Tummy Tuck Myths

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A tummy tuck, or abdominoplasty, is one of the most common plastic surgery procedures performed. It is a procedure designed to restore the appearance of the abdominal region by removing excess skin, tightening underlying muscle separation, and removing extra fat. The American Society of Plastic Surgery (ASPS) reports over 100,000 Tummy tucks, or abdominoplasties, are performed each year. However, there are still many common misconceptions about tummy tucks. Let’s take a closer look at some of the most common myths surrounding the tummy tuck procedure.

Tummy tucks are for women only – MYTH

Because women more commonly experience changes in their abdominal region due to aging, weight fluctuations and pregnancy, a tummy tuck is most commonly performed on women. However, anyone with excess skin and loose abdominal muscles can be a tummy tuck candidate. This means that even men can successfully undergo a tummy tuck procedure. The most common reasons for men to desire a tummy tuck is weight loss. Weight loss can result in excess skin that hangs below the belt line, as well as laxity of the abdominal wall. So even though 90% of tummy tuck patients are women, that still means that men can successfully undergo this operation if indicated.

Tummy tucks are designed to help you lose weight – MYTH

Much like most plastic surgery procedures, a tummy tuck is not a weight loss operation – it is a shaping procedure, specifically designed to shape the abdominal area. This means that the best candidates for tummy tucks are men or women who are not overweight, and complain of excess skin usually from previous weight loss. The procedure itself will remove the excess skin and fat. The number of pounds removed is minimal. In fact, even patients who have a large amount of skin removed during their tummy tuck operation, should only expect to lose a few pounds on the scale. Excess skin just doesn’t weigh as much as you would think. Only in extreme cases of massive weight loss ,in which the patient is left with massive amounts of hanging skin, should you expect any significant reduction in the number on the scale. Now it is true that after a tummy tuck procedure most patients will lose weight on their own. This is because they are more likely to continue with a healthy lifestyle, given that they just spent money and subjected themselves to themselves to the pain of a major operation. Also, people find it harder to eat large amounts of food after a tummy tuck because the skin of their abdomen is tighter and they naturally feel fuller faster.

Exercises can repair abdominal muscle separation – MYTH

One of the main things that a tummy tuck addresses is the separation of the abdominal muscles. The separation generally occurs during pregnancy as the baby grows. There are some people who believe that there are some abdominal exercises that can reverse this separation. While there are some exercises specifically designed to do this, the truth is that the improvement will be limited. You can strengthen muscles through exercise, but you can’t “move” them. It may be possible to close small gaps in the abdominal muscle, such as 1 to 3 cm, with targeted exercises. However, it is common for abdominal muscle separation to exceed 5or 6 cm. No amount of exercise can reverse this. During a tummy tuck, those muscles are sewn together using sutures. This is a key part of the tummy tuck procedure and is also the part that causes the most discomfort and restrictions after the surgery.

The scar is too big – MYTH

Many people are hesitant to have a tummy tuck procedure because of the scar. The scar length will depend on the amount of excess skin that needs to be removed. This means that if you have a lot of skin laxity, your tummy tuck scar may extend from hip to hip. While you may think this is “huge”, it is what is required to perform the surgery appropriately. Shorter scars will remove less skin and have less internal tightening. The key to the scar is not the length, but the location. Plastic surgeons take great effort in placing the scar low so that it is hidden beneath underwear and bikini bottoms. This means that even if your scar is hip to hip, it should be low and completely hidden with minimal clothes. Only you can decide if this scar is too large for you and not worth the operation. In my experience, most people find that the improvement in the shape and contour of their abdomen is well worth any scar that is necessary.

I don’t need a tummy tuck, I can just get liposuction – MYTH

A tummy tuck and liposuction new york city are two different procedures with two different purposes. Liposuction will remove excess fat. This is a great procedure for people who have excess fat but no excess skin. If you have excess skin, then liposuction will not help you. In fact, it can make things worse. A tummy tuck is designed to remove the excess skin. Often times liposuction is combined together with a tummy tuck to improve your results. So, if your issue is excess skin, muscle separation, and some extra fat, then a tummy tuck is the appropriate operation for you. Liposuction will only make the excess skin worse and will do nothing to improve the underlying muscle separation.

You can be too old for a tummy tuck – MYTH

Much like all elective cosmetic procedures, age itself is not a reason not to do it. The main concern is whether or not you are healthy and can undergo a surgical procedure without elevated risk of complications. The main concern is your overall health. Therefore, to have a tummy tuck, you will need to be in good health without medical issues such as uncontrolled high blood pressure, cardiac disease, diabetes, anemia, or lung issues. All patient will undergo a full medical evaluation prior to having a tummy tuck. There certainly will be people who are now not candidates for tummy tuck based on their medical history, but this has nothing to do with age. Most plastic surgeons have performed tummy tucks on patients in their 60s and 70s. We have all seen 60 year olds who are in better physical health than some 25 year olds.

 

Belly Button Surgery New York City Patient 12

Any plastic surgeon can perform my tummy tuck – MYTH

 As I said earlier, tummy tucks are one of the most common plastic surgery procedures. This means that every plastic surgeon has had some training in performing a tummy tuck operation. But, th

is does not 

mean that every plastic surgeon is good at tummy tucks. As plastic surgeons we all specialize in specific aspects of plastic surgery. Some specialize in face procedures and some specialize in body procedures. Some perform reconstructive surgery while other Focus on cosmetic surgeries. When choosing your plastic surgeon for your tummy tuck, make sure that they are experienced with this specific procedure. You want to make sure that this is an operation that they perform regularly and you should look at their before and after results. This is the same advice you would be given for any surgical procedure ,since not every plastic surgeon is good at every plastic surgery procedure.

