Abdominoplasty in Uberlândia, Brazil

Like any surgical procedure, abdominoplasty carries risks described in the medical literature, such as seroma, hematoma, infection, sensitivity changes, poor scarring, skin necrosis and, more rarely, anesthesia-related complications or thromboembolism. These risks are discussed in detail at the consultation.

An apron belly is the excess skin and fat that hangs over the pubic area, common after pregnancies or major weight loss, and it is exactly what abdominoplasty addresses: a band of skin and fat below the navel is removed and the incision is closed at the suprapubic level. Stretch marks lying inside the removed skin go with it — so part of the stretch marks on the lower abdomen tends to go too, to the exact extent of what is resected. Those above the navel stay, because that skin is not removed, only drawn downward. A low C-section scar usually comes out with the resection when it lies inside the removed area; if it sits above it, it may remain. The exact extent is defined at the pre-operative marking, with the patient standing.

There is not. Removing skin requires resection, and resection requires an incision — no technique takes excess abdominal skin away without leaving a scar. Nor is there a laser tummy tuck: lasers and radiofrequency act on skin retraction, not on skin removal. What does exist are shorter-incision routes, for different situations: liposuction combined with skin-retraction devices, indicated for mild to moderate laxity and for localized fat, and, for diastasis, endoscopic correction, which brings the muscles together without the long incision and is assessed jointly with digestive system surgery — the route described on the MILA lipoabdominoplasty page of this site. None of these routes removes skin in any quantity: where there is a skin apron, resection remains the only route. The definition comes from the physical exam: if the pinched skin of the lower abdomen is small and the wall is firm, a non-surgical indication may make sense; if there is frank excess skin, treatment involves an incision, and the conversation is about where it sits and how it matures.

If weight loss is still under way, yes — surgery goes better with weight stable, generally for three to six months, because losing weight afterwards leaves new excess skin and gaining it changes the contour obtained. Weight also enters the risk calculation: in the largest published database on abdominoplasty, a body mass index of 30 or above was an independent risk factor for major complications, with a relative risk of 1.3. This does not mean a number is required in order to operate: it means the plan changes with weight, and that in some cases the better route is to address the weight first, with the professional who manages it — that decision is theirs — and schedule the abdominoplasty afterwards, often with a wider resection.

They treat different problems. Liposuction removes fat from the subcutaneous layer through thin cannulas; it does not remove skin and does not reach the muscle, so where there is significant skin laxity the fat leaves and the skin is left even looser. Abdominoplasty removes skin and fat together and allows the rectus muscles to be brought back together when diastasis is present — a separation of more than 2 cm between them. Skin laxity and localized fat are distinct entities, and the physical exam separates them: the skin of the lower abdomen is pinched and the abdominal wall is assessed with the patient lying down and contracting. The two techniques can also be combined in one operation, according to individual assessment.

Duration varies according to technique and case complexity, generally ranging from 2 to 4 hours — the exact time is estimated at the consultation, after individual assessment.

Yes. For abdominoplasty the approach is always at least one night of hospital observation, to monitor pain, bleeding and recovery from the anesthetic, and it may be longer according to the extent of the surgery. Whether you go home the same day or stay overnight is always assessed case by case, according to the extent of the surgery, the anesthesia, whether other procedures are combined and your pre-operative assessment — and it is defined before the surgery, not on the day. That same decision determines the venue: procedures with same-day discharge are performed in the operating theatre of Healme Clinic itself, and those requiring admission in the operating theatre of the UMC Hospital — in the same complex, with no travel between sites.

