Abdominoplasty as part of a Mommy Makeover

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A Mommy Makeover may be performed in one or more stages. Age, health, needs and desires are all considered carefully when formulating a plan for each patient. Many patients choose to do more than one procedure at a time.

The abdomen tends to experience the greatest change following pregnancy with stretch marks, loose skin and lower abdominal fat being the most common complaints. The abdominal muscles may also be stretched to the point that they remain separated in the midline, accentuating the patient’s lower abdominal bulge. To treat these problems, an abdominoplasty (tummy tuck) can be performed where excess skin and fat is removed from the abdomen and the muscles tightened.

After having children, fat tends to redistribute to new areas on the body where it may be unwanted. This is frequently true even if women are successful at losing their baby weight. Most often, bulges of fat accumulate around the waist and on the thighs. On these areas, liposuction is frequently performed as part of a Mommy Makeover. My preferred technique is power-assisted liposuction (PAL), the safest and most effective way to remove fat from these areas.

The breasts also go through dramatic changes with pregnancy and breastfeeding. Patient concerns about their breasts vary greatly, but the most common breast procedures I perform as part of a Mommy Makeover include:

  1. Breast augmentation
  2. Breast augmentation and lift (Augmentation Mastopexy)
  3. Breast lift
  4. Breast reduction

To learn more about abdominoplasty (tummy tuck), request a consultation by contacting us at 13000DRTIM or emailing us at info@drtim.com.au 

 

This middle aged lady underwent a Body Lift following massive weight loss of 70kg with diet and exercise alone. DrTim demonstrates the 2 phases of the operation- starting on the back by removing excess tissue and lifting the buttock region and finishing on the front by further excising tissue, performing a lateral thigh lift, tightening the separated rectii muscles and reconstructing the belly button. The B & As show a much better contoured torso with an improved waistline.

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Body Lift: What type of techniques are there?

 

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Body lifts can be performed in two different ways, to treat either the upper or the lower body:

  • Lower body lift: The lower body lift is the most common type of body lift in my practice. It typically includes a tummy tuck (abdominoplasty), thigh lift and buttocks lift performed at the same time. The incision is concealed around the waistline so that it’s not visible when wearing underwear or a bikini.
  • Upper body lift: For patients with severe skin laxity of the upper torso, an upper body lift may be the appropriate treatment. This typically includes a bra line back lift and upper abdominoplasty. The procedure is individualised for the particular patient.

To learn more about body lifts, request a consultation by contacting us at 13000DRTIM or emailing us at info@drtim.com.au 

Tummy Tuck Gives You a Waist You’ve Been Longing For!

Flabby bellies are notoriously difficult to control through diet and exercise.  Liposuction may be beneficial for someone who has extra fat around the abdomen, but anyone who also has lost muscle tone and developed extra sagging skin will require a tummy tuck, otherwise known as an abdominoplasty, to achieve a flatter waistline.

A tummy tuck addresses all three major problem areas at once. In one operation we remove:

1)  excess fat,

2)  saggy skin, and

3)  tighten abdominal muscles that may have become distended with pregnancy or age.

Men and women can develop abdominal wall weaknesses as they age that can be repaired during a tummy tuck.

During pregnancy, women lose their waistline as a result of the spreading of the surrounding tummy muscles. This spreading is referred to as ‘diastasis recti’ and is not an actual hernia but does cause a bulge from the pubic area to just above the belly button. Men may also experience this spreading following weight gain or in the presence of abdominal hernias.

The modern tummy tuck is not only a removal of skin but also an operation on fat, and muscle. Incisions for a tummy tuck are made below the bathing suit line from hipbone to hipbone and are generally tailored to the patient’s wishes. Some female patients prefer to wear french cut bathing suits. In that case, the incision comes up a little higher on the side extension. For those patients who prefer a traditional cut swimsuit, the incision is made right at the hip line. In all cases, the incision and resulting scar are fashioned to meet the patient’s wishes and afford them complete camouflage in a bikini or other bathing suit.

Next, an incision is made around the belly button. While the belly button is left intact on the underlying muscle, the tissues beneath are elevated from the lower tummy to the rib cage area and redundant skin and fat are removed, exposing the abdominal wall. At that point, the abdominal wall is lightened by suturing together (or “lacing-up”) the abdominal muscles and repairing any damage that occurred during pregnancy or weight gain. At no time are these muscles actually cut.  It is the lightening of the muscles that really reduces the waistline (and is the main reason for the post-operative pain in tummy tucks). We then perform liposuction on the abdominal wall, waist, hips and “love handles” in an effort to create a smooth, pleasing contour across the entire waistline.