To find out more about tummy tucks and whether or not this is the right operation for you, contact Dr. Matthew Schulman, a New York City board-certified plastic surgeon.

References

Do I need a Tummy Tuck or Liposuction?

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Two of the most common procedures performed by plastic surgeons are Tummy Tucks and Liposuction. In fact, according to the American Society of Plastic Surgeons, these two procedures account for almost half a million procedures per year. These are two very different procedures, but are commonly confused. Each one addresses different things and may not be the right procedure for everyone.  To get the best possible results from your plastic surgery, it is important to make sure you get the right operation. To understand if a tummy tuck or liposuction is best for you, you must understand the difference between these two procedures. To understand the difference, we need to take a closer look at what each procedure is, what each procedure does, and who is a candidate for these procedures.

Tummy Tuck:

  • What is a Tummy Tuck?

A tummy tuck is a procedure that addresses the abdominal skin, fat, and muscles in a one operation.  This is why it is such a powerful procedure. The result is a firmer, flatter, and smoother abdomen. Specifically, a tummy tuck includes:

  • Removal of excess abdominal skin
  • Tightening of loose or separated abdominal muscles
  • Removal of excess fat with liposuction
  • Rejuvenation of the belly button

  • Who is a Good Candidate for a Tummy Tuck?

A tummy tuck is so popular because it offers advantages for so many different people, all in different situations.  A tummy tuck may be indicated for people who have lost weight, have skin changes associated with aging, or have abdominal changes from pregnancy.  A tummy tuck will specifically address the excess or loose skin, the belly button, and the separated abdominal muscles. Because of the removed skin, the scar will be a longer scar hidden beneath the underwear line.

  • What type of anesthesia is used?

A tummy tuck is performed under general anesthesia. This allows you to be completely relaxed so that the maximum amount of skin can be removed and your abdominal muscles can be tightened as much as possible.

  • What is the Recovery from a Tummy Tuck?

After a few hours in the recovery room, you will be allowed to go home with your escort. You will have pain medication and antibiotics. The first few days is usually the worst, since you will be “hunched over” and in pain, but it will be manageable.  After about a week, most people feel better, but not great. You should plan on having help at home for a few weeks. You are encouraged to walk throughout this process to promote good circulation. While everyone is different, most patients will require about 3 weeks off from work and 6 weeks off from heavy exercise.

Liposuction:

  • What is Liposuction?

Liposuction is a procedure to specifically remove excess fat. It can be performed on virtually any part of the body. Obviously, liposuction is most commonly directed towards the abdomen, back and flanks. However, it is commonly performed on areas such as the neck, arms, and thighs.  This is specifically done using a small suction tube and inserted into tiny incisions.

  • Who is a Good Candidate for Liposuction?

Liposuction is a good procedure for anyone who has excess fat and good skin quality. Even though it is a fat removal procedure, it Is not intended to be a weight loss procedure. Instead, it is a body shaping procedure. This means that the best candidates for liposuction are those who are in good shape but have “problem areas” that are resistant to diet and exercise. Additionally, those with loose skin may be poor candidates for liposuction, since skin laxity may increase afterwards, causing more hanging skin.

  • What type of anesthesia is used?

The type of anesthesia required for your liposuction will vary depending on exactly what you need done. For small areas, it may be possible to have liposuction done under only local anesthesia. For larger areas, or more areas, it is best to have your procedure performed under general anesthesia, allowing your surgeon to more completely remove fat.  

  • What is the Recovery from Liposuction?

Liposuction is a less invasive procedure than a tummy tuck, since no skin is removed. After the procedure, you will be monitored in our recovery room for about an hour. You will experience soreness, bruising, and swelling in the area that you had fat removed. The severity of the recovery will depend on the areas you had liposuction and how much fat you had removed. Most people can return to regular activities in about a week.

How do I know which procedure I need?

Many people are confused whether they need a tummy tuck or liposuction. However, determining which is best for you, should not be difficult. The most important thing to figure out is whether you have excess fat or excess skin.

If you have loose, hanging skin on your abdomen, then a tummy tuck is best. This is because the tummy tuck operation will directly cut off the excess skin. Usually, women who have lost significant weight or have had multiple pregnancies, have excess skin and would do best with a tummy tuck.

If you don’t have excess skin, and only have excess fat, then liposuction may be a better option. Liposuction will remove the fat, but not the skin.  Liposuction tends to be best for people with good skin quality but no skin laxity.

Can the two procedures be combined?

Yes, it is very common to combine a tummy tuck with liposuction. In these cases, the tummy tuck removes the excess skin, rejuvenates the belly button, and tightens the underlying abdominal muscles. Liposuction will then be performed on the sides and flanks, removing excess fat and further improving the waistline.  It is also common for people to want a tummy tuck and liposuction of a separate area such as the thighs, neck, arms, etc.  So, it is also possible to have a tummy tuck and liposuction of separate areas at the same time.

What Happens if I need a Tummy Tuck but only get Liposuction?