Six months of stable weight is the usual criterion, and it is what the published indication criteria in post-weight-loss body contouring describe. The reason is not bureaucratic. Weight regain after this kind of surgery is common: in a follow-up of patients who underwent trunk-based contouring, those who had had bariatric surgery regained on average about 12% after reaching their lowest weight, against about 8% among those who had not. Operating before the weight settles means operating on a body that is still going to change. Body mass index comes into it as well, and not as a detail: in a series of 2,533 post-weight-loss abdominoplasties, patients with a higher BMI had more seroma, dehiscence, hematoma requiring reintervention and surgical site infection. Stable weight and BMI are therefore assessed together, and the target is defined individually at the consultation — in some cases the advice is to keep losing weight before scheduling surgery, which frustrates those who arrive wanting a date, and is what protects the result. Nutritional assessment and stopping smoking are part of it too.

Nutritional assessment is neither optional nor outsourced: the clinic has a dietitian on the team, and every patient has a nutritional consultation, with bioimpedance analysis. This exists for a reason the post-weight-loss body contouring literature documents well. GLP-1 analogues suppress appetite and delay gastric emptying, which reduces protein and micronutrient intake; bariatric surgery, sleeve gastrectomy included, predisposes to deficiencies in iron, vitamin B12 and protein. And protein deficiency is not a detail: it impairs collagen production, angiogenesis and immunity, and is a risk factor for poor wound healing — precisely what is most feared in this kind of surgery. Guidelines describe a target of 60 to 120 g of protein a day, and a substantial share of patients on these medications fall short of it; hence the emphasis on spreading protein through the day, in smaller and more frequent meals, rather than concentrating it. The laboratory work-up before surgery is broad and includes screening for anemia and for the deficiencies most associated with this profile. The exact list is defined case by case and discussed at the consultation, because it depends on how the weight was lost, how long ago, and what was already being replaced.

Abdominoplasty can be performed under spinal anesthesia combined with sedation, or general anesthesia, as jointly decided with the anesthesiology team based on the extent of surgery and the patient's health profile.

Some discomfort in the first days is expected, controlled with prescribed post-operative analgesia. Intensity varies from person to person.

Some discomfort in the first days is expected and is controlled with prescribed post-operative analgesia. What bothers most is not the skin, it is bringing the muscles back together: suturing the rectus muscles leaves a sensation of tightness and weight in the abdominal wall, felt when breathing deeply, coughing, laughing and above all when getting out of bed. Patients who have had a C-section often recognize the sensation, though the tightness of sutured muscle tends to be greater and to last longer — so the direct comparison only helps up to a point, and intensity varies from person to person. The first 48 to 72 hours concentrate the discomfort, improving progressively through the first and second weeks. Analgesia is prescribed on a fixed schedule rather than only when pain appears. In the early days patients walk slightly bent forward to relieve tension on the suture, a posture that commonly causes back discomfort until they straighten up again.

The choice belongs to the anesthesia team and follows the extent of the surgery. The usual routes are spinal anesthesia combined with sedation, and general anesthesia: general anesthesia makes ventilation easier to control when the muscle repair is extensive, since the suture reduces the space available to the diaphragm. An epidural is another form of neuraxial block, with the particular advantage of allowing catheter analgesia afterwards. Local anesthesia alone is not a route used for surgery of this size, and no anesthetic technique can be treated as a single standard — the decision is individual, made at the pre-anesthesia assessment, based on the patient's health profile. Abdominal wall blocks are commonly added to reduce pain in the first hours, whichever route is chosen.

In most cases, yes: the suction drain collects the fluid that gathers in the space between the lifted skin and the abdominal wall, and that collection — seroma — was the most frequent early complication in the series of 278 abdominoplasties published in the literature, at 5% of cases. The evidence on drains is debated: there is the alternative of progressive tension sutures between the flap and the wall, which close that space down, and services that leave the drain out for that reason — whether one is used follows the extent of the dissection and the team's routine. Removal takes place at a follow-up visit in the first days, once the drained volume falls below the limit set by the team. It is a single movement lasting a few seconds: most patients describe a burning or pulling sensation along the tract, unpleasant but brief, and no anesthesia is used for it. A small opening is left behind, which usually closes within a few days. It would be wrong to say it does not hurt; it is fair to say it lasts only a few seconds.

