The
GALE
E
NCYCLOPEDIA
o
f
Surgery
A GUIDE FOR PATIENTS AND CAREGIVERS
VOLUME
A-F
ANTHONY J. SENAGORE, M.D., EXECUTIVE ADVISOR
CLEVELAND CLINIC FOUNDATION
The
GALE
E
NCYCLOPEDIA
o
f
Surgery
A GUIDE FOR PATIENTS AND CAREGIVERS
1
Gale Encyclopedia of Surgery: A Guide for Patients and Caregivers
Anthony J. Senagore MD, Executive Adviser
Project Editor
Kristine Krapp
Editorial
Stacey L. Blachford, Deirdre Blanchfield,
Madeline Harris, Chris Jeryan, Jacqueline
Longe, Brigham Narins, Mark Springer,
Ryan Thomason
Editorial Support Services

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LIBRARY OF CONGRESS CATALOGING-IN-PUBLICATION DATA

Adenoidectomy
Admission to the hospital
Adrenalectomy
Adrenergic drugs
Adult day care
Ambulatory surgery centers
Amniocentesis
Amputation
Anaerobic bacteria culture
Analgesics
Analgesics, opioid
Anesthesia evaluation
Anesthesia, general
Anesthesia, local
Anesthesiologist’s role
Angiography
Angioplasty
Anterior temporal lobectomy
Antianxiety drugs
Antibiotics
Antibiotics, topical
Anticoagulant and antiplatelet drugs
Antihypertensive drugs
Antinausea drugs
Antiseptics
Antrectomy
Aortic aneurysm repair
Aortic valve replacement
Breast reduction
Bronchoscopy

Colpotomy
Appendectomy
Arteriovenous fistula
Arthrography
Arthroplasty
Arthroscopic surgery
Artificial sphincter insertion
Aseptic technique
Aspirin
Autologous blood donation
Axillary dissection
B
Balloon valvuloplasty
Bandages and dressings
Bankart procedure
Barbiturates
Barium enema
Bedsores
Biliary stenting
Bispectral index
Bladder augmentation
Blepharoplasty
Blood donation and registry
Blood pressure measurement
Blood salvage
Bloodless surgery
Bone grafting
Bone marrow aspiration and biopsy
Bone marrow transplantation
Bone x rays

Defibrillation
Dental implants
Dermabrasion
Dilatation and curettage
Discharge from the hospital
Disk removal
Diuretics
Do not resuscitate order (DNR)
E
Ear, nose, and throat surgery
Echocardiography
Elective surgery
Electrocardiography
Electroencephalography
Electrolyte tests
Electrophysiology study of the heart
Emergency surgery
Endolymphatic shunt
Gastrostomy
General surgery
Gingivectomy
Glossectomy
Glucose tests
Goniotomy
H
Hair transplantation
Hammer, claw, and mallet toe
surgery
Hand surgery
Health care proxy

cholangiopancreatography
Endoscopic sinus surgery
Endotracheal intubation
Endovascular stent surgery
Enhanced external counterpulsation
Enucleation, eye
Epidural therapy
Episiotomy
Erythromycins
Esophageal atresia repair
Esophageal function tests
Esophageal resection
Esophagogastroduodenoscopy
Essential surgery
Exenteration
Exercise
Extracapsular cataract extraction
Eye muscle surgery
F
Face lift
Fasciotomy
Femoral hernia repair
Fetal surgery
Fetoscopy
Fibrin sealants
Finding a surgeon
Finger reattachment
Fluoroquinolones
Forehead lift
Fracture repair

Islet cell transplantation
K
Kidney dialysis
Kidney function tests
Kidney transplantation
Knee arthroscopic surgery
Knee osteotomy
Knee replacement
Knee revision surgery
Kneecap removal
L
Laceration repair
Laminectomy
Laparoscopy
Laparoscopy for endometriosis
Laparotomy, exploratory
Laryngectomy
Laser in-situ keratomileusis (LASIK)
Laser iridotomy
Laser posterior capsulotomy
Laser skin resurfacing
Laser surgery
Laxatives
Leg lengthening/shortening
N
Necessary surgery
Needle bladder neck suspension
Nephrectomy
Nephrolithotomy, percutaneous
Nephrostomy