Finally, the tummy skin above the belly button is stretched down to the meet the incision at the pubic hairline. A small incision is made for the belly button, which will reach back through the abdominal wall as usual. The shape and nature of the belly button don’t change unless a patient specifically requests it. Any hernias of the belly button can be corrected. For example, ‘outies’ can be made ‘innies’ or it can be made a bit smaller if the patient so desires. Patients are usually instructed to wear a ”girdle” or medical compression garment over the entire tummy area to provide support and comfort while healing. It takes generally two to three weeks to make a complete recovery, and most of our tummy tuck patients are back to work within three to four weeks.

Question: What steps do you take to try and get rid of that bothersome flabby tummy? You can leave a comment below.

What Is a Mummy Makeover?

Many of today’s mums don’t feel they should sacrifice the way they look just because they’ve had children. After multiple pregnancies and breastfeeding, many women find it impossible for diet and exercise alone to restore their figures. These women usually want their tummies and breasts back the way they looked before pregnancy.

These so-called “Mummy Makeovers” are usually performed on women in their 30s or early 40s. There are multiple variations of the Mummy Makeover, of course, and I individualise the plan for each patient depending on their needs. Many women will not need or desire all of these procedures. Each patient determines what her personal Mummy Makeover will involve after we discuss her concerns and options in a thorough consultation.

A Mummy Makeover may be performed in one or more stages. Age, health, needs, and desires are all considered carefully when I formulate a plan for each patient. The majority of my patients choose to do more than one procedure at a time. I’ve had a great deal of experience performing these combined surgeries over the past decade. We take many steps to assure both minimal pain and maximum safety during our procedures:

  1. TUMMY TUCK: The tummy tends to experience the greatest change following pregnancy with stretch marks, loose skin and lower tummy fat being the most common complaints. The tummy muscles may also be stretched to the point that they remain separated in the midline, accentuating the patient’s lower tummy bulge. To treat these problems, I perform a tummy tuck where I remove the excess skin and fat from the tummy and tighten the muscles. Whenever we do a tummy tuck as part of the Mummy Makeover, we perform liposuction and pay special on to the belly button to help create a nice looking midriff.
  2. LIPOSUCTION: After having children, fat tends to redistribute to new areas on the body where it may be unwanted. This is frequently true even if women are successful at losing their baby weight. Most often, bulges of fat accumulated around the waist and on the thighs. On these areas, I frequently perform liposuction as part of a Mummy Makeover.
  3. BREAST SURGERY: The breasts go through dramatic changes with pregnancy and breastfeeding. Patient concerns about their breasts vary greatly, but the most common breast procedures I perform as part of a Mummy Makeover include:

Many of our patients for the Mummy Makeover travel from places outside of Sydney. Our staff can help with the planning of these sorts of trips through our CosmeticCulture Makeover Vacation Program, which makes travel for cosmetic surgery quite easy. More information is available on our website www.cosmeticculture.com.au, including descriptions of tummy tuck and breast augmentation or breast lifts as well as liposuction. You can also email us for more information at info@drtim.com.au or call us at 13000DRTIM.

Question:  Which parts of your post-childbirth body would you like to change with a Mummy Makeover? You can leave a comment below.

Why a Body Lift Can Help You After a Massive Weight Loss

If you desire a firmer, more youthful-looking body contour, then a surgical body lift may help achieve your goals. It improves the shape and tone of the underlying tissue that supports fat and skin. In addition, the procedure(s) can improve a dimpled, irregular skin surface, commonly known as cellulite.

Body lift surgery essentially sculpts the body by excision of excess skin and fat and reconstruction of what remains into some reactive contours. Body lifts can be performed in two different ways, to treat either the upper or the lower body:

  • Lower body lift: The lower body lift is the most common type of body lift in my practice. It typically includes a tummy tuck (abdominoplasty), thigh lift, and buttocks lift performed at the same time. The incision is concealed around the hipline so that it’s not visible when wearing underwear or a bikini.
  • Upper body lift: For patients with severe skin laxity of the upper torso, an upper body lift may be the appropriate treatment. This typically includes a bra line back lift and upper abdominoplasty. The procedure is individualised for the particular patient.