It is important to get the right procedure, because if you don’t, your results will not be ideal. So, what if you have excess skin and need a tummy tuck, but for some reason, you get liposuction instead. The result will be increased laxity of the skin. This is because the liposuction will remove the fat, but not the skin. The skin will then appear more loose, since there is less underlying fat. Also, if your abdominal muscles are separated, as is common after pregnancies, your abdomen will skin protrude and appear round after liposuction. In a situation like this, you will likely need a secondary procedure (a tummy tuck) to remove the skin and improve the outcome.

Discuss with your Board Certified Plastic Surgeon

To truly learn which procedure is best for you, you should meet with a board certified plastic surgeon. You should select a surgeon who is experienced in both procedures, so that he or she can give you the best advice.  During your consultation, your surgeon will examine you to figure out how much excess fat you have and how much excess skin you have.  This will determine whether you will get a better. Result with a tummy tuck or with liposuction. Perhaps you would do best with a combination of the two.

If you would like to learn more about whether a tummy tuck or liposuction is right for you, contact New York City, Board Certified Plastic Surgeon, Dr. Matthew Schulman.

Reference

Why a Tummy Tuck may be what you need

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One of the most popular procedures performed by Board Certified Plastic Surgeons is a Tummy Tuck, or abdominoplasty. This is a procedure that almost every plastic surgeon has performed. In fact, recent statistics from the American Society of Plastic Surgeons indicate that over 93% of plastic surgeons report that this is a procedure they routinely perform. This explains why about 200,000 tummy tucks performed each year in the United States. It is a very powerful procedure designed to transform the abdomen and torso.

What is a Tummy Tuck?

A tummy tuck is a procedure that addresses the abdominal skin, fat, and muscles in a one operation. This is why it is such a powerful procedure. The result is a firmer, flatter, and smoother abdomen.

Specifically, a tummy tuck includes:

  • Removal of excess abdominal skin
  • Tightening of loose or separated abdominal muscles
  • Removal of excess fat with liposuction
  • Rejuvenation of the belly button

Who is a Good Candidate for a Tummy Tuck?

A tummy tuck is so popular because it offers advantages for so many different people, all in different situations. A tummy tuck may be indicated for people who have lost weight, have skin changes associated with aging, or have abdominal changes from pregnancy

  • Weight Changes

Commonly, weight changes results in laxity of the skin. Weight gain will stretch out the skin as the amount of underlying fat increases. Subsequent weight loss that reduces the underlying volume of fat can lead to loose skin, since the skin may remain stretched. It is true that skin can adjust to weight loss and tighten over time. However, the more significant the weight loss or the more rapid the weight loss, the less your skin will be able to tighten. Also, constant up-and-down in weight that constantly occurs with people will likely lead to more loose skin as the elasticity is decreased. After loss, it is common to have a section of hanging skin along the waistline. Think of this like a rubber band. Continuous stretching of the rubber band will eventually lead to its loss of elasticity. The skin acts in a similar way. During a tummy tuck after weight loss, the excess skin is removed. This is not always accompanied by internal muscle repair or liposuction, since these may not be needed.

  • Aging

Aging causes many changes within the skin of the entire body. Advancing age often causes loss of collagen and disruption of elasticity. This is why people get saggy skin as they age. The skin of the face begins to be wrinkled and sags, as does the skin of the body. So, aging will cause the abdominal skin to become loose, and wrinkled which is removed during a tummy tuck. Also, aging affects how your body stores excess fat. As you get older, your body is more likely to store fat in places such as your abdomen and flanks. This is the result of hormonal changes, decreasing metabolism, and decreased activity associated with the normal aging process. This excess fat can be addressed by performing liposuction during your tummy tuck.

  • Pregnancy

Pregnancy is the most common reason why people desire a tummy tuck. There are so many changes that occur within the body during pregnancy. These changes are basically a combination of those described above. The stretching of the skin that happens with a growing baby, plus the rapid loss of volume when the baby is born, results is skin laxity similar to that seen with a rapid weight loss. There are hormonal changes that make the skin thinner and more loose, as well as making stretch marks appear. Also, the weight gain associated with pregnancy can result in storage of excess fat in the abdomen and flanks.

One major change that is unique to pregnancy is abdominal muscle separation, or rectus muscle diasthasis. This is the separation of the abdominal muscles that occurs in the midline from the expansion of the growing baby. When the muscles separate in the middle, the abdominal wall does not work as well at holding in the contents of the abdomen (like the organs). This results in a round belly, oftentimes giving the appearance of still being pregnant. During a tummy tuck after pregnancy, these abdominal muscles are put back together with internal sutures. This muscle repair is one of the most powerful improvements a tummy tuck offers. If the muscles are separated, but a muscle repair is not performed, the abdomen will never be completely flat.

Determining what specific type of Tummy Tuck you need:

The first step is an evaluation by a Board Certified Plastic Surgeon, experienced in a tummy tuck procedure. During your evaluation, your surgeon will take your medical history and perform a physical examination. The reason for the changes in your abdomen is important in coming up with an appropriate surgical plan. He or she will specifically examine your abdomen, looking carefully at the amount of excess skin, the quality of that skin, underlying muscle separation, and the presence of excess fat. This will help your surgeon determine what specific type of tummy tuck you will require.

Where is the Procedure Performed?

A tummy tuck is a surgical procedure that needs to be performed in an accredited ambulatory surgery center or hospital. These are regulated facilities with the appropriate safety standards and appropriately trained staff. The procedure is usually performed on an out-patient basis, meaning, you are able to go home the same day. In situations where other procedures are being done at the same time, you may be required to stay overnight for monitoring.

