure is performed under general anesthesia. In the full abdominoplasty procedure, an incision is made across the lower abdomen, just above the pubic area. Another incision is made around the belly button to free the surrounding skin, and the all of the skin is separated from the abdominal wall. Then Dr. Karp tightens the lax muscles with sutures. This creates a stronger abdominal wall and a smaller waist. Excess skin is removed and liposuction is performed as needed. A new opening is made for the belly button in the right position. The incisions are closed with sutures and drains are placed.

If your only problem area is below the belly button, you may benefit from a less complex procedure called a mini-abdominoplasty. This procedure can often be performed on an outpatient basis, under local anesthesia with sedation. Dr. Karp may recommend either a mini- abdominoplasty with liposuction to achieve for a better body contour. In some cases, liposuction alone offers the best results.

Abdominoplasty generally takes about 2-4 hours, depending on the extent of the repair. A mini-abdominoplasty takes about about 2 hours.

This depends on the extent of the repair. An overnight stay is most common for full abdominoplasty. If the area of repair is smaller, you may be able to go home the same day. This is usually discussed and decided by you and Dr. Karp during the initial consultation.

For the first few days, your abdomen will probably be swollen and you're likely to feel some pain and discomfort, which can be controlled by medication. Depending on the extent of the surgery and the technique used, you may be released within a few hours or you may have to remain hospitalized for uo to one or two days.

Bed rest for two to three days is recommended. While in bed, your legs should be bent at the hips in order to reduce the strain on the abdominal area. You may be provided with an abdominal binder to offer support to the tightened areas.

Dr. Karp will give you instructions for showering and using any drains that may be placed. You may not be able to stand straight at first, but you should start walking as soon as possible.

Dr. Karp uses absorbable sutures under the skin. There usually are no sutures to be removed. Any drains that are placed are removed in 5 to 7 days.

It may take you several weeks to feel completely back to normal. If you are in top physical condition, recovery will be much faster. Some people return to work after one to two weeks, while others take longer to recuperate.

After about three days, you may begin light activity.

Even if you never exercised before, you should begin a light exercise program to reduce swelling, lower the chance of blood clots, and improve muscle tone. However, vigorous exercise, especially lifting is not permitted for 4 to 6 weeks. Dr. Karp will tell you when and what exercise is permitted.

Your scars may appear to worsen during the first few months, but this is normal. It may take up to a year before your scars flatten out and lighten in color.

As long as you keep your weight relatively constant, eat a healthy diet, exercise regularly, and follow Dr. Karp's instructions about how to resume physical activity, the long-term results from this procedure are generally excellent.

Ideal candidate:

• 18 years of age or older
• Mature enough to fully understand the procedure
• In relatively good shape, except for the abdominal area
• Not pregnant or planning to become pregnant
• Not severely overweight
• Not planning to lose a considerable amount of weight
• In good health
• Wanting to improve their appearance and/or comfort
• Realistic in their expectations

Risks:

All surgery has some potential risks, including the risks of bleeding, reaction to the anesthetic, infection, and blood clots. Scars are to be expected, but they will become lighter and flatter with time.

Smoking may increase the risk of complications and delay healing. This could result in larger scars, and a second surgery. You can reduce your risk of complications by closely following Dr. Karp's instructions before and after the surgery, especially with regard to when and how to resume physical activity.