In most cases, yes — suction drains are placed during surgery and usually removed at a follow-up visit in the first days, depending on drainage volume.

Use is generally recommended for about 4 to 6 weeks, which may vary according to each patient's individual recovery — the exact guidance is given post-operatively.

Generally 2 to 3 weeks, depending on the nature of the job — physically demanding work usually requires more time off. Return to work is always assessed individually.

Light activities are usually cleared gradually starting at 3 to 4 weeks, and higher-impact exercise or abdominal strengthening only after specific medical clearance, generally between 6 and 8 weeks.

For the first weeks the advice is to sleep on your back, with the trunk slightly raised and a pillow under the knees: the position reduces tension on the muscle suture and on the suprapubic closure, which is precisely what hurts when the body straightens out. Many patients sleep better in a reclining chair or propped on pillows in the early days. Sleeping on the side is usually cleared around three to four weeks, according to comfort and the follow-up assessment, and face-down is the last to return, generally after the sixth week. Getting up by rolling to the side and using the arms, instead of sitting up with abdominal strength, protects the muscle suture during this phase.

Showering is usually cleared within the first 24 to 48 hours, depending on the dressing used and whether a drain is in place — the garment comes off for the shower only, with no scrubbing of the incision and no jet of water aimed at it, drying by gentle pressure. Immersion is what stays restricted longest: bathtub, pool, sea and sauna generally only after healing is complete, from four to six weeks. Driving is usually cleared between two and three weeks, the same interval as time off work, but the criterion is functional: being off any analgesic that dulls reflexes, turning the trunk without pain, and being able to perform an emergency stop, which needs firm pressure on the pedal. A medical certificate follows that timeline and the nature of the job.

Numbness of the abdomen below the navel is expected: lifting the skin interrupts sensory branches of the abdominal wall, and the area is left with reduced sensation or an odd feeling to the touch. Recovery is slow, over six to twelve months, and a band of reduced sensation can remain permanently — it is one of the points stated before surgery. Swelling is greatest in the first two weeks, drops noticeably between the sixth and eighth week, and still varies residually for some months, fluctuating through the day and with the weather. The compression garment is advised for the first weeks of this phase — generally four to six weeks — according to individual recovery.

In most cases, the scar is positioned in the lower abdomen, discreet under underwear. Its extent depends on the technique used, and it fades and softens over the following months.

It does not go away — it is permanent, and what changes is its appearance. It is usually red and slightly raised between the first and third month, when collagen production peaks, then fades and softens over twelve to eighteen months, with strict sun protection over the area and, depending on how it evolves, measures such as silicone tape, silicone gel or silicone sheets. A personal or family history of keloid or hypertrophic scarring raises the risk of the scar widening and staying raised, and the abdominoplasty incision is long and under tension, which works against that type of skin — old scars are usually examined at the consultation to estimate the response. Smoking, skin tone and closure tension also weigh. In the series of 278 consecutive abdominoplasties published in the literature, the scar was rated unsatisfactory in 8% of patients and 5% underwent scar revision. A flat, imperceptible scar is not something that can be promised.

It can. The final height depends on how much skin there was to resect, because the closure must be free of excessive tension: the smaller the excess skin, the higher the line tends to sit, and forcing a scar lower than the skin allows raises the risk of dehiscence and widening. That is why the position is estimated at the pre-operative marking, with the patient standing and taking the underwear usually worn into account — the intention is for the line to sit in the lower abdomen, but it is the anatomy of each case that defines how far that is possible. When excess skin also runs vertically, frequent after major weight loss, the amount of skin to be removed may call for a different incision plan, discussed before surgery. The scar is also not necessarily straight or symmetrical on both sides: small excesses at the ends — known as dog ears — appeared in 12% of the series of 278 cases published in the literature and are the most common reason for a touch-up.