Pectus excavatum repair
Pediatric concerns
Pediatric surgery
Limb salvage
Lipid tests
Liposuction
Lithotripsy
Liver biopsy
Liver function tests
Liver transplantation
Living will
Lobectomy, pulmonary
Long-term care insurance
Lumpectomy
Lung biopsy
Lung transplantation
Lymphadenectomy
M
Magnetic resonance imaging
Mammography
Managed care plans
Mastoidectomy
Maze procedure for atrial
fibrillation
Mechanical circulation support
Mechanical ventilation
Meckel’s diverticulectomy
Mediastinoscopy
Medicaid
Medical charts

Photocoagulation therapy
Photorefractive keratectomy (PRK)
Physical examination
Planning a hospital stay
Plastic, reconstructive, and
cosmetic surgery
Pneumonectomy
Portal vein bypass
Positron emission tomography (PET)
Post-surgical pain
Postoperative care
Power of attorney
Preoperative care
Preparing for surgery
Presurgical testing
Private insurance plans
Prophylaxis, antibiotic
Pulse oximeter
Pyloroplasty
Q
Quadrantectomy
R
Radical neck dissection
Recovery at home
Recovery room
Rectal prolapse repair
Rectal resection
Red blood cell indices
Reoperation
Retinal cryopexy

Tube enterostomy
Tube-shunt surgery
Tumor marker tests
Tumor removal
Tympanoplasty
Type and screen
U
Umbilical hernia repair
Upper GI exam
Ureteral stenting
Ureterosigmoidoscopy
Ureterostomy, cutaneous
Rhinoplasty
Rhizotomy
Robot-assisted surgery
Root canal treatment
Rotator cuff repair
S
Sacral nerve stimulation
Salpingo-oophorectomy
Salpingostomy
Scar revision surgery
Scleral buckling
Sclerostomy
Sclerotherapy for esophageal
varices
Sclerotherapy for varicose veins
Scopolamine patch
Second opinion
Second-look surgery

Urinary anti-infectives
Urologic surgery
Uterine stimulants
V
Vagal nerve stimulation
W
Webbed finger or toe repair
Weight management
White blood cell count and
differential
Wound care
Wound culture
Wrist replacement
Vagotomy
Vascular surgery
Vasectomy
Vasovasostomy
Vein ligation and stripping
Venous thrombosis prevention
Ventricular assist device
Ventricular shunt
Vertical banded gastroplasty
Vital signs
GALE ENCYCLOPEDIA OF SURGERY
xi
List of Entries
The Gale Encyclopedia of Surgery is a medical ref-
erence product designed to inform and educate readers
about a wide variety of surgeries, tests, drugs, and other
medical topics. The Gale Group believes the product to

performs the surgery and where, and on questions to
ask the doctor.
This encyclopedia minimizes medical jargon and
uses language that laypersons can understand, while still
providing detailed coverage that will benefit health sci-
ence students.
Entries on surgeries follow a standardized format
that provides information at a glance. Rubrics include:
Definition
Purpose
Demographics
Description
Diagnosis/Preparation
Aftercare
Risks
Normal results
Morbidity and mortality rates
Alternatives
Resources
Inclusion criteria
A preliminary list of surgeries and related topics
was compiled from a wide variety of sources, including
professional medical guides and textbooks, as well as
consumer guides and encyclopedias. Final selection of
topics to include was made by the executive adviser in
conjunction with the Gale editor.
About the Executive Adviser
The Executive Adviser for the Gale Encyclopedia of
Surgery was Anthony J. Senagore, MD, MS, FACS,
FASCRS. He has published a number of professional ar-