The Surgery

  • The Anesthesia

The procedure is performed under intravenous sedation or general anesthesia. This anesthesia is administered by a Board Certified Anesthesiologist and you will be monitored the entire time. You breathing and heart rate will be monitored, as well as your oxygen level.

  • The Incision

A tummy tuck is performed using a low incision the curves beneath your underwear of bikini line. This incision is used to lift up the skin and expose the muscles of the abdominal wall. The incision also allows removal of the excess skin. A lot of effort is made to keep this incision well hidden beneath clothes, since the incision is what creates the scar. During your pre-operative visit, your Plastic Surgeon may ask you to bring in underwear and bikini bottoms. This helps to determine the best placement of the incision, since modifications of the incision can be made depending the type of clothes you prefer to wear.

The length of the incision, and ultimate scar, will depend on the amount and distribution of excess skin. If your excess skin is mostly in the front of your abdomen, you may require a shorter incision than if you had extra skin more on the sides by your flanks. Of course, everyone prefers a short scar, but the shorter the incision, the less skin that can be removed. There is a balance. Your surgeon will draw the planned incision on you so you can visualize where the scar will be located and how long it will be.

  • Repairing the Muscles

After the incision is made, the skin of the abdominal wall is lifted. This exposes the underlying muscles. If there is separation of the abdominal muscles as described earlier, the muscles will be repaired using internal sutures. Carefully placed sutures are placed in the abdominal muscles, bring the muscles back to the midline. This serves as an internal corset, flattening the belly and narrowing the waistline. This muscle tightening, or plication, is done all the way form the breast bone to the pubic bone.

  • Removing the Skin

After the muscles are tightening, the skin of the abdominal wall will be pulled downward. The excess skin will be marked and then cut off. Usually all the skin between the initial incision and the top of the belly is removed. Any stretch marks on this skin is also removed. Multiple layers of sutures will be placed connecting the remaining skin back together, resulting in a low, smooth scar.

  • The Belly Button

Up to this point, the belly button was left attached to the abdominal wall. The next step is to bring your old belly button out through a new opening. The location of your belly button is marked and a small opening is made. The belly button is then brought through this opening and secured in place with meticulous sutures. The creation of the belly button is a critical step in your tummy tuck, since it is essentially the only scar anyone will see. Overly large or overly round belly buttons tend to appear “surgical” and are a tell-tale sign of a tummy tuck. The ideal belly button tends to be a vertically-oriented oval belly button that is not too large.

  • Liposuction

If you are storing excess fat in the abdomen and sides, liposuction is often performed. It may be true that you don’t have any excess fat and your issue is 100% excess skin. If this is the case, then liposuction would be an unnecessary part of your tummy tuck.

Recovery

After a few hours in the recovery room, you will be allowed to go home with your escort. You will have pain medication and antibiotics. The first few days is usually the worst, since you will be “hunched over” and in pain, but it will be manageable. After about a week, most people feel better, but not great. You should plan on having help at home for a few weeks. You are encouraged to walk throughout this process to promote good circulation. While everyone is different, most patients will require about 3 weeks off from work and 6 weeks off from heavy exercise.

Combining a Tummy Tuck with Other Procedures

It is very common to combine a tummy tuck with other procedures. Most commonly, tummy tucks are combined with breast implants, breast lifts, or breast reductions. This is because breasts, like the abdomen, are very susceptible to changes associated with aging, weight fluctuations and pregnancies. Breast and tummy procedures combine well together and can be performed in a single operation, assuming you are healthy. Combining multiple procedures together is commonly called a Mommy Makeover. Other procedures commonly combined with a tummy tuck include a Brazilian Butt Lift, where your own fat is used to increase the size and improve the shape of your butt and hips.

If you would like to learn more about whether a tummy tuck is right for you, contact Board Certified Plastic Surgeon, Dr. Matthew Schulman.

Tummy Tuck versus Mini Tummy Tuck

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There are almost 200,000 tummy tucks, or abdominoplasty, performed each year in the United States. This is a procedure that is designed to flatten the belly and narrow the waistline. It is a procedure performed by 93% of all Board Certified Plastic Surgeons. The reason for it’s popularity is how powerful it is at transforming the body and erase years off someone’s appearance. However, there several variations in a tummy tuck procedure. Let’s discuss some of the main differences between traditional tummy tuck (“Full” tummy tuck) and a mini tummy tuck. Both are intended to improve the appearance of the abdomen, but there are several key differences and one may be a better option for you.

What is a Traditional Tummy Tuck?

A Traditional tummy tuck is a procedure that simultaneously addresses skin, fat, and muscles in a one operation. Specifically, a tummy tuck includes:

  • Removal of excess abdominal skin
  • Tightening of separated abdominal muscles – repair of rectus muscle diasthasis
  • Removal of excess fat with liposuction
  • Rejuvenation of belly button

This is performed through a low horizontal, generally hip-to-hip, and ideally below the underwear or bikini line. The procedure tends to offer the most complete abdominal improvement since it addresses many aspects of the entire abdomen. Additionally, the repair of the abdominal muscle separation creates the flattest belly. This is often referred to as a “full” tummy tuck, especially when comparing it with a mini tummy tuck.

What is a Mini Tummy Tuck?

A mini Tummy Tuck is a procedure designed to be a less invasive version of a traditional tummy tuck. It is intended to improve the appearance of your abdomen, through a shorter incision and with less recovery needed. Specifically, a mini tummy tuck includes:

  • Removal of excess skin that is below the belly button
  • Removal of excess fat through liposuction

It is important to note that there is usually no repair of separated abdominal muscles (rectus muscle diasthasis) during a mini tummy tuck. Also, the belly button is not placed through a new abdominal wall opening, as is done with a traditional tummy tuck.