It can. Wound and scar problems are among the most frequent complications: in the series of 278 consecutive abdominoplasties published in the literature, 18% of patients had an early complication, including skin or fat necrosis in 2.5% and delayed healing in 2%. Dehiscence tends to occur at the point of greatest tension in the suprapubic closure, where the blood supply to the skin is most fragile. Active smoking is the most consistent risk factor, which is why stopping weeks in advance is advised. The skin is usually closed with absorbable thread and no visible stitches; where external stitches are used, removal is usually between the seventh and fourteenth day, according to the follow-up assessment. A small opening is generally managed with dressings and heals by second intention, leaving a wider scar along that stretch.

There is risk, as with any operation of this size under anesthesia, and it is not zero. In an international database of 25,478 abdominoplasties, major complications came to 4.0% — a higher proportion than for other aesthetic procedures, at 1.4% — and about a fifth of those were suspected or confirmed venous thromboembolism. Thromboembolism is the complication of greatest concern in body contouring surgery because it is the one that can be fatal, and risk rises with long operating time, obesity, smoking, older age, oral contraceptive use, thrombophilia and combining several procedures. That last point is measured: in the same database, abdominoplasty alone had 3.1% major complications, rising to 3.8% with liposuction, 4.3% with a breast procedure and 10.4% when combined with liposuction and another body contouring procedure. Hence compression stockings, intermittent pneumatic compression in the operating room and early walking are routine in every case, with pre-operative risk assessment by the Caprini score defining how long prophylactic enoxaparin is used. What lowers risk most is careful clinical screening and limiting the number of procedures combined in one operation.

Like any surgical procedure, abdominoplasty carries risks described in the medical literature. In the series of 278 consecutive abdominoplasties published in the literature, 18% of patients had an early complication: seroma in 5%, hematoma in 3%, infection in 3%, skin or fat necrosis in 2.5% and delayed healing in 2%. Late complications, generally minor, appeared in 25% — excess tissue at the ends of the scar in 12%, localized fatty excess in 10% and unsatisfactory scarring in 8% — and about a quarter of patients underwent some revision procedure, most often additional liposuction or scar revision. To these are added sensitivity changes, contour irregularity and, more rarely, anesthesia-related complications and thromboembolism. Signs that call for immediate contact with the team: fever, pain that increases instead of easing, spreading redness, foul-smelling discharge or fluid leaking from the incision. And two signs call for emergency care rather than a phone call: sudden shortness of breath or chest pain, with or without a racing heartbeat, and pain, swelling or firmness in one leg only, usually the calf — this is how venous thrombosis and pulmonary embolism present, and they need to be seen at once. Caught early, most of the other situations are treatable. Misaligned expectations are the most described complaint after surgery — which is why the limits of the technique are addressed at the consultation, before any indication.

Venous thromboembolism prophylaxis is used in every patient, not only in those at higher risk. It has two parts. The mechanical one is routine: anti-thrombosis compression stockings and intermittent pneumatic compression of the legs, used during the operation and in the immediate postoperative period, until early ambulation — the third pillar, and the reason the team insists on short, frequent walks from the first hours. The chemical part is individualised: how long enoxaparin is used is defined by the Caprini score, a validated instrument that adds up factors such as age, body mass index, expected length of surgery, hormone use, smoking and personal or family history of thrombosis. None of these measures eliminates the risk, which is why asymmetrical pain or swelling in a leg, shortness of breath and chest pain need immediate assessment, not waiting.

In the full technique the navel is repositioned through a new opening made at the level matching its original height — which is why a scar is left around it, in addition to the low horizontal one. The design of that opening shapes the appearance: it can look rounder or like a vertical slit, and widening, retraction, asymmetry or partial loss of natural depth are described in the literature and sometimes call for a touch-up. There is also the less frequent risk of circulatory compromise of the navel, which can lead to partial or total loss of it and require later reconstruction — described mainly in smokers and after bariatric surgery, and one of the reasons stopping smoking is insisted upon. No technique gives back a navel identical to the one before, and what is reasonable to expect is discussed at the consultation, from your own anatomy.