INTRODUCTION
• The Resources section directs readers to additional
sources of medical information on a topic. Books, peri-
odicals, organizations, and internet sources are listed.
• A Glossary of terms used throughout the text is col-
lected in one easy-to-use section at the back of book.
• A valuable Organizations appendix compiles useful
contact information for various medical and surgical
organizations.
• A comprehensive General index guides readers to all
topics mentioned in the text.
Graphics
The Gale Encyclopedia of Surgery contains over 230
full-color illustrations, photos, and tables. This includes
over 160 step-by-step illustrations of surgeries. These il-
lustrations were specially created for this product to en-
hance a layperson’s understanding of surgical procedures.
Licensing
The Gale Encyclopedia of Surgery is available for li-
censing. The complete database is provided in a fielded
format and is deliverable on such media as disk or CD-
ROM. For more information, contact Gale’s Business
Development Group at 1-800-877-GALE, or visit our
website at www.gale.com/bizdev.
GALE ENCYCLOPEDIA OF SURGERY
xiv
Introduction
Laurie Barclay, M.D.
Neurological Consulting Services
Tampa, FL

Lorraine K. Ehresman
Medical Writer
Northfield, Quebec, Canada
L. Fleming Fallon, Jr., MD,
DrPH
Professor of Public Health
Bowling Green State University
Bowling Green, OH
Paula Ford-Martin
Freelance Medical Writer
Warwick, RI
Janie Franz
Freelance Journalist
Grand Forks, ND
Rebecca J. Frey, PhD
Freelance Medical Writer
New Haven, CT
Debra Gordon
Medical Writer
Nazareth, PA
Jill Granger, M.S.
Sr. Research Associate
Dept. of Pathology
University of Michigan Medical
Center
Ann Arbor, MI
Laith F. Gulli, M.D.
M.Sc., M.Sc.(MedSci), M.S.A.,
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FRSH, FRIPHH, FAIC, FZS

Victoria E. DeMoranville
Medical Writer
Lakeville, MA
Altha Roberts Edgren
Medical Writer
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CONTRIBUTORS
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RT(R), FAHRA
Medical Writer
Chatsworth, CA
Maureen Haggerty
Medical Writer
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Robert Harr, MS, MT (ASCP)
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Bowling Green, OH
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Medical Writer
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Contributors
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As an imaging tool, abdominal ultrasound generally
is indicated for patients afflicted with chronic or acute
abdominal pain; abdominal trauma; an obvious or sus-
pected abdominal mass; symptoms of liver or biliary
tract disease, pancreatic disease, gallstones, spleen dis-
ease, kidney disease, and urinary blockage; evaluation of
ascites; or symptoms of an abdominal aortic aneurysm.
Specifically:
• Abdominal pain. Whether acute or chronic, pain can
signal a serious problem—from organ malfunction or
injury to the presence of malignant growths. Ultra-
sound scanning can help doctors quickly sort through
potential causes when presented with general or am-
biguous symptoms. All of the major abdominal organs
can be studied for signs of disease that appear as
changes in size, shape, or internal structure.
• Abdominal trauma. After a serious accident such as a
car crash or a fall, internal bleeding from injured ab-
dominal organs is often the most serious threat to sur-
vival. Neither the injuries nor the bleeding may be im-
mediately apparent. Ultrasound is very useful as an ini-
tial scan when abdominal trauma is suspected, and it
can be used to pinpoint the location, cause, and severity
of hemorrhaging. In the case of puncture wounds, from
a bullet for example, ultrasound can locate the foreign
object and provide a preliminary survey of the damage.
(CT scans are sometimes used in trauma settings.)
• Abdominal mass. Abnormal growths—tumors, cysts, ab-
scesses, scar tissue, and accessory organs—can be located
and tentatively identified with ultrasound. In particular,