Candidates for body lifts typically have lost large amounts of weight. They should be healthy and well-nourished without vitamin or mineral deficiencies. They should not smoke, as smoking increases the risk of complications.

Body lift is performed under general anaesthesia, with the patient positioned on their stomach, and the surgeon removes a large, belt-like segment of skin above the buttocks, up to the lower back. When the wound is closed, the thighs and buttocks are lifted. The patient is turned over and the surgeon continues to work on the front of the thighs and abdomen. Indeed, when a surgeon performs a circumferential removal of skin and fat of the lower abdomen, and when combined with undermining of the thighs, it will lead to a lift of the buttocks and thighs. A body lift can be done in two stages, with a three-month gap between procedures, or as a single stage surgery.

Patients usually take at least two weeks off from work following a body lift. I encourage patients to ambulate shortly after surgery. They may resume full exercise approximately 6 weeks following surgery. The results of a body lift are visible almost immediately. However, it may take as much as one to two years, or more, for the final results of the body lift procedures to fully develop. Since weight loss patients have poor skin elasticity, the closure must be as tight as possible. However, over-resection of the skin followed by overly tight closure of the tissues can lead to wound rupture or to broadly depressed scars resulting from suture pull through, breakage or premature dissolution. At the same time, insufficient removal of skin and low-tension closure leaves sagging tissues, skin rolls and/or wrinkles. A body lift should be seen as a critical step in overcoming obesity, with the potential of ceasing or reducing medications used for diabetes and high blood pressure. Patients need to take steps following surgery to maintain a healthy lifestyle, ensuring that their new shape will be long term.

Question: Do you feel that a body lift can improve self-esteem following massive weight loss? You can leave a comment below.

Is CoolSculpting® An Alternative To Liposuction?

CoolSculpting is a non-invasive, clinically proven procedure to selectively reduce fat layers in problem areas using a patented cooling technology. It is a safe procedure that gently cools unwanted fat cells in the body to induce a natural, controlled elimination of fat cells. This reduces bulges in treated areas of the body without harming surrounding tissue.

CoolSculpting Female Pic

Tummy Tuck: 3 essential things you must know!

  1. Before a tummy tuck

When you continually gain and lose weight, the excess tissue composed of skin and fat in the lower part of the tummy becomes a real problem for some people. This excess tissue along with the underlying lax muscles can be dealt with by a surgical procedure known as a tummy tuck, otherwise known as an abdominoplasty. Removing the “muffin top” (the tissues between the belly button and pubis), then re-draping the skin from above the belly button to meet the skin on the pubis and repositioning the belly button, are the basis of all tummy tucks.

One of the keys to a tummy tuck is finding out how much excess skin and fat, as well as, muscle laxity you have in your tummy, is to bend over at the waist and “let it all hang out.” The next step is to pinch these tissues and tighten the tummy muscles, which will give you an idea of how much of the tissues need to be removed.x

Also, you will notice that most of the tissue bulk is in the midline and fades out at the sides. If you imagine this excess tissue as an ellipse on the lower tummy, it will give you an indication of how long the scar will be from one side of the hip to the other. I tell all my patients that the resulting scar can be concealed, that it will generally fade with time, but will always be there.

 

  1. Tummy tuck operation

Just prior to beginning the tummy tuck, I mark the tummy while the patient is standing up. I mark the midline from the xiphoid (“breast bone”) to the pubis. This enables me to realign the midline after removing the excess tissues and to place the belly button in the midline. A second line indicates the position of the lower-tummy incision. This usually lies quite low in the tummy since the most common garment worn by women today is jeans. Finally, areas for liposuction are marked in the upper tummy, the hips and lower flanks (liposuction thins the tissues and allows them to re-drape better).

Our anaesthetists use a laryngeal-mask airway (a breathing tube that sits at the back of the throat) and do not paralyse the patient, allowing them to breathe independently during the entire operation. I begin the tummy tuck operation with liposuction to the tummy, hips and lower flanks.  Then, I incise the skin around the belly button which is still attached to the underlying muscle wall. After making the lower tummy incision, I widely undermine the tissue up to the level of the belly button. I continue the dissection above the belly button to the level of the xiphoid process (lower part of the sternum), making a central tunnel (about the size of a hands width). I then “lace-up” the separated muscles of the midline from above and below the belly button.

