Abdiminoplasty (Tummy tuck)
The operation is carried out under general anaesthesia and takes from two to four hours. Theincision is placed along the so-called bikini line, and the scar will be easily hidden by an ordinarybikini. An auxiliary incision is made around the navel. The skin and underlying tissue areloosened as far as the edge of the rib cage, abdominal muscles are tightened if necessary, excessskin and fatty tissues are removed, and the navel is moved into its new position. In some casesthis procedure is complemented by liposuction. If the operation requires it, the surgeon will inserta drain (two plastic tubes) that will be removed a few days after the operation.
With normal healing, the scars will become less visible over time.
Complications that can arise are hæmorrhaging, infection, and œdema. Wide, thick scars can alsoform. Because the skin of the whole abdominal area is loosened and repositioned during thisoperation, there can also be some loss of skin due to ‘necrosis’. This occurs especially in thelower part of the abdomen. Smokers are at the greatest risk for this complication. Temporary orlasting loss of sensitivity can also occur in some patients. After the operation compression underpants or panties must be worn for six weeks. This willtemporarily limit activities, but patients can count on returning to work and living a normal lifewithin a month at most.
Occasionally a post-operation intervention is necessary in order to correct an uneven scar orremove the broken down skin that can form at the extremities of the scar.
Any fungus infection or skin damage will disappear and not recur.
The operation leads to firmer abdominal skin and a better general shape and silhouette, and it iseasier to find clothes that fit well. About the operation
During your first consultation you will meet the surgeon who will perform the operation. He willpropose a treatment plan based on your questions and expectations. You will receive informationabout the operation, possible supplementary treatment, post-operative check-ups, and follow-up.
These will be adapted to your particular assumptions and personal situation. Your doctor willexplain the expected results, and the risks and possible complications the procedure may entail.
During the two weeks preceding the operation you must not take any medication that thins theblood. First and foremost, you must avoid medicines that contain acetylsalicylic acid (aspirin),anti-inflammatory drugs, vitamin E, garlic and garlic tablets. The same applies to homeopathicpreparations and those used in ‘alternative’ medicine. If you are uncertain, you should ask yourdoctor about the specific medicine you are taking. Use of the anticoagulant warfarin (coumadin) deserves special attention and you must discuss itspecifically with your doctor. You must avoid all forms of tobacco use at least one week before and one week after theoperation.
During the six hours preceding the operation you cannot eat, drink or smoke; nor should you chewfruit drops (hard candy) or chewing gum. (Sometimes an exception can be made for water andclear beverages up to two hours before the operation.) On the morning of the operation, and preferably on the preceding evening too, you must showerand wash your hair with a disinfectant soap that you can buy at the chemist’s or pharmacy.
You will meet the surgeon again on the day of the operation. Pictures will be taken, the area of theoperation will be defined with a marker, and you will have a chance to ask about anything you areuncertain of before the operation.
The first post-operative check-up usually takes place in the course of the week following theoperation. You will then arrange for an additional check-up sometime between one and sixmonths later, depending on the type of surgery and treatment plan.
The last routine check-up takes place about a year after the operation.


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Journal of Thrombosis and Haemostasis, 1: 1398–1402Cardiovascular pharmacogenetics in the SNP eraV . M O O S E R , D . M . W A T E R W O R T H , T . I S E N H O U R and L . M I D D L E T O NGenetics Research, GlaxoSmithKline, King of Prussia, Pennsylvania, USATo cite this article: Mooser V, Waterworth DM, Isenhour T, Middleton L. Cardiovascular pharmacogenetics in the SNP era. J Thromb Haemos

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