Abdominal ultrasound
An ultrasound screen shows a patient’s kidney. (Photograph by Brownie Harris. The Stock Market. Reproduced by permission.)
Description
Ultrasound includes all sound waves above the fre-
quency of human hearing—about 20 thousand hertz, or
cycles per second. Medical ultrasound generally uses
frequencies between one and 10 megahertz (1–10 MHz).
Higher frequency ultrasound waves produce more de-
tailed images, but they are also more readily absorbed
and so cannot penetrate as deeply into the body. Abdom-
inal ultrasound imaging is generally performed at fre-
quencies between 2–5 MHz.
An ultrasound scanner consists of two parts: the
transducer and the data processing unit. The transducer
both produces the sound waves that penetrate the body
and receives the reflected echoes. Transducers are built
around piezoelectric ceramic chips. (Piezoelectric refers
to electricity that is produced when you put pressure on
certain crystals such as quartz.) These ceramic chips
react to electric pulses by producing sound waves (trans-
mitting) and react to sound waves by producing electric
pulses (receiving). Bursts of high-frequency electric
pulses supplied to the transducer cause it to produce the
scanning sound waves. The transducer then receives the
returning echoes, translates them back into electric puls-
es, and sends them to the data processing unit—a com-
• Spleen disease. The spleen is particularly prone to injury
during abdominal trauma. It may also become painfully
inflamed when infected or cancerous. The spleen can be-
come enlarged with some forms of liver disease.

point of varying brightness. In this way, the echoes are
translated into an image.
Four different modes of ultrasound are used in med-
ical imaging:
• A-mode. This is the simplest type of ultrasound in
which a single transducer scans a line through the body
with the echoes plotted on screen as a function of
depth. This method is used to measure distances within
the body and the size of internal organs.
• B-mode. In B-mode ultrasound, which is the most
common use, a linear array of transducers simultane-
ously scans a plane through the body that can be
viewed as a two-dimensional image on screen.
• M-Mode. The M stands for motion. A rapid sequence of
B-mode scans whose images follow each other in se-
quence on screen enables doctors to see and measure
range of motion, as the organ boundaries that produce re-
flections move relative to the probe. M-mode ultrasound
has been put to particular use in studying heart motion.
• Doppler mode. Doppler ultrasonography includes the
capability of accurately measuring velocities of moving
material, such as blood in arteries and veins. The prin-
ciple is the same as that used in radar guns that mea-
sure the speed of a car on the highway. Doppler capa-
bility is most often combined with B-mode scanning to
produce images of blood vessels from which blood
flow can be directly measured. This technique is used
extensively to investigate valve defects, arteriosclero-
sis, and hypertension, particularly in the heart, but also
in the abdominal aorta and the portal vein of the liver.

advised by his or her physician about what to expect and
how to prepare. As mentioned above, preparations gener-
ally include fasting.
Aftercare
In general, no aftercare related to the abdominal ul-
trasound procedure itself is required. Discomfort during
the procedure is minimal.
Risks
Properly performed, ultrasound imaging is virtually
without risk or side effects.
Results
As a diagnostic imaging technique, a normal abdomi-
nal ultrasound is one that indicates the absence of the sus-
pected condition that prompted the scan. For example,
symptoms such as abdominal pain radiating to the back
suggest the possibility of, among other things, an abdomi-
nal aortic aneurysm. An ultrasound scan that indicates the
absence of an aneurysm would rule out this life-threaten-
ing condition and point to other, less serious causes.
Because abdominal ultrasound imaging is generally
undertaken to confirm a suspected condition, the results
of a scan often will confirm the diagnosis, be it kidney
stones, cirrhosis of the liver, or an aortic aneurysm. At
that point, appropriate medical treatment as prescribed
by a patient’s physician is in order.
Ultrasound scanning should be performed by a reg-
istered and trained ultrasonographer, either a technolo-
GALE ENCYCLOPEDIA OF SURGERY
3
Abdominal ultrasound

formed by the accumulation of excess mineral salts
and other organic material such as blood or mu-
cous. They can cause problems by lodging in and
obstructing the proper flow of fluids, such as bile
to the intestines or urine to the bladder.
Cirrhosis—A chronic liver disease characterized
by the degeneration of proper functioning—jaun-
dice is often an accompanying symptom. Causes
of cirrhosis include hepatitis, alcoholism, and
metabolic diseases.
Common bile duct—The branching passage
through which bile—a necessary digestive en-
zyme—travels from the liver and gallbladder into
the small intestine. Digestive enzymes from the
pancreas also enter the intestines through the com-
mon bile duct.
Computed tomography scan (CT scan)—A special-
ized type of x-ray imaging that uses highly focused
and relatively low-energy radiation to produce de-
tailed two-dimensional images of soft-tissue struc-
tures, such as the brain or abdomen. CT scans are
the chief competitor to ultrasound and can yield
higher quality images not disrupted by bone or
gas. They are, however, more cumbersome, time
consuming, and expensive to perform, and they
use ionizing radiation.
Doppler—The Doppler effect refers to the appar-
ent change in frequency of sound-wave echoes re-
turning to a stationary source from a moving target.
If the object is moving toward the source, the fre-

