Body shape is a symbol of charm. As people’s understanding of beauty is also deepening, they are not only pursuing the beauty of their faces, but are beginning to focus on the coordination of their body proportions. The purpose of abdominoplasty is to resolve abdominal deformities caused by excess skin and subcutaneous tissue and loose abdominal wall muscles, to restore tension in the abdominal muscles and tendons, and to reshape the aesthetics of the body. Pregnancy is the most common cause of abdominal deformities, especially in multiple pregnancies. Pregnancy stretches the skin beyond its biomechanical range and prevents it from retracting, and the musculotendinous structures of the abdominal wall also stretch. The result is lengthening and thinning of these structures and laxity of the rectus abdominis muscle. Abdominoplasty brings beauty to the curves of the body, improves the quality of work and life, and increases self-confidence. Generally speaking, different abdominal wall deformities have their own treatment principles, such as limited fat accumulation in the abdominal wall that is not accompanied by abdominal wall tissue laxity can be controlled by diet, bodybuilding exercises or local liposuction for weight loss purposes. And abdominal wall plastic mainly refers to the abdominal wall more fat accumulation and accompanied by obvious abdominal wall tissue relaxation, and even the formation of a loose and sagging “apron-like” deformity abdominal wall or “pot belly” deformity abdominal wall. Such deformities lead to ugly appearance, clumsy movement, inconvenience, seriously affect the patient’s social, sports, work, resulting in some patients mental disorders, psychopathy. Only through abdominoplasty can be corrected. First, the abdominal wall laxity classification age laxity: more occur after middle age. Genetic laxity: obese body or family genetic obesity. Pregnancy and childbirth. Endocrine disorders: abnormal body fat metabolism, uneven fat distribution. Irrational diet. Second, the abdominal wall laxity type 1, mild laxity type: manifested as a small amount of subcutaneous fat accumulation, mild separation of the rectus abdominis muscle, scattered skin stripes and visible skin laxity. The treatment can be non-surgical, both diet control, physical exercise. 2, moderate laxity type: manifested by a moderate accumulation of subcutaneous fat, significant separation of the rectus abdominis muscle, relaxation of the abdominal wall fascia, a large number of skin stripes and obvious skin laxity. Treatment can choose preoperative diet control; preoperative exercise program; cosmetic abdominoplasty; abdominal fat aspiration combined with endoscopic abdominoplasty; postoperative exercise program and postoperative diet control. 3, heavy laxity type:manifested as a kind of overhanging lax abdominal wall that exceeds the proportion of other parts of the body. Usually presents “apron” shape due to excessive laxity, and its swinging overhang obstructs the physiological activities of the patient. Skin irritation is exacerbated by friction with the pubic bone and thighs, and in cases of heavy friction in the folds of the “apron”, vesicles and occasionally skin lesions may develop. Back pain is common. The patient feels very inconvenienced during various activities, whether sports, social activities, or sexual intercourse. Psychological trauma. The goal of surgery is to remove the large “apron” and the thick layer of fat. It is best to peel off a small amount and remove a large amount in order to maintain the function of the abdominal wall. Third, abdominoplasty – indications limited abdominal wall laxity and subcutaneous fat accumulation; abdominal wall stretch marks; obesity; surgical procedures and scar contracture. IV, abdominoplasty – contraindications 1, suffering from uncontrollable pulmonary, coagulopathies, cardiovascular and metabolic diseases; 2, patients with plans to get pregnant again or severe pathological obesity; 3, psycho-psychiatric abnormalities; 4, scar body; 5, the abdominal wall of the original transverse surgical scar affects the distal blood flow of the abdominal wall flap. V. Abdominoplasty – surgical method The basic surgical procedure is to remove the subcutaneous tissue including loose skin and excess fat tissue on the surface of the rectus abdominis sheath, pull together the separated rectus abdominis muscle, and tighten the loose abdominal wall tendon membrane. Before the operation, according to the specific laxity of different conditions, choose different procedures. 