Combining a hysterectomy and tummy tuck

As a woman gets older, she may develop a fibroid which is a benign muscular tumor of the womb, aka the uterus. This can result in a bloated abdomen, pain or irregular bleeding not necessarily associated with the menses. The treatment in many cases is a hysterectomy, or the removal of the uterus. As an aside, the ovaries can be left in place to avoid premature menopause.

So it’s not unreasonable to consider returning a woman’s abdomen to its pre-pregnancy shape with a tummy tuck at the same time as a hysterectomy. There are various ways to perform a hysterectomy these days. If performed through a lower abdominal incision, the hysterectomy can be done through the same incision as a tummy tuck. But there are instances where a hysterectomy is done without a lower abdominal incision. This includes removing the uterus through the vagina. Or laparoscopically through small incisions in the abdomen with the use of long thin instruments and a camera.

Regardless of which method is utilized, the plastic surgeon can perform the tummy tuck after the uterus is removed. Just as the surgeon “marks” the patient before an isolated tummy tuck, it’s also critical to mark the patient prior to the combination procedure.

It’s important that the OR staff, in the process of prepping the patient with betadine at the beginning of the operation, doesn’t remove the proposed tummy tuck markings. If that were to happen, the plastic surgeon would be at a loss as to where to make the incision since the skin shifts from standing preop to laying down during the procedure.

Will insurance cover a hysterectomy and tummy tuck

While your insurance typically covers a hysterectomy, you still may have out of pocket costs if you haven’t met your deductible. But no part of your insurance will cover the tummy tuck. It gets even more complicated than that.

Insurance can cover the hysterectomy costs. These include the surgeon’s fees, the operating room costs and the anesthesia fees. The tummy tuck costs include the surgeon’s fees. But that may be the least expensive part of this operation. Since the operation occurs at a hospital, the patient will also be responsible for the OR and anesthesia fees during the tummy tuck portion of the procedure.

Just because the procedures occur during the same operating room and anesthesia “event,” they’re not all covered by insurance. For example, once the hysterectomy ends and the tummy tuck begins, the clock also begins for the tummy tuck. Insurance won’t cover the time necessary to perform the tummy tuck. Those costs must be paid out of pocket by the patient. More importantly, the OR fees and anesthesia fees are way more expensive than those same fees when the procedure is performed in a doctor’s own office-based operating room.

A hospital is the most expensive place to receive care. We just don’t realize it since insurance often covers a bulk of it. Not so with cosmetic procedures performed at a hospital. And even though you can contact the hospital in an attempt to determine the cost, you will still receive an erroneous bill. Guaranteed!

Prepare yourself as best as possible and check pricing on procedures from Dr. Kaplan by clicking here.

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

The post Can you do a hysterectomy and tummy tuck at the same time? [video] first appeared on Plastic Surgeon San Francisco | Pacific Heights Plastic Surgery.

These days, if a patient can avoid surgery, they’ll try, even if it means a substandard result. But when it comes to dark circles under the eyes, avoiding surgery can actually be the right decision.

Dark circles under the eyes

Whether surgery or fillers are right for dark circles depends on what’s causing them. If the eyes are sunken in, such that the eyes are casting a shadow over the lower lids, those are best treated with fillers.

In this scenario, injecting fillers like Juvederm or Radiesse can volumize hollow eyes. This brings the lid-cheek junction out from under the shadow of the eyes. Thus eliminating those dark circles.

Compare that to circles due to a deep tear trough (the crease under puffy lower lids). While fillers can be injected on and around that deep crease to camouflage the puffiness, the patient may be very disappointed.

In this situation, removing lower lid fat from within the lower lid, can minimize the appearance of the deep creases. The benefit of this procedure is the avoidance of a skin incision or sutures.

To check pricing on dark circle treatment from Dr. Kaplan, click here.

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

The post Dark circles under the eyes: Fillers vs Surgery first appeared on Plastic Surgeon San Francisco | Pacific Heights Plastic Surgery.

1. If I get liposuction to one area, fat will come back in another area

I don’t care how many times you read it or say it, it still isn’t true. This is how it works.

By the end of your adolescence, your body forms a certain number of fat cells. They don’t multiple after that. That only expand or shrink depending on your fat intake. So after liposuction, you have a fewer number of fat cells. You can still eat fatty foods and what fat cells you have left after lipo will absorb that fat.

However, the fat that you take into your body isn’t smart enough to say, “oh, they did liposuction to the abdomen, so I’m going to go to the arms.” It doesn’t work that way. Your body is genetically predisposed to have more fat collect on the hips or the thighs or the bra chub or wherever. We’re all a little different. So whether you’ve had liposuction or not, fat will continue to deposit in those same areas. Simply having liposuction won’t change your genetic predisposition and therefore won’t change where your fat tends to deposit.

2. Once I get liposuction, I can eat whatever I want and not get fat

You can, but you shouldn’t. Don’t use liposuction as a way to lose weight. Use it as a way to motivate yourself to work harder to stay in shape. And as mentioned above, eating more after liposuction won’t increase your number of fat cells, it’ll just make your remaining fat cells swell.

3. Liposuction can treat cellulite

It can’t. Cellulite, the dimpling often seen on the outer thighs near the buttocks is not caused by fat only. There are fibers that extend from the deep tissues of the thigh up to the skin. Those fibers pull on the undersurface of the skin, and the fat in between those fibers give the skin that characteristic dimpling. So if you only get rid of fat, the fibers and the dimples will still be there. The treatment is to cut the fibers.

There are several treatments for this but the problem is that the fibers can regrow and reattach to the undersurface of the skin. So while there are new good treatments for cellulite, like Cellfina, it’s not clear how long the improvement lasts.

4. You’re left with sagging skin after liposuction

Luckily, if you have good quality skin with lots of collagen and recoil, the skin will tighten after liposuction. But it’s also up to your surgeon to exercise good judgement to know when you have so much skin that you need the skin removed (like in a tummy tuck) vs only liposuction. And contrary to popular belief, laser liposuction does not tighten the skin better than regular liposuction. However, laser lipo certainly can increase the risk of you getting 3rd degree burns of the skin from the inside!

5. Liposuction is an easy way to lose weight or cure obesity

While you certainly do lose a few pounds with aggressive liposuction, that’s not the point. Liposuction is there to help sculpt your body, not weight loss. In fact, removing too much fat in an effort to help you lose weight can be dangerous. By removing too much fluid, you can go into an extreme case of dehydration calling hypovolemic shock. Even if you don’t know exactly what that means, it certainly sounds bad. So don’t go through lipo to lose weight. Do it for the right reasons.

And here’s a bonus myth of liposuction debunked:

Liposuction is expensive!

See for yourself, check pricing on liposuction from Dr. Kaplan by clicking here.

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

The post 5 myths of liposuction first appeared on Plastic Surgeon San Francisco | Pacific Heights Plastic Surgery.