Yes. A systematic review of the literature does not describe pregnancy after abdominoplasty as contraindicated. The route of delivery is the obstetrician's decision, taking the previous scar into account in planning — it is not decided by plastic surgery. What changes is the result: the skin stretches again and the muscle repair can give way, so some patients see laxity or bulging return and eventually look for a revision. That is why patients who have completed childbearing tend to be the most suitable candidates. Where another pregnancy is intended, the usual advice is to wait — generally at least twelve months after surgery, with stable weight — or to postpone the abdominoplasty, and that conversation happens before the indication.

The skin removed does not come back — in that sense the resection is permanent. But contour is not the same as skin: it depends on keeping weight stable, on the quality of the remaining skin and on aging, and a significant weight change or a new pregnancy can alter what was achieved. As for the muscle repair, published long-term follow-up is scarce and comes from small series: in one, twelve patients followed with CT six to seven years after surgery showed no recurrence of the separation, even with an average weight gain over the period; in another, twenty-eight patients followed with ultrasound for about two years also showed no recurrence — in both, the suture was made with non-absorbable thread. These are favorable data, but from small series, which cannot predict an individual case, and there is no durability period that can be stated. So the wording is not a definitive result: it is a result that stays stable while weight and habits do, followed up at return visits.

Indication depends on individual clinical assessment. Generally, it is not indicated during pregnancy, for patients still in the middle of significant weight loss, or in health conditions that contraindicate elective surgery — each case is carefully assessed before indication.

Yes, and the most common indication is after major weight loss, including after bariatric surgery, when skin is left that will not retract. The incision sits in the same suprapubic position, and combining it with liposuction of the flanks is frequent, because in men the excess tends to gather at the waist. There is an important limit on expectations: in the male pattern much of the abdominal volume is visceral fat, inside the cavity, and no contouring operation reaches it — it responds to weight loss, not to a scalpel. It is worth noting that male sex was an independent risk factor for major complications in the largest published database on abdominoplasty, with a relative risk of 1.8, which calls for even more careful pre-operative screening. That is why the physical exam separates what is excess skin, what is subcutaneous fat and what is internal volume before any indication is made.

Surgical fees are always private — Dr. Lorena does not operate through health insurance. What is possible, when a genuine, documented medical indication exists — such as repair of an abdominal wall hernia, or the excess skin remaining after major weight loss —, is to guide the patient and attempt to have the health plan cover part of the hospital admission, which may include the operating room, the hospital stay and materials, according to the terms of her policy. Authorisation is the insurer's decision and cannot be guaranteed; the team advises on the documentation required and on how to proceed.

Yes, where there is a reconstructive or functional indication — for example repair of an abdominal wall hernia, or the excess skin remaining after major weight loss, including after bariatric surgery. Surgery for purely aesthetic purposes is not covered by the SUS. Dr. Lorena is a plastic surgeon appointed by public examination to the Hospital de Clínicas of the Federal University of Uberlândia (HC-UFU) and preceptor of its plastic surgery residency, and she operates on SUS patients there. The route, however, does not run through this site or the private practice: the patient must register at the primary care unit (Unidade Básica de Saúde) nearest to where she lives, be assessed by a doctor there and, if there is an indication, be placed in her municipality's regulation queue. The surgeon cannot choose who is operated on through the SUS — the order follows the queue and the rules of the system strictly.

We do not publish isolated before-and-after pairs. Resolution 2,336/2023 of the Brazilian Federal Council of Medicine allows results to be demonstrated, but only within a set that also includes unsatisfactory outcomes and the complications described in the literature, across different body types, age ranges and stages of healing, and with no editing of the images (art. 14, II). An isolated pair of photos does not meet those requirements and also implies a guaranteed result, which the same resolution prohibits (art. 11, XII). At the consultation the expected outcome is discussed from your own anatomy — what is reasonable to expect, what is not possible, and what the risks are.