cine, morphology refers to the size, shape, and
structure rather than the function of a given organ.
As a diagnostic imaging technique, ultrasound fa-
cilitates the recognition of abnormal morphologies
as symptoms of underlying conditions.
KEY TERMS
Kevles, Bettyann Holtzmann. Naked to the Bone: Medical
Imaging in the Twentieth Century. New Brunswick, New
Jersey: Rutgers University Press, 1997.
Zaret, Barry L., ed. The Patient’s Guide to Medical Tests.
Boston: Houghton Mifflin Company, 1997.
PERIODICALS
Kuhn, M., R. L. L. Bonnin, M. J. Davey, J. L. Rowland, and S.
Langlois. “Emergency Department Ultrasound Scanning
for Abdominal Aortic Aneurysm: Accessible, Accurate,
Advantageous.” Annals of Emergency Medicine 36, No. 3
(September 2000): 219-23.
Sisk, Jennifer. “Ultrasound in the Emergency Department: To-
ward a Standard of Care.” Radiology Today 2, No. 1 (June
4, 2001): 8-10.
ORGANIZATIONS
American College of Radiology. 1891 Preston White Drive,
Reston, VA 20191-4397. (800) 227-5463. <http://www.
acr.org>.
American Institute of Ultrasound in Medicine. 14750 Sweitzer
Lane, Suite 100, Laurel, MD 20707-5906. (301) 498-
4100. <http://www.aium.org>.
American Registry of Diagnostic Medical Sonographers. 600
Jefferson Plaza, Suite 360, Rockville, MD 20852-1150.
(800) 541-9754. <http://www.ardms.org>.

troschisis repair is performed to repair the other abdomi-
nal wall defect through which the bowel thrusts out with
no protective sac present. Gastroschisis is a life-threaten-
ing condition that requires immediate medical interven-
tion. Surgery for abdominal wall defects aims to return
the abdominal organs back to the abdominal cavity, and
to repair the defect if possible. It can also be performed
to create a pouch to protect the intestines until they are
inserted back into the abdomen.
Demographics
Abdominal wall defects occurs in the United States
at a rate of one case per 2,000 births, which means that
GALE ENCYCLOPEDIA OF SURGERY
5
Abdominal wall defect repair
WHO PERFORMS
THE PROCEDURE AND
WHERE IS IT PERFORMED?
Abdominal wall defect surgery is performed by a
pediatric surgeon. A pediatric surgeon is special-
ized in the surgical care of children. He or she
must have graduated from medical school, and
completed five years of postgraduate general
surgery training in an accredited training pro-
gram. A pediatric surgeon must complete an ad-
ditional accredited two-year fellowship program
in pediatric surgery and be board-eligible or
board-certified in general surgery. (Board certifi-
cation is granted when a fully trained surgeon has
taken and passed first a written, then an oral ex-

closed. Sometimes closure of the opening is not possi-
ble, for example when the abdominal cavity is too
small or when the organs are too large or swollen to
close the skin. In such cases, the surgeon will place a
plastic covering pouch, commonly called a silo because
of its shape, over the abdominal organs on the outside
of the infant to protect the organs. Gradually, the or-
gans are squeezed through the pouch into the opening
and returned to the body. This procedure can take up to
a week, and final closure may be performed a few
weeks later. More surgery may be required to repair the
abdominal muscles at a later time.
Diagnosis/Preparation
Prenatal screening can detect approximately 85% of
abdominal wall defects. Gastroschisis and omphalocele
are usually diagnosed by ultrasound examinations before
birth. These tests can determine the size of the abdomi-
nal wall defect and identify the affected organs. The
surgery is performed immediately after delivery, as soon
as the newborn is stable.
Aftercare
After surgery, the infant is transferred to an intensive
care unit (ICU) and placed in an incubator to keep warm
and prevent infection. Oxygen is provided. When organs
are placed back into the abdominal cavity, this may in-
crease pressure on the abdomen and make breathing diffi-
cult. In such cases, the infant is provided with a breathing
tube and ventilator until the swelling of the abdominal or-
gans has decreased. Intravenous fluids, antibiotics, and
pain medication are also administered. A tube is also

