Mini tummy tuck vs full tummy tuck

A mini tummy tuck is perfect for a marathon runner with rock hard abs and minimal excess skin. Maybe they just have a little roll of skin above their C-section scar. And somehow, miraculously, their pregnancy didn’t leave them with an abdominal bulge, aka rectus diastasis.

A mini tummy tuck can remove that small roll of skin with no need to tighten the abdominal wall with a rectus plication and no need for liposuction. We’re not all that lucky.

A full tummy tuck will require a longer incision to remove more skin. Liposuction will be necessary to improve the waistline and remove the love handles. The patient will need a rectus plication to tighten the abdominal wall because no amount of exercise will flatten the tummy. The bigger incision is necessary, not only to remove excess skin, but also to gain access to the abdominal wall to do all of that tightening and lipo.

If you’ve heard of an extended tummy tuck, that’s nothing more than a longer incision to get excess skin that extends out further. If the skin extends all the way around, some doctors will call that a circumferential tummy tuck. Other will call it a body lift.

Video of Mini tummy tuck vs full tummy tuck

No matter what you call it, you can check pricing for all of them here.

Click here for the original blog post written by Dr. Kaplan for BuildMyBod.

The post Mini tummy tuck vs full tummy tuck…and the rest! [video] first appeared on Plastic Surgeon San Francisco | Pacific Heights Plastic Surgery.

Why BMI isn’t enough

Sure BMI is better than looking at weight alone. Because even if a person weighs a lot, they may be very tall. And in that case, they would not be considered overweight.

However, BMI doesn’t take all nuances of body shape into account. For example, in the video below, the patient had a BMI of greater than 30. She would be considered obese. But there were several reasons she was a great candidate for a tummy tuck. First, she was healthy. No high blood pressure or diabetes. Second, her weight was concentrated in her thighs, not her abdomen.

So while her BMI was high, it didn’t accurately reflect the operation she wanted – skin removal from her abdomen. If most of her weight was in her abdomen, then it would be more appropriate for her to lose weight first since skin removal would not address the excess fat around her intestines (visceral fat). In her case, she her torso and abdomen were amenable to a tummy tuck and she had a great result.

If a patient is considered obese, they can still be offered a procedure. As long as no more than 5 liters of fat is removed in an operation, the patient can go home. With that limitation, they may have to come back in stages for surgery. But when patients undergo a cosmetic procedure that’s not medically necessary, there’s no reason to take unnecessary risks.

Video on Body Mass Index

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Click here for the original blog post written by Dr. Kaplan for BuildMyBod.

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Achieving the best cosmetic surgery results

The most common impediment to patients achieving their best surgical result is when they depend solely on the operation to fix everything. But as in the case study below, this patient ultimately achieves her best result by accomplishing something surgery can’t. Why can’t surgery fix everything?! Keep reading to understand why.

In this scenario, the patient had a tummy tuck. We made her abdominal wall tighter along with removal of fat and excess skin. These are typical elements of a tummy tuck procedure. But when it comes to fat removal, there are two types of fat. There is the subcutaneous fat – the fat under the skin that we remove with liposuction. And there’s the fat inside the abdomen, around the intestines referred to as visceral fat. Visceral fat can only be removed with weight loss and it’s particularly hard fat to lose.

At the time, the patient was fine with a tummy tuck that couldn’t address the visceral fat. If she did lose visceral fat in the future, her skin could tighten up on its own after a tummy tuck. What we weren’t expecting was the development of abdominal wall laxity after losing visceral fat with a keto diet. Again, the abdominal wall was tightened in the original operation. But once she lost more visceral fat, her abdominal wall had room for more tightening.

So the patient came back for more abdominal wall tightening and now has the result she was looking for. All thanks to surgery and an effective keto diet. You can see the journey in her own words in the video below.

Video: How to achieve the best cosmetic surgery results…lifestyle changes along with surgery

 
To check pricing on these procedures from Dr. Kaplan, click here.

Click here for the original blog post written by Dr. Kaplan for BuildMyBod.

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Do you need to tighten your abdominal wall during a tummy tuck?

During pregnancy, the abdomen stretches. Luckily, the skin recoils and tightens after delivery. The question is will it recoil and tighten enough. Additionally, will the deeper abdominal wall tighten or will you be left with a “pooch” or diastasis.

If the abdominal wall stretches out, exercise won’t necessarily fix it. You can work out your six-pack muscles but the “pooch” or diastasis isn’t a muscle problem. The tough tissue that makes up the abdominal wall, the fascia, encases the muscles. So while the muscles will get stronger with exercise, the surrounding fascia won’t tighten with exercise.

That’s where a tummy tuck comes in. Aside from removing excess skin and performing liposuction, a tummy tuck is also a great opportunity to tighten the abdominal wall via a rectus plication. This is done by inserting stitches into the fascia and tightening the abdominal wall like a corset as described here.

It’s not always clear looking at the patient’s abdominal wall during the operation whether they need tightening or not. The easiest way to tell is to determine if the 6-pack muscles are in the middle of the abdomen. If they are, that means the muscles are in the right place because the abdominal wall isn’t stretched out. If the 6-pack muscles are widely separated, then the muscles need to be brought back into the middle with tigtening described above.

