Posts Tagged tummy tuck

Reader Question: Hips and Butt Getting Bigger After Tummy Tuck

Hi Dr,
I’m just wondering what your thoughts are on this. I am 5 months po from a FTT, MR (full tummy tuck with muscle repair). I have been working out and still eating healthy as I did b4 surgery, BUT my hips and butt seem to expanding. I’ve been going for lymph drain massages for my tummy and while it is helping that, I can’t help but wonder if it’s pushing fluid to other places. Not only can I not get back into my preop size 8 jeans, but I couldn’t even squeeze into a 12! I’m frustrated because I keep hearing different theories on this.

Prior to surgery did your weight fluctuate much? Patients like this following abdominoplasty can gain this weight in new places. This can become a problem.

At this point swelling is usually coming down, although in large cases it may not be completely gone for 6-8 months. Did you have much liposuction with your tuck? Liposuction frequently makes swelling more pronounced for a longer period of time. Also if you smoke, try to stop it or limit it as it interferes with wound healing. Assuming you went to a good surgeon, give it time. It gets better.

Best Regards,

John Di Saia MD

Related:

Dr D’s Tummy Tuck FAQs

Originally posted 2005-09-18 17:44:00.

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Dr D Tummy Tuck Morph and Comments

I have contributed some videos to YouTube. Who hasn’t? Interesting is the fact that the video upon which I spent the least effort is the one with nearly 2.5 million hits.

It’s a low res tummy tuck before and after morph. I just plugged her before and after pictures into a program I was trying out and that was it. YouTube has improved in the five years that it has been online. The distortion that used to be there has decreased.

Best Regards,

John Di Saia MD

Originally posted 2011-07-14 07:00:00.

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Weight Loss Tummy Tuck – Orange County, Ca

Weight loss tummy tuck surgery is tummy tuck surgery after significant weight loss. Here we have Before & After images of the oldest patient for whom I have ever performed abdominoplasty. She was 73 at the time of her tummy tuck, but a very healthy 73. She had of her own accord lost some 65 pounds and wanted her “fat apron” lifted from her tummy. After her internist cleared her for surgery, we went ahead.

weight loss tummy tuck

She recovered well and quickly after her surgery and was pleased with her outcome. This weight loss tummy tuck resulted in a loss of a few pounds. The patient had lost the majority of her weight beforehand. This is the way it usually works out. These operations are “cleanup” for the effects of large scale weight loss most often.

Best Regards,

John Di Saia MD

Related:

Dr D’s Website Tummy Tuck Section

Originally posted 2005-05-16 20:29:00.

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Belly Button as a Mark of a Good or Bad Tummy Tuck Result

Belly Button Repair Tummy Tuck Immediate

We have discussed before the issue of tummy tuck surgery and quality. There are many docs who perform tummy tuck surgery and they have not all had residency training as plastic surgeons. Even some well-trained docs are in too much of a rush to do the “fine touches” that make a good tummy tuck great as well. One of the areas that may serve to separate the good tummy tuck from the mediocre (regardless of the surgeon) is the quality of the belly button repair or umbilicoplasty.

At the top of the post here is a fresh belly button repair by someone untrained or in a rush (my opinion of course.) The blue sutures show the belly button to be held in place primarily by external stitches that will require removal. Better tummy tuck surgeons use more “under the skin” sutures and fewer “over the top” types. Things scar less this way. This belly button isn’t one of mine.

Best Regards,

John Di Saia MD

Related:

Dr D’s Website Umbilicoplasty page

Dr D’s Tummy Tuck FAQs

Originally posted 2011-10-24 07:30:51.

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“Best OC Tummy Tuck Surgeons” – A Reader Comments

Looking online you look like a “dark horse” candidate for a list of best oc tummy tuck surgeons. I see your results look nice and your medical board sheet is clean. You write that you don’t do liposuction with your full tummy tucks though and you keep your patients overnight with a private nurse. How do you get tight looking results without the lipo and is the overnight really necessary?

Thanks for the kind words “best oc tummy tuck surgeons” although the “dark horse” part is kinda plus and minus. :)

Lipo really doesn’t tighten anything. In tummy tuck surgery it is the design of the tissue removed and the closure that does that. The blood supply of the tissue after a tummy tuck makes lipo (in my opinion) risky if done too aggressively. I see my tummy tuck patients with less swelling and with a better shorter recovery since I dropped the flank lipo years ago. I do not make “Swell Hell” patients very often and my skin necrosis rate is very low.

The overnight stay with the private nurse is mainly for leg vein clot prophylaxis as well as to teach patient the “dos and don’t s” of tummy tuck post-op before they go home. I insist upon overnight stays of this sort for anything over a minor tummy tuck in a really healthy patient. The cost is nominal and my safety record has been really great.

I guess I have a defined philosophy for tummy tuck surgery and thus far it has worked pretty well.

Best Regards,

John Di Saia MD

Related:

Dr D’s Orange County Tummy Tuck

Originally posted 2011-07-01 07:30:51.

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Tummy Tuck and the Totally Flat Tummy

At an online forum, I responded to a post by a woman who had had tummy tuck surgery elsewhere (the famous Dr “X”) and was unhappy that her tummy was not “totally flat” afterward. She was asking whether this might represent fat that her doctor hadn’t removed. At this forum they refer to the after tummy tuck appearance as the “flatlands.” Kinda cute.

Tummy Tuck surgery results vary between surgeons and patients. The reasons for this are multiple:

(1) Different surgeons work with different techniques and spend more or less effort than others to get their best result.

(2) Some patient’s tissues stretch more after being placed upon tension than others. We see this over the weeks and months after an operation.