Resources
BOOKS
Iannucci, Lisa. Birth Defects. Berkeley Heights: Enslow Pub-
lishers Inc., 2000.
GALE ENCYCLOPEDIA OF SURGERY
6
Abdominal wall defect repair
QUESTIONS TO ASK
THE DOCTOR
• What will happen when my baby is born?
• Does my baby have any other birth defects?
• What are my baby’s chances of full recovery?
• Will my baby have a “belly button”?
• How many abdominal wall defect surgeries
do you perform each year?
• How many infants have you operated during
your practice?
OTHER
“Abdominal Defects.” Medical and Scientific Information On-
line, Inc. [cited April 8, 2003]. <http://www.cpdx.com/
cpdx/abdwall.htm>.
National Birth Defects Prevention Network. January 27, 2003
[cited April 8, 2003]. <http://www.nbdpn.org>.
Monique Laberge, Ph.D.
Abdominoplasty
Definition
Also known as a tummy tuck, abdominoplasty is a
surgical procedure in which excess skin and fat in the ab-
dominal area is removed and the abdominal muscles are
tightened.

dominal skin and fat from morbidly obese patients dur-
PERIODICALS
Kurchubasche, Arlet G. “The fetus with an abdominal wall de-
fect.” Medicine & Health/Rhode Island 84 (2001): 159–161.
Lenke, R. “Benefits of term delivery in infants with antenatally
diagnosed gastroschisis.” Obstetrics and Gynecology 101
(February 2003): 418–419.
Sydorak, R. M., A. Nijagal, L. Sbragia, et al. “Gastroschisis:
small hole, big cost.” Journal of Pediatric Surgery 37 (De-
cember 2002): 1669–1672.
White, J. J. “Morbidity in infants with antenatally-diagnosed
anterior abdominal wall defects.” Pediatric Surgery Inter-
national 17 (September 2001): 587–591.
ORGANIZATIONS
American Academy of Pediatrics. 141 Northwest Point Boule-
vard, Elk Grove Village, IL 60007-1098. (847) 434-4000.
<http://www.aap.org>.
GALE ENCYCLOPEDIA OF SURGERY
7
Abdominoplasty
KEY TERMS
Abdomen—The portion of the body that lies be-
tween the thorax and the pelvis. It contains a cavi-
ty with many organs.
Amniotic membrane—A thin membrane that con-
tains the fetus and the protective amniotic fluid
surrounding the fetus.
Anesthesia—A combination of drugs administered
by a variety of techniques by trained professionals
that provide sedation, amnesia, analgesia, and im-

tients under 35 accounting for 20% and patients over 50
accounting for 22%. Eighty-two percent of all plastic
surgery patients during 2001 were white, 7% were His-
panic, 5% were African American, and 5% were Asian
American.
Description
The patient is usually placed under general anesthesia
for the duration of surgery. The advantages to general
anesthesia are that the patient remains unconscious during
the procedure, which may take from two to five hours to
complete; no pain will be experienced nor will the patient
have any memory of the procedure; and the patient’s mus-
cles remain completely relaxed, lending to safer surgery.
Once an adequate level of anesthesia has been
reached, an incision is made across the lower abdomen.
For a complete abdominoplasty, the incision will stretch
from hipbone to hipbone. The skin will be lifted off the
abdominal muscles from the incision up to the ribs, with
a separate incision being made to free the umbilicus
ing gynecologic surgery results in better exposure to the
operating field and improved wound healing.
Contraindications
Certain patients should not undergo abdominoplas-
ty. Poor candidates for the surgery include:
• Women who wish to have subsequent pregnancies.
• Individuals who wish to lose a large amount of weight
following surgery.
• Patients with unrealistic expectations (those who think
the surgery will give them a “perfect” figure).
• Those who are unable to deal with the post-surgical

