Tummy Tuck (Abdominoplasty)
Generally referred to as a “tummy tuck”, abdominoplasty removes excess fat and skin from the abdomen. The procedure also helps to flatten the abdomen by tightening the surrounding muscles. Women, with stretched abdominal areas due to previous pregnancies, can benefit considerably from abdominoplasty, although they should have completed their childbearing. Older individuals whose skin has lost some of its elasticity and are slightly obese can experience an improvement in their abdominal area.
If you are in generally good physical shape but are concerned about abdominal fat deposits or loose skin that does not respond to diet and exercise, the procedure can potentially reduce or even eliminate a protruding abdomen. It can also be very helpful in getting rid of persistent stretch marks, caused by pregnancy or rapid weight loss or gain.
What about the scar?
It is impossible to remove the excess skin of the lower abdomen without a scar. Other treatments such as lasers, mesotherapy, and even liposuction will not remove or significantly tighten loose, hanging skin. They are a waste of time and money. The only way to remove this skin, tighten the loose muscle, and create the flattest tummy possible is via a tummy tuck. This surgery does create a relatively long permanent scar, however in most patients the scar fades with time. While abdominoplasty will produce a permanent scar, make sure your board-certified plastic surgeon focuses on placing the scar low, below the bikini or bathing suit line. In this way it can be easily hidden. There is a technique, called the High Lateral Tension Abdominoplasty, which often has the scar higher on the sides of the abdomen. I am not a big fan of this procedure, but some well-respected plastic surgeons do perform it regularly.
How long is the recovery from the surgery?
Most patients need 2-3 weeks to recover from a tummy tuck and are back to exercising by 3-4 weeks, depending on your plastic surgeon’s preferences. I usually use a pain pump in my patients, which significantly decreases discomfort for the first 3-4 days. Patients must wear an abdominal binder, which is like a corset, for three weeks, sometimes more depending on your plastic surgeon’s recommendations. Small drains are also used to remove fluid which can accumulate in the surgical area. These are removed within 1-3 weeks depending on your plastic surgeon’s techniques. I utilize progressive tension sutures, which are absorbable sutures that help close off open surgical areas. This can decrease, or even prevent, the need for drains.
Tummy tucks can be performed in one of three ways, depending on how much excess skin needs to be removed. Most patients are candidates for a “full abdominoplasty”, where the scar extends from hip to hip.
Click here to view before and after images.
Patients with less excess skin are candidates for a “mini-abdominoplasty,” where the scar is shorter and there is no scar around the belly button. The scar is usually not visible under a bikini. This is best for patients who have loose skin in the lower abdomen only, and remain flat above the belly button. While the scar is shorter than with a full abdominoplasty, the results are unfortunately less dramatic with a mini-abdominoplasty. I am very cautious in recommending this procedure, since the results are dramatically less than a traditional abdominoplasty. I tell my patients, “Mini-tummy tucks equal mini-results.” If that’s ok with you, then you may be a candidate for this procedure.
Patients who have a lot of excess skin, usually after massive weight loss, are candidates for a “circumferential abdominoplasty,” where the scar extends around to the back, or a “Fleur-de-lis abdominoplasty” which creates an upside-down ‘T’ shaped scar of the abdomen. Both of these procedures are for patients with a large amount of excess skin which would be inadequately removed with a traditional abdominoplasty. While health insurance may help to pay for some of the operating room and surgeon costs, it usually does not pay for the cosmetic portions of this procedure.
During the consultation, your board-certified plastic surgeon should explain these different types of tummy tucks in detail, and decide together which is right for you.
Now among the most popular cosmetic surgery procedures, liposuction (also known as “lipoplasty” or “suction lipectomy”) sculpts the body by removing undesirable fat from areas around the thighs, knees, buttocks, waist, hips, abdomen, chin, cheeks, neck and upper arms. In general there are three types of liposuction: traditional liposuction, ultrasonic liposuction, and laser liposuction. Ultrasculpt and VASER are the two most popular ultrasonic liposuction techniques, where a specialized instrument is used to melt the fat prior to removing it. In this way, the fat to be removed is liquefied prior to removal. Ultrasonic liposuction can be very effective in areas of fibrous fat, such as male breast tissue (gynecomastia) or for areas which have been liposuctioned before (revision liposuction). Laser liposuction utilizes a small laser fiber to melt the fat and heat the overlying skin. Some names of popular laser liposuction devices include Lipolite, SmartLipo, Cool Lipo, and Slim Lipo. Laser liposuction is typically used in smaller areas such as under the chin.
Liposuction is not a substitute for a healthy diet and exercise, but the procedure can eliminate areas of fat that are unresponsive to typical weight-loss methods. In general, two main types of patients benefit most from liposuction. The first type are those healthy individuals who have certain areas of fat which do not respond to diet and exercise, such as the woman who inherited her mother’s thighs, or the man who inherited his father’s love handles. They are ideal candidates for liposuction. The second type is that person who needs a jump start in their weight loss program, which liposuction can provide.
Click here to view before and after images of Dr. Youn’s liposuction patients.
My practice promotes a cellulite treatment program using the FDA-approved Dermosonic™ anti-cellulite method. This is a non-invasive treatment for temporarily reducing the appearance of cellulite (or the dimpling seen in areas of localized fat).
The Dermosonic™ method is a two stage process. The first stage incorporates ultrasonic waves to penetrate beneath the skin to stimulate blood circulation and soften fat deposits. This first stage enhances the second stage of the Dermosonic™ method, which is the elongation of connective tissue and the promotion of lymphatic drainage using specialized vibratory and suction techniques. This method is a typical two stage treatment that lasts 45-60 minutes.
The Dermosonic™ method appears to be very similar to Endermologie™, however, with the added benefit of external ultrasound. Although there is no cure for cellulite, the Dermosonic™ method is my preferred technique for combating cellulite. The treatments are painless, non-invasive, and are comparable to a relaxing massage.
Other anti-cellulite techniques include Velashape and Smoothshapes. Velashape uses radiofrequency, whereas Smoothshapes uses a laser. These devices have not been compared head-to-head so it’s difficult to determine which one is the best. I presume that they all work to temporarily reduce the appearance of cellulite.
To view a Fox News broadcast I did on anti-cellulite treatments, click here.