Key Differences Between a Tummy Tuck and Mini Tummy Tuck

  • Scar: A traditional tummy tuck scar is longer, often hip-to-hip, while the scar of a mIni Tummy Tuck can be just slightly longer than a c-section scar. This is because more skin is removed during a traditional tummy tuck, and a longer incision is needed for access to the abdominal muscle repair work.
  • Muscle Repair: A key component of a traditional tummy tuck is repair of abdominal muscle separation. Muscle separation commonly occurs after pregnancies and prevents the abdomen from being flat, no matter how strong your abdominal muscles are or how muscle you diet or exercise. To repair the muscles, stitches are placed along the entire length of the abdomen, from the breast bone to the pubic bone. A mini tummy tuck, usually does not include any muscle repair.
  • Skin Removal: A larger amount of excess skin is removed during a traditional tummy tuck. The skin is tightened above and below the belly button. A mini tummy tuck only removes excess skin below the belly button.
  • Belly Button: During a traditional tummy tuck, the belly button is brought through a new opening in the abdominal skin. This gives a rejuvenated appearance to the belly button, but requires a scar that goes around the belly button. However, this is not done during a mini tummy tuck. The belly button is not placed through a new opening. This means that there will be no scar going around the belly button, but it will do very little to change the belly button appearance.
  • Recovery: A mini tummy tucks requires less recovery. This is because it requires a shorter scar and because no abdominal muscle repair is performed. It is generally accepted that the repair of the abdominal muscles is what requires the most healing and the most activity restrictions.

Which Procedure is Best for You?

Deciding between a traditional Tummy Tuck and a mini Tummy Tuck really depends on what your specific abdominal issues are. If you have a significant amount of excess or loose skin throughout your abdomen, then a traditional tummy tuck will be best for you. Also, if you have a lot of excess skin and stretch marks around your belly button, then a traditional tummy tuck is also indicated. If your abdominal muscles are separated, which is common after pregnancies or significant weight loss, then a traditional tummy tuck with abdominal muscle diastasis repair is best.

If you only have excess skin below your belly button, and do not have a significant separation of your abdominal muscles, then a mini tummy tuck may be all that you need. A mini tummy tuck is usually a good option for people who are in good shape but complain of that lower abdominal “pooch”. The mini tummy tuck is also a popular choice among men, who usually do not suffer from abdominal muscle separation.

A mini tummy tuck is a less invasive procedure and requires less recovery. BUT, it also offers less improvement. This means that if you are best served by having a traditional tummy tuck, but you elect to have a mini tummy tuck because you desire a more rapid recovery or want a shorter scar, then you need to understand that you will be sacrificing some of your results. Your Board Certified Plastic Surgeon will be able to have a detailed discussion with you about which procedure is most appropriate for you.

Where is the Procedure Performed?

Both a Traditional Tummy Tuck and a Mini Tummy Tuck are performed in an accredited operating room under general anesthesia. After either procedure, you will be allowed to go home the same day after an appropriate stay in a recovery unit.

Can it be combined with other Procedures?

Tummy Tucks, whether traditional or mini, are commonly performed with other procedures such as breast augmentation, liposuction, and Brazilian Butt Lifts. Oftentimes, when these procedures are combined, it is referred to as a “Mommy Makeover”. Of course, when multiple procedures are combined, it will require longer surgical times, loner recovery room stays, and longer required recovery.

Can this be done on Men also?

Yes, both women AND men can benefit from abdominal contouring with either a traditional tummy tuck or a mini tummy tuck.

If you would like to learn more about slimming your abdomen and gaining back the confidence, contact NYC Board Certified Plastic Surgeon, Dr. Matthew Schulman. During your consultation, you can find out whether a Traditional Tummy Tuck or a Mini Tummy Tuck is the better option for you.

A Tummy Tuck Explained

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One of the most popular procedures performed by Board Certified Plastic Surgeons is a Tummy Tuck, or abdominoplasty. There are almost 200,000 tummy tucks performed each year in the United States. This is a procedure performed by 93% of all Board Certified Plastic Surgeons. The reason for it’s popularity is how powerful it is at transforming the body and erase years off someone’s appearance.

What is a Tummy Tuck?

A tummy tuck is a procedure that addresses the abdomen and mid-section. It simultaneously addresses skin, fat, and muscles in a one operation. The result is a firmer, flatter, and smoother abdomen, Specifically, a tummy tuck includes:

  • Removal of excess abdominal skin
  • Tightening of lax or stretched abdominal muscles
  • Removal of excess fat with liposuction
  • Rejuvenation of the belly button

Who is a Good Candidate for a Tummy Tuck?

Because a tummy tuck addresses many aspects of the abdomen and mid-section, it is an operation appropriate for a variety of people. If you have skin that has been stretched out from weight fluctuations, aging, or pregnancy, a tummy tuck may be right for you. If you have a lot of stretch marks on your abdominal skin, a tummy tuck will help. If pregnancy has left you with separation of your abdominal muscles, called rectus diastasis, a tummy tuck will tighten those muscles with the use of carefully placed internal sutures. Because of the wide variety of things that this operation addresses, it can be appropriate for both women and men, young and old.