a technique that removes fat that cannot be removed by
diet or exercise. During the procedure, which is generally
performed in an outpatient surgical facility, the patient is
anesthetized and a hollow tube called a cannula is insert-
ed under the skin into a fat deposit. By physical manipu-
lation, the fat deposit is loosened and sucked out of the
body. Liposuction may be used during abdominoplasty to
remove fat deposits from the torso, hips, or other areas.
This may create a more desired body contour.
Some patients may choose to undergo breast aug-
mentation, reduction, or lift during abdominoplasty.
Breast augmentation involves the insertion of a silicone-
or saline-filled implant into the breast, most often behind
the breast tissue or chest muscle wall. A breast reduc-
tion may be performed on patients who have large
breasts that cause an array of symptoms such as back
and neck pain. Breast reduction removes excess breast
skin and fat and moves the nipple and area around the
nipple (called the areola) to a higher position. A breast
lift, also called a mastopexy, is performed on women
who have low, sagging breasts, often due to pregnancy,
nursing, or aging. The surgical procedure is similar to a
breast reduction, but only excess skin is removed; breast
implants may also be inserted.
Breast reconstruction
A modified version of abdominoplasty may be used
to reconstruct a breast in a patient who has undergone
mastectomy (surgical removal of the breast, usually as a
treatment for cancer). Transverse rectus abdominis my-
ocutaneous (TRAM) flap reconstruction may be per-

9
Abdominoplasty
WHO PERFORMS
THE PROCEDURE AND
WHERE IS IT PERFORMED?
Abdominoplasty is usually performed by a plas-
tic surgeon, a medical doctor who has complet-
ed specialized training in the repair or recon-
struction of physical defects or the cosmetic en-
hancement of the human body. In order for a
plastic surgeon to be considered board certified
by the American Board of Plastic Surgery, he or
she must meet a set of strict criteria (including a
minimum of five years of training in general
surgery and plastic surgery) and pass a series of
examinations. The procedure may be performed
in a hospital operating room or a specialized
outpatient surgical facility.
ty is $6,500, but may range from $5,000–9,000, depend-
ing on the surgeon and the complexity of the procedure.
Diagnosis/Preparation
There are a number of steps that the patient and
plastic surgeon must take before an abdominoplasty may
be performed. The surgeon will generally schedule an
initial consultation, during which a physical examina-
tion will be performed. The surgeon will assess a num-
ber of factors that may impact the success of the surgery.
These include:
• the patient’s general health
• the size and shape of the abdomen and torso

tension on the surgical site.
• Walking as soon as possible after the procedure is rec-
ommended to improve recovery time and prevent blood
clots in the legs.
• Mild exercise that does not cause pain to the surgical
site is recommended to improve muscle tone and de-
crease swelling.
• The patient should not shower until any drains are re-
moved from the surgical site; sponge baths are permitted.
• Work may be resumed in two to four weeks, depending
on the level of physical activity required.
Surgical drains will be removed within one week
after abdominoplasty, and stitches from one to two
weeks after surgery. Swelling, bruising, and pain in the
abdominal area are to be expected and may last from two
to six weeks. Recovery will be faster, however, in the pa-
tient who is in good health with relatively strong abdom-
inal muscles. The incisions will remain a noticeable red
or pink for several months, but will begin to fade by nine
months to a year after the procedure. Because of their lo-
cation, scars should be easily hidden under clothing, in-
cluding bathing suits.
Risks
There are a number of complications that may arise
during or after abdominoplasty. Complications are more
often seen among patients who smoke, are overweight,
are unfit, have diabetes or other health problems, or have
scarring from previous abdominal surgery. Risks inher-
ent to the use of general anesthesia include nausea, vom-
iting, sore throat, fatigue, headache, and muscle sore-