(3) Some people are more successful than others at pushing away from the buffet.

Is has been true for as long as there has been cosmetic surgery that the most important issue for a patient to comprehend relates to reasonable expectations.

Expecting “absolutes” in a world of “relatives” is an invitation to disappointment. “Totally flat” sounds great but might be off the charts for some patients. Some surgeons are going to make more of an effort to get you there though. And what is “Totally flat” for one patient might not be flat enough for another anyway. When plastic surgery doesn’t get you where you want to be there are several issues to address regarding the cause.

It is far more productive to look at degrees of improvement and focus your pre-op conversation on what you might be able to achieve. Picking the right surgical talent never hurts either. :)

Best Regards,

John Di Saia MD

Related:

Dr D’s Practice Web Site Tummy Tuck Section

Originally posted 2011-07-25 07:30:16.

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Reader Question: Help My Seroma Won’t Go Away!

I had a tummy tuck two months ago. Now I have a little water-filled “pouchie” above my couchie where the water waves move when I poke it. My surgeon says it is not a problem and will go away. Should I be worried?

A seroma is a lymph filled pocket in your soft tissues. We are most aware of them when they are just under the skin as they can demonstrate a “fluid wave” phenomenon when they are tapped. Larger scale surgery is more of a risk toward the formation of a seroma and tummy tuck surgery is included.

On the positive side, these things tend to resolve when small and wounds are newer. The longer they manage to persist, the greater the chance that they will not go away, but rather form a scarred in cavity that will tend to stay. In a worst case scenario they can require surgery to fix. Alternate treatments include draining them intermittently with a needle or with a drainage tube or injecting them with a chemical to encourage them to shrink or go away. Opinions as to how often or urgent treatment of a seroma is vary substantially. Left alone they can mar good tummy tuck results, so I like to deal with them quickly. My tummy tuck results have benefited by this policy by my way of thinking. I haven’t needed to re-operate to repair one in over ten years.

Seromas are best avoided. The best ways to do this involve the proper use of drains and compression garments after a large scale operation as well as tailoring that operation to be less risky.

Best Regards,

John Di Saia MD

Originally posted 2011-06-09 07:30:09.

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Top Ten Tummy Tuck Facts

Tummy Tuck surgery is almost invariably greatly appreciated by the proper patient. These top ten facts might help you figure if you are such a person. ;)

(1) Tummy Tuck surgery is one of the largest scale operations a plastic surgeon can offer a patient.

(2) Patients who have lost a good deal of weight or completed child bearing involving large weight gain and loss are the most common candidates. Patients do not lose much weight from the operation itself in most cases….maybe a few pounds on average.

(3) Post-operative pain used to make it necessary to admit the patient to a hospital for narcotics.

(4) Pain pumps when properly utilized can decrease pain significantly. Overnight stays often reduce risk when properly supervised.

(5) Revisions are not uncommon but can often be done in a lower key environment….such as local in the office. The revision rate varies enormously between surgeons.

(6) All tummy tucks are not alike. The work of the novice really shows in this operation.

(7) Many physicians in the OC offer these operations including plastic surgeons, cosmetic surgeons, gynecologists and general surgeons. You guess which ones look the best? ;)

(8) When you go to the bargain basement doctor, some of what may happen may not be correctable later.

(9) Drains and pump catheters will need to be used for a week or longer. They reduce risk of fluid collections that can ruin otherwise nice results (My opinion of course.) :)

(10) Smoking can really impair healing and lead to skin necrosis which commonly detracts from the quality of the result and delays wound healing sometimes for months. Don’t have the surgery if you can’t stop the cigarettes and tell your surgeon a true indication of how many cigarettes you are smoking daily.

Best Regards,

John Di Saia, M.D.

Originally posted 2011-04-20 07:30:15.

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Good Tummy Tuck Results with Breast Lift/Implants

Good Tummy Tuck Results

Good Tummy Tuck Results Orange County California

Years ago I did some work for a great looking 40 year old mom who worked out incessantly and had a great athletic body. Despite the working out though, her tummy had some changes from her pregnancy years before and her breasts were a bit small and droopy for her tastes. After a few years and two operations (Breast lift/implants and a tummy tuck,) she sent me this bikini image with a thank-you note.

Plastic surgery can work out well when done properly in the right patient. These are good tummy tuck results, but in reality all plastic surgery results vary. Only few patients get this kind of “knock it out of the park” result. They tend to be the people who are already in great shape. There is no overemphasizing doing your part.

Diet and exercise make you a better candidate for surgery anyway. :)

 

 

Best Regards,

John Di Saia MD

Originally posted 2011-06-24 07:30:43.

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Lingerie Choices for the Tummy Tuck / Lower Body Lift Patient

Over the years my tummy tuck patients have asked about a surgeon’s perspective on lingerie recommendations. To answer this at least in part, I went through the catalog of one of my blog advertisers and picked a few for your consideration. Comments follow each. Your incision type and personal taste will of course rule supreme here:


A Dr D Post TT Fav – Great raised sides to cover most of my tummy tuck and lower body lift incisions and inexpensive too.

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This sort of bikini panty tends to cover my low cut incision well.

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Pretty good for a high cut incision or a lower body lift.

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For a real high cut and/or those who like one piece styles. May have trouble covering the incision though.

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The panty here plays well with raised sides for incision covering options.

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For those who like more covered wear.

My main goal is covering the incision which will vary with the surgeon and the patient of course.

Enjoy ladies…..

Best Regards,

John Di Saia MD

Originally posted 2010-12-03 07:30:52.

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