If any of the following applies to you, you may want to consider exploring a tummy tuck:

  • Your abdomen sticks out despite diet and exercise
  • Your belly has the appearance of you being pregnant
  • There is loose of hanging skin from your belly
  • Your skin has significant stretch marks

Preparation for Your Tummy Tuck

The first step is an evaluation by a Board Certified Plastic Surgeon, experienced in a tummy tuck procedure. During your evaluation, your surgeon will take your medical history and perform a physical examination. He or she will specifically examine your abdomen, looking carefully at the amount of excess skin, the quality of that skin, underlying muscle separation, and the presence of excess fat. Your surgeon will also examine you for any underlying hernias, or holes in the abdominal wall.

If you are an appropriate candidate for the procedure, your surgeon will discuss specific details about the anesthesia, recovery, and scars. He or she will also discuss the risks associated with this tummy tuck procedure. You will also be sent for medical clearance with your primary medical doctor. This will include a physical examination, bloodwork, and an EKG, along with any other tests required to make sure you are healthy enough to undergo the surgery.

Where is the Procedure Performed?

A tummy tuck is a surgical procedure that needs to be performed in an accredited ambulatory surgery center or hospital. These are regulated facilities with the appropriate safety standards and appropriately trained staff. The procedure is usually performed on an out-patient basis, meaning, you are able to go home the same day. In situations where other procedures are being done at the same time, you may be required to stay overnight for monitoring.

See Also Clearing up the confusion versus Liposuction and Tummy Tucks

The Surgery

  • The Anesthesia

The procedure is performed under intravenous sedation or general anesthesia. This anesthesia is administered by a Board Certified Anesthesiologist and you will be monitored the entire time. You breathing and heart rate will be monitored, as well as your oxygen level.

  • The Incision

A tummy tuck is performed using a low incision the curves beneath your underwear of bikini line. This incision is used to lift up the skin and expose the muscles of the abdominal wall. The incision also allows removal of the excess skin. A lot of effort is made to keep this incision well hidden beneath clothes, since the incision is what creates the scar. During your pre-operative visit, your Plastic Surgeon may ask you to bring in underwear and bikini bottoms. This helps to determine the best placement of the incision, since modifications of the incision can be made depending the type of clothes you prefer to wear.

The length of the incision, and ultimate scar, will depend on the amount and distribution of excess skin. If your excess skin is mostly in the front of your abdomen, you may require a shorter incision than if you had extra skin more on the sides by your flanks. Of course, everyone prefers a short scar, but the shorter the incision, the less skin that can be removed. There is a balance. Your surgeon will draw the planned incision on you so you can visualize where the scar will be located and how long it will be.

  • Repairing the Muscles

After the incision is made, the skin of the abdominal wall is lifted. This exposes the underlying muscles. Very commonly after pregnancy, aging, and weight fluctuations, the abdominal muscles separate in the midline. This is called a rectus muscle diastasis and can make the abdomen appear to bulge outward. The muscles are normally responsible for keeping a flat, tight abdomen, but when they are separated, they cannot hold back the internal organs. This can give the appearance of being bloated and pregnant.

Carefully placed sutures are placed in the abdominal muscles, bring the muscles back to the midline. This is the most powerful part of a tummy tuck and serves as an internal corset, flattening the belly and narrowing the waistline. This muscle tightening, or plication, is done all the way form the breast bone to the pubic bone.

  • Removing the Skin

After the muscles are tightening, the skin of the abdominal wall will be pulled downward. The excess skin will be marked and then cut off. Usually all the skin between the initial incision and the top of the belly is removed. Any stretch marks on this skin is also removed. Multiple layers of sutures will be placed connecting the remaining skin back together, resulting in a low, smooth scar.

  • The Belly Button

Up to this point, the belly button was left attached to the abdominal wall. The next step is to bring your old belly button out through a new opening. The location of your belly button is marked and a small opening is made. The belly button is then brought through this opening and secured in place with meticulous sutures. The creation of the belly button is a critical step in your tummy tuck, since it is essentially the only scar anyone will see. Overly large or overly round belly buttons tend to appear “surgical” and are a tell-tale sign of a tummy tuck. The ideal belly button tends to be a vertically-oriented oval belly button that is not too large.

  • Liposuction

In a well-crafted tummy tuck, liposuction is the icing on the cake. It allows the surgeon to perform the final contours. Specifically, any residual fat can be removed. Usually, liposuction is done on the flanks, bra rolls, and upper abdomen. Careful grooves can be made in the midline, creating highlights that accentuate the natural contours of the underlying muscles.

Recovery

After a few hours in the recovery room, you will be allowed to go home with your escort. You will have pain medication and antibiotics. The first few days is usually the worst, since you will be “hunched over” and in pain, but it will be manageable. After about a week, most people feel better, but not great. You should plan on having help at home for a few weeks. You are encouraged to walk throughout this process to promote good circulation. While everyone is different, most patients will require about 3 weeks off from work and 6 weeks off from heavy exercise.

Scar management

Scars never go away, but they will fade. Special care is taken during your surgery to promote good healing and the best possible scar. However, everyone’s skin is different and creates different scars. Some scars are thin and flat, while others are raised and dark. Your Board Certified Plastic Surgeon should be able to assess your skin before surgery in order to determine the types of scar you are likely to produce. In general, the darker the skin, the higher the possibility of thick and dark scars. If you have a history of making “bad” scars, be sure to let your surgeon know about that so proper precautions can be made. There are some things that can be done after the surgery to help your body create better scars These include the early use of silicone scar gels or tapes, and laser treatments. Your scar will continue to evolve over the next 9-12 months. During this time, you should limit the exposure to the sun since UV rays can make the scar appear more red and irritated.

