The patients' skin type and age plays an important part in this surgery. In many patients it is not possible to remove all striae and folds and this will be explained to the patients before surgery.
Female patients must plan abdominoplasty after completing their family. It is not necessary to achieve a specific weight for this procedure but need to fulfill a few conditions.
Body weight should have stabilized several months before the procedure and this should be at a level, the patient can maintain after the procedure. The procedure is successful in the long term and satisfactory to the patient.
Obese patients must be given thrombosis prophylaxis and infection prophylaxis intra operatively and to continue if needed.
Weight is the first important factor that affects presentation of patients. BMI which relates weight to height is the most commonly used parameter.
BMI = weight in kg/height in m². Upper limit of normal BMI is 25. 26-30 is considered overweight, 30 and above is obese.
A variety of surgical procedures is required to treat patients in different BMI ranges.
Second factor that affect the presentation is fat deposition pattern which is genetically controlled. Women typically deposit fat in infraumbilical abdomen, thighs and hip. Men in flanks, below umbilicus and inside abdomen.
Quality of skin fat envelope is a third factor to evaluate. Women who have had one or more pregnancies tend to have abdominal skin laxity and stretch marks. A similar process occurs with massive weight gain and subsequent weight loss in which skin is over expanded leading to a loose inelastic skin fat envelope.