1. Total abdominoplasty is generally indicated for those with severe total abdominal wall laxity. It consists of 8 to 9 steps: a. Incision selection: the low horizontal resection technique, which follows the line formed by the inguinal and pubic symphysis on both sides of the lower abdomen as the surgical incision line and separates the flap upwards from it. The advantage is that the scar is the most discreet, and a large area of skin and subcutaneous fat tissue below the umbilicus can be removed. Depending on the shape of the incision line, the flap can be divided into low horizontal, low curved, low “W”, and low inverted trapezoid. b. Skin separation: The skin and superficial subcutaneous fat fascia are incised according to the selected incision to reach the superficial layer of deep fascia, and fat aspiration is performed along the incision to shape the abdomen, and the superficial layer of deep fascia is separated to reach the glabella and the rib arch on both sides. c, abdominal wall tightening sutures: first interrupted sutures to tighten the anterior sheath of the lower rectus abdominis, and then sutures to the anterior sheath of the upper rectus abdominis if necessary. Sometimes it is necessary to transfer the extra-abdominal oblique fascial flap on both sides of the lower abdomen, and the extra-abdominal oblique muscles on both sides are sutured with figure 8 sutures in order to tighten the lower abdomen again. d. Excision of excess skin and suturing of the incision: the patient is placed in the flexed abdominal position (flexion of the knee joint), so that the abdominal wall is relaxed, the separated abdominal skin flap is stretched downward, excess skin is excised, and the skin is incised in the corresponding abdomen of the umbilicus to position the umbilicus. e. Umbilical reconstruction. f, epigastric fat aspiration: further shaping of the upper abdomen is possible. g, adjacent fat aspiration: the adjacent area is supplemented with fat aspiration to obtain a better shaping effect. h, cat ear flap trimming and aspiration: i, drainage in pressure dressing 2, lower abdominal wall plasty Some patients only have lower abdominal fat accumulation, laxity and deformity, full abdominal wall plasty incision can be used, separation only up to the umbilicus; also can be carried out at the same time lower abdominal fat aspiration and lower abdominal wall shrinkage suture to achieve abdominal shaping purpose. 3, upper abdominoplasty Some special cases are suitable for upper abdominoplasty. The obesity and deformity of such patients are mainly manifested in the upper abdomen. The incision is located in the inframammary fold. The separation is only in the upper abdomen and the other operations are similar to those of total abdominoplasty. 4, skin fat superficial fasciotomy This type of operation is suitable for no obvious muscle relaxation and only skin relaxation has formed the part of the bag-like changes, mostly occur in middle-aged and elderly people, most have a family history, but also obese patients for some reason wasting or gravity caused. Six, abdominoplasty – postoperative care The first few days after surgery, the abdomen will be swollen, the wound will be some pain and discomfort, can be controlled by drugs. Depending on the extent of the surgery, it may be possible to leave the hospital a few hours after the surgery or to stay there for a few days. The sutures are usually removed from the skin 7-10 days after surgery. Once the sutures are removed, the dressings can be replaced by elastic pants. Abdominoplasty – normal recovery It takes several weeks or months to fully recover from surgery. Depending on your situation, some people can return to normal work within 2 weeks after surgery, while others need 3-4 weeks of rest to return to work. Proper exercise can promote recovery and should be started after surgery to eliminate swelling as soon as possible, reduce the chance of blood clots and increase muscle strength. However, strenuous exercise should be avoided until full recovery is achieved. The scarring of the abdomen may be evident for 1-6 months after removal of the stitches, which is a normal physiological process. It usually takes 9 months to 1 year for the abdominal scar to flatten out and fade in color. Eight, abdominoplasty – reshape the perfect curve Whether complete abdominoplasty or partial abdominoplasty, can make men and women with sagging abdominal wall muscles and excess skin achieve excellent results. The results of abdominoplasty can be maintained if exercise and a controlled diet are maintained after surgery.