So how do you tell if the muscles are in the middle? Stimulate them with electricity and see if they jump! Electrocautery, the instrument that helps stops bleeding during a procedure, can stimulate the muscles to jump so you know if they’re in the middle or spread out. Not sure what I mean? Watch the video below!

Video of rectus plication

To check pricing on a tummy tuck from Dr. Kaplan, click here.

Click here for the original blog post written by Dr. Jonathan Kaplan for BuildMyBod.

The post Need to tighten the abdominal wall during a tummy tuck? [video] first appeared on Plastic Surgeon San Francisco | Pacific Heights Plastic Surgery.

Your typical tummy tuck includes liposuction to the abdomen, removal of excess skin and often-times, abdominal wall tightening. It’s not always necessary but it’s important for the patient to be aware of this aspect of the procedure. The tummy tuck tightens the abdominal skin but the abdominal wall is a whole different animal.

When is abdominal wall tightening necessary

Here are some new words to learn! The abdominal wall is beneath the skin and is made up of fascia. The fascia is the abdominal wall covering that contains all of your organs. Sometimes after having kids, the abdominal wall fascia in the front stretches out around the six-pack muscles. These are the rectus abdominus muscles. When this area stretches during pregnancy and stays stretched, it’s called a rectus diastasis.

While the area contains muscles, the rectus muscles themselves don’t stretch or become weak. However, the left rectus muscle is moves further towards the left and the right rectus muscle is pushed more towards the right. The area in between the muscles is the rectus diastasis. Since the fascia stretches and not the muscles, doing crunches won’t “un-stretch” the fascia. Only a tummy tuck will fix this.

During the tummy tuck procedure, stitches tighten up the fascia to help flatten the tummy. So if you haven’t had kids or your abdominal wall recovered and you don’t have a rectus diastasis after pregnancy, you won’t need the abdominal wall tightening. It’s great if you don’t need it since this can be the most painful portion of the operation. Unfortunately, there’s no way to make your abdominal wall tighten after pregnancy with specific exercises. It either happens or it doesn’t. Cross your fingers you don’t need it!

To check pricing on a tummy tuck from Dr. Kaplan, click here.

Click here for the original blog post written by Dr. Jonathan Kaplan for BuildMyBod.

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What’s the purpose of postop garments

It’s not clear why postop garments became such an integral part of cosmetic procedures. There’s not a peer-reviewed, multi-center, high quality study showing the effectiveness of using postop garments. Nothing similar to a drug trial with and without postop garments.

However, many surgeons use them. Here are some possible reasons.

After a breast augmentation, with fresh incisions under the breast, your surgeon may worry you’ll wear a bra with underwire. This could cause irritation to the incision, possibly risking it to open. To avoid this problem, your surgeon may recommend a special postop bra because they are usually soft, without much structure. And certainly don’t have underwire. Therefore, your surgeon knows exactly what you’re wearing after surgery and can rest easy it’s not a bra that will place undue stress on “their work.”

In the case of a tummy tuck or liposuction, the patient is often sore and the potential for fluid to collect under the skin is high. With swelling, the skin stretches, causing pain fibers to fire, putting the patient in more pain. To alleviate some of this pain, the garment can reduce the amount of swelling, theoretically reducing skin stretch and therefore pain.

While there’s no proof of these benefits in a large study, many patients like the garment and the “sense of security” it provides after surgery. It’s also interesting to see how many patients are reluctant to embrace the idea of a postop garment before the operation but come to appreciate its benefits after surgery.

Click on the links to check pricing on the procedures that often require a postop garment. Breast augmentation, tummy tuck, liposuction.

Click here for the original blog post written by Dr. Jonathan Kaplan for BuildMyBod.

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During a tummy tuck, your plastic surgeon will raise the abdominal skin off of the abdominal wall. This is done to “get some slack” on the excess skin in the process of removing it. Separating the excess skin from the underlying abdominal wall creates a space that can fill with fluid after the operation. That’s why many doctors insert drains after the operation to remove the excess fluid. Using the “no drain tummy tuck” technique, fluid never accumulates in the first place, so no drain necessary!

Benefits of a no drain tummy tuck

As you’ll see in the video below, the undersurface of your remaining abdominal skin is tacked back down to the abdominal wall with stitches at the end of the operation. By closing this space, the typical fluid no longer accumulates under the skin. And that’s the biggest benefit – the patient no longer needs a drain afterwards. Drains can be painful or simply a nuisance to take care of. Typically, the doctor will remove the drains 7-14 days after the operation. With the no drain tummy tuck, you can bypass that whole experience associated with drain care and drain removal.

The other benefit of the no drain tummy tuck is less scarring. This takes a little explanation. As the undersurface of the skin is stitched back down to the abdominal wall, it advances the skin down the abdominal wall. As you move the abdominal skin down, it reduces the tension on the lower abdominal scar. With less tension on the incision, the scar is less likely to widen. Therefore, a better scar.

Watch a no drain tummy tuck here!

To check pricing on a tummy tuck from Dr. Kaplan, click here.

Click here for the original blog post written by Dr. Jonathan Kaplan for BuildMyBod.

The post No drain tummy tuck [video] first appeared on Plastic Surgeon San Francisco | Pacific Heights Plastic Surgery.