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The cause of a tummy that is not flat for many reasons. It may be excess abdominal skin only, excess fat only or a combination of both excess abdominal skin and fat. Occasionally on fit patients without excess skin or fat, it may be due to excessive stretching of the abdominal muscles that occurred during pregnancy.
Pregancy effect on abdomen- muscles stretch apart. Exercise will help to strengthen muscles and over time the space between the muscles may retract bringing the muscles closer together as they were before pregnancy. Give yourself at least a year of abdominal exercises to see what can be obtained. Some muscles will never return to their prestretched state. For those, the muscles must be brought back together with surgery. If excess skin or excess skin and fat is present, these will be removed at the same time. If the problem is excess fat only, liposuction alone may be an option. In this case, skin elasticity will tighten up the minimal amount of excess skin allowing for an improved abdominal conour witout the scars of a tummy tuck. Most benefit if wait for surgery until after done with pregnancy. Safe to get pregnant after the surgery but will likely lose benefits of the surgery
There is not one tummy tuck for all patients. Abdominoplasty must be tailored for each individual. In the realm of abdominal procedures there are various options depending on the tissue of each patient. A patient with large amount of excess skin will likely need a full abdominoplasty, incision on the lower abdomen from hip to hip. A patient with excess skin only in the lower abdomen may need a mini abdominoplasty, which is a simpler procedure performed through a small incision above the pubic area. A patient who has good skin tone, no sagging skin and excess fat, would be a good candidate for liposuction. A patient with no excess skin and fat, but bulging of the abdomen from spreading apart of underlying muscles may need a tightening of the muscles (muscle placation) without skin removal.
Massive Weight Loss Patients
Gastric surgery to help people lose large amounts of weight are becoming more and more common. What many of these patients don’t realize is that with rapid loss of large amounts of weight comes a large amount of excess. The younger a person is when they lose weight, the slower they lose the weight and the less weight they have to lose in the first place leads to the best outcome. Unfortunately, the skin can only retract so much. In a young person with a 25-50 pound weight loss, they may see significant tightening of the skin, but the same patient with a 100 pound weight loss will very likely be left with large amounts of excess skin requiring a lift
The most important thing for these patients is realistic expectations. Once adequately educated, massive weight loss patients understand the trade off of scars for improved contour.
Liposuction removal of fat through suction
Maintain healthy fit body- daily exercise, healthy diet and stble ideal weight. Avoid weight fluctuations which can permanently stretch skin as well as sun exposure and pollutants asuch as cigareete smoke which can weaken the bodies ability to repair itself. Even with a healthy lifestyle and adequate wieght, some people can not obtain the shape they desire. It may be a genetic predisposition to carry weight on your hips or the extra skin left behind after pregnancy., which no amount of exericise will get rid of. Body contouring procedures help to obtain those goals by removing stretrched skin or excess fat.
- Not for weight loss
- Patients should be within 30% of ideal body weight
(Consider BMI chart Here)
- Healthy and physically active with good elastic skin tone
- Liposuction works best when it addresses specific areas resulting in slimmer contours with better overall body proportion.
Permanent if weight is stable
Works best on patients with distinct areas of excess fullness( ex saddle bags, abdomen)
Which always seem to “gain the weight” first. Fat cells are permanently removed form these areas bringing the number of fat cells more in propoartion with the rest of your body. When gaining weight you will gain it all over instead of it concentrating in one area. Liposuction does keep you from gaining weight and therefore a healthy acive lifestyle must be continued to maintain your results.
Liposuction does not erase cellulite. It could make cellulite worse.
A series of hollow tubes are used to remove fat cells from beneath the skin. Performed through multiple small inciasions. 1-4 hours. General or local if small area. Ambulate immediately, Outpatinet unless large voume. Pressure garment to decrease sewelling and bruising. If weight stable with preop, results 4-6 weeks, butlikely improve 6 months if continue physical activity. Weight Maintenance is KEY.
Areas
Male breasts
Female breast(uncommon)
Upper and lower Back
Abdomen
Medial thighs
Lateral thighs
Anterior thighs
Calves
Body contouring
Lower body lift
This procedure addresses loose and sagging skin in the abdomen, buttocks and thighs. Excess skin and fat are removed through incisions placed on the lower abdomen and upper buttock regions to tighten the skin and improve the contour of the buttock, abdomen, hips and thighs. Patients must be willing to accept scars to improve the contour and remove the extra skin. Once there is excess skin which is sagging, removing it through incision is the only option. The amount of scarring is dependent on each patient. The more excess skin present, the more likely scars will need to be longer and possibly more noticeable to give the best result. An example of this is a medial thigh lift. If the amount of excess skin is small, this lift can be done through an incision in the groin. However, with large amounts of skin, as is often seen in patients after massive weight loss, the incision must be made down the inside of the thigh towards the knee to give the best result.
Lower body lift requires general anesthetic, and at least a one night stay in the hospital. Drains are placed and compressive dressings are worn postop to decrease swelling and fluid collection. Walking soon after surgery is important to decrease the chance for blood clot formation.
Postop instructions
- Lots of pillows- base spine and under knees
- Mouthwash in case brushing difficult
- Safe gentle skin care products
- Creams
- Antibiotic ointment
- Scar cream
- Sunblock
- Moisturizer for lips with vitamin E
- Emollient body lotion
- Petroleum jelly
- Stool softener
- Over the counter sleep aid- Melatonin
- Homeopathic remedies
- Soft foods and water
- Juice- avoid orange and grapefruit
- Flexible straws
- Plastic chair for shower
- Mild hair products
- Lubricating eye drops
- 2 large bags of frozen peas and 6 large self-sealing plastic storage bags to make cold packs, replace after 20 minutes
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