TUMMY TUCK AND BODY LIFTS

Every woman wants a flat and firm tummy, and a beautiful shaped silhouette but pregnancies and weight gains and losses take a toll on a woman's figure.  Fat can get concentrated in the belly of both men and women. The belly becomes loose and out of shape because the abdominal muscles are weakened and stretched apart and the skin becomes flaccid (loose).

Now you can get rid of the extra fat and skin, protruding belly and weak muscles and whatever else that bothers you. A tummy tuck can help you. If your buttock has dropped or if you have significant mobility and looseness of skin in your thighs, a thigh lift and buttock lift can help.  There are several popular approaches and since every person is different each procedure is tailored to your specific needs.

Procedures--

The operation is performed in our office surgical suite or at the hospital under general anesthesia. If you smoke, you must quit at least 4 - 6 weeks before and for 6 weeks after surgery. You must also stop taking certain medications, vitamins and herbal supplements than can cause bleeding.

The following are treatment options and keep in mind that tummy tucks are sometimes combined with liposuction and lifts in single or multistage planned procedures.

1) Liposuction with Skin Excision of the Abdomen
Liposuction with simple removal of lower skin is indicated for those persons with excess fat especially if a previous C-section was performed.

2) Mini-Abdominoplasty
Mini-abdominoplasty helps those women with a problem limited to their lower belly. If you are displeased with the bulge in your lower belly especially when seating and you have moderate excess of skin and fat then you are a candidate for this procedure. The incision is much smaller and is placed horizontally over the pubic hair ("Victoria's Secret" type) or sometimes it is shaped as an inverted U completely hidden within the pubis ("Venus" type). The scar is usually inconspicuous. The belly button (the umbilicus) remains untouched at its present location, but the abdominal muscles below it are tightened and the excess skin and fat are removed. Sometimes Dr. Herve` Gentile will combine it with liposuction to give you even a better figure.

3) Abdominoplasty (traditional or classical )
The classical abdominoplasty is reserved for those patients with significant skin and fat both above and below the belly button who also have very weak muscles which have widened and are apart. Frequently these patients have poor elasticity of the skin, which can easily be grabbed with the hand and unfortunately surgery will not correct this inelastic skin problem. The surgery is much more extensive then the mini-abdominoplasty as elevation of the skin is continued up to the rib cage and the entire rectus abdominal muscles are tightened from the sternum ( center bone of the rib cage ) all the way to the pubic bone. This creates a firmer abdominal wall and narrows the waistline. A new belly button is fashioned. Currently the scar is designed as a W or bicycle handle, fashionably called a French cut, and Dr. Herve` Gentile makes his scar as short as possible and tries to avoid extending it from hip to hip. Although this is not always possible, the scars are usually hidden easily by swimwear or other clothing.

4) High Lateral Tension Abdominoplasty
This procedure is designed to tighten the lateral aspects of the abdomen and outer thigh. Although the resultant scar is somewhat longer it places the highest tension laterally allowing excessive skin removal and lifting over the hip and thigh in addition to providing the results of the classical abdominoplasty. This procedure, in the ideal candidate, offers a more natural and pleasing feminine shape.

5) Medial Thigh Lift, Lower Body Lift and Transverse Thigh and Buttock Lift, and Brachioplasty
These procedures tighten and lift the skin in the upper arms, medial thigh and /or hip and buttock areas and are often combined with liposuction and tummy tucks. Candidates are patients who have either, (1) generalized skin excess and flaccidity in the upper arms and/or medial and lateral thighs after massive weight loss ( bariatric surgery ) or (2) generous amounts of fat deposits in the upper arms, trunk, thighs and buttocks. In the latter group the lift procedure is often done after first liposuctioning the bulk of the fat, in two stages. The scar in the medial thigh lift is placed in the inner thigh fold, while in the transverse thigh and buttock lift the scar continues as a high bikini line from a tummy tuck. Sometimes only the combination of liposuction and lifting with or without a tummy tuck creates the desired body figure and achieves results superior than either technique alone; but remember these procedures are not designed to correct obesity. All these procedures are associated with longer healing times and a higher risk of complications than a tummy tuck alone. In medial thigh lifts and in brachioplasty some risks can be minimized by staging one arm or thigh a few weeks to months apart from the other. The scar in the brachioplasty is placed low in the front of the arm at the junction of the biceps and triceps muscles and starts at the armpit and then continues until stopping 2-3 inches above the elbow. Additional risks of the brachioplasty procedure are a thick and visible scar. Sometimes liposuction with a mini-brachioplasty locating the scar entirely in the armpit can be performed to avoid the traditional brachioplasty procedure.

6) Bariatric Surgery or Massive Weight Loss (MWL) Surgery.
Aesthetic Surgery following a bariatric procedure or MWL is a unique field because it involves both reconstructive as well as cosmetic components. Both the bariatric surgery and subsequent cosmetic surgery for the MWL patient is challenging and is only the last stop of a long and arduous journey. Aesthetic surgery can only be contemplated after your weight has stabilized for at least the previous 3 months and a minimum of 12 months have passed following bariatric surgery, but 18 months is preferable. Generally you can divide patients in 2 categories: the first group is composed of those persons who decided to change their lifestyle and could no longer tolerate to be obese. This group is well motivated and determined, most likely will have realistic expectations from their aesthetic surgery and ultimately will continue to do well in life; the second group is composed of those persons who were pressured to undergo bariatric surgery by their doctors, coworkers or family members. This group is at a higher risk to regain their lost weight and less motivated to lead a healthy lifestyle. However, all MWL patients are to be commended because of the tremendous accomplishment they were able to achieve in transforming their body. Aesthetic Surgery is associated with a higher risk of complications and to manage them successfully it is mandatory that a good support system be in place forehand as well choosing a surgeon who is compassionate and caring to enhance their surgical experience. Multiple stages are usually required with multiple procedures performed in a single stage and a lengthy informal consultation is a must to establish a successful physician-patient relationship and formulate a realistic plan.

Postoperative period--

 You will experience swelling and a feeling of tightness, which will create some pain and discomfort which can be controlled with medications. You will also be fitted with an abdominal binder type garment to reduce swelling and hasten healing and you need to wear it faithfully day and night for several weeks especially if you also had liposuction. In the latter case the special garment covers your thighs and knees as well. It is very important that you limit your activities for the first few days to lying down and avoid sitting, walking and other activities. I have found over the years that patients have a tendency to over do their activities at home resulting in delayed healing. It is normal for you to have prolonged swelling over the pubis. This will disappear with time but at a different rate, since we are all not alike. Wearing the garment will definitively help in reducing this swelling. Depending on how you heal and the type of work you do, you may be able to return to work after a week, but it may take several weeks to feel yourself again. Strenuous exercise should be avoided for a few weeks but moderate exercise is helpful in healing. If you are in top physical condition with strong abdominal muscles your recovery will be much faster. Remember that to safeguard the result you have achieved, you are urged to avoid excessive weight gain or loss and begin an exercise program if you never exercised before. Dieting, Exercising and Body Contouring Surgery are all different approaches and no single modality is going to work all the time. Therefore we advocate a combination of liposuction /tummy-tuck/body lifts, sensible eating and a maintainable exercise program and if you need it we make referrals to specialists, dieticians and body trainers to address your bad habits.