Combining a Tummy Tuck with Other Procedures

It is very common to combine a tummy tuck with other procedures. Most commonly, tummy tucks are combined with breast implants, breast lifts, or breast reductions. This is because breasts, like the abdomen, are very susceptible to changes associated with aging, weight fluctuations and pregnancies. Breast and tummy procedures combine well together and can be performed in a single operation, assuming you are healthy. Combining multiple procedures together is commonly called a Mommy Makeover. Other procedures commonly combined with a tummy tuck include a Brazilian Butt Lift, where your own fat is used to increase the size and improve the shape of your butt and hips.

If you would like to learn more about slimming your abdomen and gaining back the confidence, contact Board Certified Plastic Surgeon, Dr. Matthew Schulman. During your consultation, you can find out if a tummy tuck is right for you.

Clearing up the confusion versus Liposuction and Tummy Tucks

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Many of our patients have the questions regarding liposuction and tummy tucks. These two procedures are commonly confused and they are very different. In order to get the right procedure for your needs, it is important to understand the difference between liposuction and tummy tucks.

Tummy Tuck vs Liposuction: What’s the Difference?

The biggest similarity between liposuction New York City and a tummy tuck is that both procedures aim to improve the appearance of the midsection. Still, each procedure is also distinct.

For instance, liposuction is the removal of actual fat deposits from the abdomen. The procedure involves a plastic surgeon making small incisions near where the fat is to be removed. The surgeon then inserts a thin tube called a cannula which is used to break up the fat and then removed though suction. The removed fat is either discarded or re-injected in a fat transfer procedure. The fat can be re-injected into the buttock, hips, breasts, face, or even hands. Liposuction can remove fat from the abdomen, sides, back or any area where you have unwanted fat.

A Tummy Tuck, or abdominoplasty, deals more with the skin and underlying abdominal muscles. During a tummy tuck, an incision is made in the bikini line and the abdominal skin is elevated. Sutures are placed in the abdominal muscles to tighten them. These muscles commonly stretch apart with aging, weight changes, and pregnancy. Suturing the muscles together can give a flat abdomen. The excess skin is then removed and the skin is put back together. The scar will be well hidden beneath underwear or a bikini.

So how do I know which is better for me?

Your plastic surgeon will help you understand whether a tummy tuck New York City or liposuction is the best operation. In general, if your issue is excess fat, but your skin is not loose, then liposuction may be what you need. If your skin is loose or hanging, or your muscles are separated (giving you a “pregnant” appearance), then a tummy tuck may be better.  Remember, lipo is for fat, tummy tucks are for skin and muscle. It is important to select the right operation so that you get a good result.

Can Liposuction and Tummy Tuck be performed together?

Absolutely! In fact, it is common for liposuction to be part of your tummy tuck. This is because most people have excess fat AND excess skin.  Oftentimes, the only way to get a great tummy tuck result is to do liposuction at the same time. Sometimes, your surgeon may recommend a staged approach, in which liposuction and tummy tuck is done in separate operations. This may be recommended for safety reasons or in order to improve your cosmetic results.

What is “Lipo 360”?

“Lipo 360” is a newer term that refers to liposuction in a 360 degree direction (or all around your torso). Some may refer to this as circumferential liposuction. This means that liposuction is performed on the abdomen, flanks, and back.  This allows improvement is your entire torso since it is usually necessary to make the back look better to make the front look better. It provides a much more complete improvement. Not all surgeons are experienced with this procedure since it involves multiple areas of liposuction and re-positioning the patients during the surgery. While some surgeon may say that they will lipo your “sides/flanks” during the procedure, you need to clarify if they will be turning you over in order to do this, since you will get a much better result when the liposuction is performed from the front AND the back. This is what truly differentiates Lipo 360 from standard liposuction. If you excess fat on your abdomen, flanks, and lower back, then you are probably an excellent candidate for Lipo 360. 

What Is a Tummy Tuck 360?

A tummy tuck 360 is similar to liposuction 360 in that this procedure improves the appearance of the abdomen from every angle. Like liposuction 360, a tummy tuck 360 removes the excess skin in the front, sides and back. This will involve removing the skin on the front, as is done with a standard tummy tuck, AND removing the skin of the lower back and upper buttocks. The scar will go all the around, like a belt, but is completely hidden under bikini or underwear. The other advantage of this procedure is that you will get improvement in the appearance of your thighs, hips, and buttocks. It is the surgical equivalent of “pulling up your pants” and is a great option for people who have lost a significant amount of weight. A Tummy Tuck 360 is also referred to as a circumferential tummy tuck, lower body lift, or “around the world”. It requires an experienced body contouring surgeon with exceptional skill.

The recovery for a Tummy Tuck 360 may be slightly longer than for a traditional tummy tuck, so this may be a factor in your decision.

Also, if you have had a previous standard tummy tuck, you may benefit from a surgery to remove the skin that is still present on your backside.

Can fat transfer be combined with Liposuction, Lipo 360, Tummy Tuck, or Tummy Tuck 360?

Yes, fat transfer can be combined with any procedure. It is very common to use the fat that is removed during the procedures and re-inject it into specific areas of the body. Commonly, the fat is added to the butt and hips. This can be a very powerful was to reshape the body, by using your own tissue instead of implants. Sometimes people seem to lose their curves after procedures such as liposuction or tummy tucks. By adding fat to specific areas, we can put the curves back and give a much better appearance.

