Abdominal reconstruction

Sometimes reality can be stranger than fiction. Or how does it sound if you could fix back problems by patching up your stomach? Post-pregnancy urinary leakage may also stop after the procedure.

During pregnancy, the abdominal muscles stretch. The connective tissue membrane between the rectus abdominis muscles also stretches. After childbirth, the tissues contract, but in most cases, the membrane between the abdominal muscles remains stretched. The stretch can be several centimeters, and for some, the condition may also be accompanied by a small umbilical hernia. Some women develop chronic back pain, which may be accompanied by urinary incontinence.

The cause of the symptoms is the separation of the rectus abdominis muscles, which can be corrected with surgery. Of course, the abdominal muscles can also be trained, but training does not tighten the stretched connective tissue membrane. In surgery, the "connective tissue gap" is sutured closed and thus the back problems will be left on the operating table. Urinary incontinence also reduces. It is common for the skin and fat layer, i.e., the abdominal wall, to also be stretched or covered with millions of stretch marks, causing their own problems. The stretched fat layer is lumpy and completely lacking in elasticity. The skin festers, breaks and becomes inflamed. The condition also causes social disability, not to mention psychological stress and dissatisfaction with one's own body image. Girls' trips to the sauna are just a dream, and often the body is hidden even from one's own partner.

The solution to the problem is surgery to repair the abdominal wall. The surgery can be performed under general anaesthesia or spinal anaesthesia. The advantage of spinal anaesthesia is that the anaesthesia catheter can be left in place until the following day, allowing post-operative pain to be effectively managed with anaesthesia administered through the catheter. Of course, pain management through a spinal catheter can also be combined with general anaesthesia. After the first night, conventional anti-inflammatory drugs are usually sufficient for pain management.

The surgery can be sped up and bleeding significantly reduced by injecting a liter of saline solution mixed with a local vasoconstrictor or anaesthetic into the tissues before the surgery. The water jet technique also allows for the removal of "love handles" from the sides, resulting in a more attractive body shape.

The most common surgical complication – fluid accumulation in the surgical area – can be prevented by suturing the superficial tissues of the abdomen (i.e., the abdominal wall) to the underlying muscle membrane. We have been using this technique since 2004 without a single case of fluid accumulation. Support sutures also reduce tension in the surgical wound, resulting in very few wound problems.

The amount of tissue to be removed is usually 700-2000 g. At the same time, the rectus abdominis muscles are repaired by first suturing them transversely and then longitudinally, resulting in a secure suture and eliminating the old bulging appearance of the abdomen.

After the surgery, a support garment tailored to your measurements must be worn for 2-3 months. The support prevents swelling and pain, prevents the formation of fluid pockets by pressing the tissues together, and smooths the surface. Usually, within a couple of weeks after surgery, you will be able to walk with your back straight, and after a month, you can start abdominal muscle exercises. The stitches dissolve on their own and do not need to be removed.

According to our own research, abdominal wall repair significantly improves quality of life. When performed using the jet technique, the surgery is quick (1–1.5 hours) and safe, and as painless as possible after spinal anaesthesia.

Abdominal repair is plastic surgery at its best.