Next, the patient is bent at the waist to 45 degrees, and the excess tissues removed so that the two skin edges may be closed without tension. Two drains are brought out below the pubic hairline to capture any excess fluid that may build-up in the tissues. These usually are taken out between day 3 to 5 when the drainage is less than 30 ml’s or so. Lastly, I bring out the belly button at the midline, usually 12 to 15 cm above the lower tummy incision and place a tummy binder on the patient at this time and adjust it to allow for moderate compression.

The patient is kept in a bent position at the waist and knees as they are transferred to the recovery bed.

 

  1. After tummy tuck surgery

After a tummy tuck, the patient will continue to wear TED (compression) stockings and automated calf compressors for 24-48 hours and be commenced on blood thinning agents the following day to lessen the chance of deep vein thrombosis (clots in the legs) or pulmonary embolism (when these clots break away from the legs and migrate through the venous system to the lungs causing a “lung attack”).

The patient is instructed to sleep with several pillows behind her back and a pillow beneath their knees.

They are encouraged to walk to the bathroom the following day, have showers and to undergo regular chest physiotherapy. Patients are advised to wear the tummy binder continuously for the first 4 weeks after surgery, except when they wash themselves or the binder. After this period, I allow them to wear it only at night if they wish, but many choose to wear it longer. I also advise patients that it takes 4 weeks to get back to normal activities of daily living and 6 weeks to resume aerobics exercises.

 

Question: What questions do you have about tummy tuck surgery? You can leave a comment below.

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Patients usually take at least 3-4 weeks off from work following a body lift. I encourage patients to ambulate shortly after surgery. They may resume full exercise approximately 6 weeks following surgery.

To learn more about body lifts, request a consultation by contacting us at 13000DRTIM or emailing us at info@drtim.com.au 

Brachioplasty (aka Arm Lift) for “Bingo Arms”

Brachioplasty (or Arm Lift) removes loose skin and fat from the upper arm. It ranks high on the wish list for many plastic surgery patients who have lost large amounts of weight or who have heavy upper arms due to simple genetic factors. Loose skin hanging from the arms tends to make patients self-conscious, limits clothing options and can even cause people to avoid certain activities, like swimming or playing tennis. Good candidates for brachioplasty are often weight loss patients who shed many kilograms, resulting in excess skin and stray fat deposits. Furthermore, post-bariatric patients should be near their desired weight and well nourished. Men or women with loose upper arms due to heredity and ageing may also be interested in brachioplasty. It’s best not to smoke for proper wound healing.

Techniques

There are a variety of techniques to chose from, so choosing the best approach for each patient’s particular needs is the no. 1 priority of the plastic surgeon. Each patient is unique in terms of skin laxity and other factors. Patients may benefit from one or a combination of the following techniques:

  1. ELBOW TO ARMPIT: An incision from the fold of the elbow to the axilla, or armpit, yields dramatic improvement. This approach is frequently combined with liposuction to eliminate stubborn fat pockets and loose skin. Most brachioplasty candidates choose this method.
  2. LIPOSUCTION ONLY: Patients with some skin elasticity remaining may opt for liposuction only. An advantage to this approach is that scarring is minimal. The right candidate can expect significant improvement, but not as dramatic as when skin is removed as well.
  3. MINI-ARM LIFTS: A mini-arm lift is an option for patients with excess skin in the uppermost portion of the arm, and for those concerned about scarring. In this case, I make an incision in the armpit, sometimes extending a 6-8 cms down the arm.
  4. ARM AND ARMPIT LIFTS: Upper arm skin is thin and sags over time. Some people lose so much elasticity that skin hangs down from their armpits as well, causing embarrassment and difficulty with clothing. These patients are candidates for a combination arm/armpit lift with incisions on the upper arm and in the armpit.
  5. ELBOW LIFT: A smaller group of patients have loose skin above and below the elbow. These men and women benefit from an arm and elbow lift. Great care needs to be taken with the incision across the elbow to remove excess skin while preserving range of motion.

Recovery

Most arm lift patients take a week or two off work after surgery. Most of the swelling subsides after 3-5 days and the wound takes about 10-14 days to heal. You will be encouraged to walk as soon as possible, gradually adding light activities over a few days and resuming full workouts and lifting within 6 weeks.

Risks

Complications of brachioplasty have been rare in my experience. These uncommon risks include infection, slow wound healing, bleeding, seroma and venous blood clots. Even if a complication were to occur, diligent post-operative care would still likely lead to a nice result.

 

To learn more about your arm lift options and whether or not you are a candidate, email us at info@drtim.com.au or call our clinic at 13000DRTIM .