Schedule Your Liposuction or Tummy Tuck Consultation Today!

Both liposuction and tummy tucks can be life-changing procedures for those looking to improve their profiles and physiques. At Schulman Plastic Surgery, Dr. Schulman uses advanced techniques that New York City men and women trust. As a board certified plastic surgeon, specializing in body contouring, Dr. Schulman has performed an extensive number of procedures for his highly-satisfied patients. He often combines procedures such as liposuction, tummy tucks, and fat transfers, making him one of the most sought-after plastic surgeons in New York City.

To book your liposuction or tummy tuck consultation today, give us a call at (212) 289-1851, or contact us online!

Do I need Liposuction or a Tummy Tuck?

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Many people have questions about liposuction and tummy tucks. They tend to be confused about the differences between these procedures and have questions about which is the best option for them. So let’s talk about these two, very different, procedures. We will review what each procedure really treats, and how to figure out which one is best for you.

What is Liposuction?

Liposuction is the removal of fat from anywhere on your body. During liposuction, a special tool called a cannula is inserted under the skin through tiny incisions and then connected to a suction pump. The suction helps to remove fat cells from under the skin in the area you are concerned about. This procedure is specific for removal of fat. It does not do anything to directly improve skin, although some skin tightening can occur naturally over several months after liposuction. The scars are small and, when done properly, are usually very well hidden. Small areas of liposuction can be performed using only local anesthesia, while larger areas will require general anesthesia. The amount of fat that can be removed in a single procedure will vary by state. We consider liposuction to be a body-shaping procedure, not a weight loss procedure and requires a different way of healing.

What is a Tummy Tuck or Abdominoplasty?

A tummy tuck, or abdominoplasty, is procedure that addresses multiple aspects of the abdomen. It removes the excess skin of the abdomen and tightens the underlying abdominal muscles that have become separated from weight changes or pregnancies.  Relocation of the belly button is also a part of a tummy tuck. The belly button is brought through a new opening in the abdominal skin. Often, liposuction is performed as part of a tummy tuck to help improve the results by helping to shape the sides. Because skin is removed during a tummy tuck, there is a resulting scar. This scar can be hip-to-hip, depending on the amount of skin removed, and is placed beneath the underwear or bikini line. A tummy tuck can take 2-3 hours and requires general anesthesia administered in a properly accredited operating facility.

How to Decide if a Tummy Tuck or Liposuction is Right for You?

Deciding which procedure is right for you will depend on your specific complaints. If you are someone with tight skin but complains of excess fat, then liposuction is probably the right procedure for you. Liposuction can be performed on those specific areas that you want smaller. It is a terrific procedure for people who are in good shape and near their ideal body weight, but who have “problem areas” where there is fat that is resistant to diet and exercise. For men, these “problem areas” are commonly the chest, abdomen and flanks. For women, it is commonly the abdomen and thighs. Liposuction can be done on any other area of the body.

However, if you have hanging skin of your belly with stretch marks, then you will require removal of the skin. Also, if you have separation of your abdominal muscles, called a diasthasis, then you will require muscle tightening. Abdominal muscle separation usually occurs after pregnancy or changes in weight. Removal of the skin and tightening of the muscles can only be accomplished with a tummy tuck. Liposuction will NOT help these problems.

In general, younger patients with good skin quality, will do well with liposuction. If your skin is loose, or has a lot of stretch marks, then liposuction may actually make the appearance worse, since removing the fat will make the skin even looser.  This means that people who have had frequent or significant weight fluctuations, will usually require skin removal. If you have lost a lot of weight, then it is likely that your skin is hanging and the only way to make it better is to cut it off with a tummy tuck.  If you are a mommy and have had multiple pregnancies, it is likely that your skin has been stretched and is now loose. Also, pregnancy causes abdominal muscle separation. For these reasons, a tummy tuck is usually the solution for the typical “mommy belly”. Additionally, if you are older, your skin has likely lost some of its elastic properties and collagen. In these situations, the skin will not tighten after liposuction, and the appearance can be made worse unless the skin is removed.

If you have extra fat, then liposuction may be for you. If you have extra skin or separated abdominal muscles, you will likely need a tummy tuck.

Let Your Board Certified Plastic Surgeon Decide for You!

So, liposuction is a very different procedure than a tummy tuck. Your Board Certified Plastic Surgeon will be able to examine you and help you understand which is the better option for you. The recovery for a tummy tuck is harder and longer than liposuction, but it may be the best option for you. I would strongly recommend that if you need a tummy tuck, do not choose liposuction since it will only make your problem worse and you will need a tummy tuck even more.

Contact Schulman Plastic Surgery to Book Your Plastic Surgery Procedure.

Contact New York City Plastic Surgeon Matthew Schulman, M.D. today and schedule your procedure.

New Plastic Surgery Techniques in New York City

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As a Board Certified Plastic Surgeon and Assistant Professor of Plastic Surgery at The Mount Sinai School of Medicine in New York City, I am always looking for the latest advances in cosmetic plastic surgery. Techniques and Technologies are constantly evolving. Many of these new methods are really nothing new, but every once in a while something really exciting comes along that allows me to offer my patients better results with less pain, recovery, and scarring. There have been a few of these advances that I am really excited about. These include Smooth Tuck®, Keller Funnel™, and PermaLip™.

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