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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Candidates for an abdominoplasty (tummy tuck) have some or all of the following problems:

  1. Loose skin on the lower abdomen
  2. Stretch marks on the lower abdominal
  3. Abdominal muscle laxity
  4. Pubic laxity

Good abdominoplasty candidates should be healthy non-smokers. Avoiding smoking is important to decrease risks. Although it’s better for patients to be near their ideal weight, many patients who are overweight are still good candidates for the procedure.

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

Cosmetic Surgery Tip #5: Don’t be influenced by price or advertising

 

 

While offers and discounts might be attractive in a supermarket, a cosmetic procedure is not something which should be offered at a cut price. Remember that ‘cheaper’ does not necessarily mean ‘better’. Focus on the reputability of the plastic surgeon and the quality of their treatment. Never be coerced into undergoing a cosmetic procedure by a clever marketing campaign or a financial offer.  Take your time in making informed decisions.

VECTRA® 3D Imaging Can Simulate Cosmetic Procedures

Here is an update from CosmeticCulture SkinSpa & Laser Clinics  about the recent advances in three dimensional (3D) photography combined with revolutionary new software allow prospective patients to preview what they will look like after a breast augmentation, facial procedures, and more…

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New technology allows patients to preview how they will look with cosmetic procedures

Both the VECTRA® 3D camera and Sculptor software were developed by Canfield Imaging Systems of Fairfield, NJ, the world’s leading provider of medical photography systems. The process starts with a VECTRA® 3D session which produces a three-dimensional photograph of the patient. Then, using Sculptor software, the surgeon is able to simulate the expected results of a variety of cosmetic procedures.

Brazilian butt lift surgery task force set up after alarming death rate

A DANGEROUS butt procedure has a higher death rate than any other and Aussie women are being warned to think carefully before committing to it.

A NOTORIOUS surgical procedure, known as the Brazilian Butt Lift, is now considered so dangerous that a specialist Aussie task force has been set up to warn women of its risks.

Inspired by “bootylicious” celebrities and social media stars such as the Kardashians, Jennifer Lopez and Beyonce, the risky operation has raised alarms after a number of complications and number of deaths.

BBL is the colloquial term for buttock fat grafting, an elective cosmetic procedure which can cost up to $14,000 and involves removing fat from one part of the body via liposuction and transplanting it via injection into the butt for a fuller, perkier effect.

According to the Australasian Society of Aesthetic Plastic Surgeons (ASAPS), the mortality rate for BBLs is estimated to be one in every 3000 operations — meaning it has a higher rate of death than any other cosmetic procedure.

THE BOOTYLICIOUS EFFECT

The BBL’s popularity has increased over the last few years, with the American Society for Aesthetic Plastic Surgery tracking a 26 percent jump from 2016 to 2017, making it the surgical procedure that saw the second most significant increase performed year over year.

However, its complications have thrust it into the medical spotlight and plastic surgeons across the world have expressed deep concerns over its increasing popularity.

ASAPS has now backed a new “patient safety task force” to investigate the risks and improve patient safety of the increasingly popular procedure in Australia.

“In short, the butt is becoming the new breast,” Dr Tim Papadopoulos, specialist plastic surgeon and past president of ASAPS said.

Kim Kardashian has always denied having a BBL procedure. Picture: Mega Agency
Kim Kardashian has always denied having a BBL procedure. Picture: Mega Agency Source: Mega
‘Bootylicious’ singer Beyonce is an inspiration for many young women. Picture: Mega Agency
‘Bootylicious’ singer Beyonce is an inspiration for many young women. Picture: Mega Agency Source: Mega

Five of the world’s leading plastic and cosmetic surgery-related organisations have banded together to form an “Inter-Society Buttock Fat Grafting Task Force” to research complications and deaths associated with BBL.

“Action must be taken now in order to prevent further tragedies from occurring,” Dr Papadopoulos said.

“The task force is concerned with the high mortality rate of this operation and is aggressively investigating ways to make this procedure safer.

“This new warning emphasises the continued risk that is being encountered with this procedure. Patient safety is the highest priority for plastic surgeons and this multi-society task force is an important and unprecedented collaboration.”

He said the procedure had resulted in an “alarming rate of mortality”.

“This rate of death is far greater than any other cosmetic surgery,” he said. “Having said that, there has been no reported case of a death from BBL in Australasia.”

He this may be due to the cultural and ethnic differences and perceptions of beauty regarding bums.

“Although social media has had a huge influence in promoting BBL, especially with celebrities like Kim Kardashian and Jennifer Lopez, the volumes of buttock fat transfer overseas don’t necessarily translate to what’s going on here in Australia,” Dr Papadopoulos said.

The surgery can cost up to $14,000. Picture: Supplied/ Cosmos Clinic website
The surgery can cost up to $14,000. Picture: Supplied/ Cosmos Clinic website Source: Supplied

“In the USA, the large African-American and Hispanic populations have generally dictated their beauty norms which promote larger backsides and smaller breasts.

“This is not the case in Australia where women generally prefer larger breasts and smaller backsides.”

WHAT THE TASK FORCE WILL DO

The task force will examine the causes behind complications and deaths to try to prevent them from occurring through a variety of doctor and patient safety education measures, including unprecedented research.

Once those results are finalised, a comprehensive set of guidelines for the procedure will be submitted for publication in major clinical journals.

“Interestingly, while this procedure has been done for decades, it wasn’t recognised as risky until recently,” Dr Papadopoulos said.

The alarm bells started to ring for some surgeons after a 2015 study which looked at 19 BBL-related deaths in Colombia and Mexico over a 15-year period.

A 2017 report also noted at least 25 fatalities in the United States in the preceding five years.

WHY IS THE BBL SO DANGEROUS?

Dr Papadopoulos says every BBL-related death is caused by bits of fat (or “emboli-globules”) which enter the blood stream and clog up the patient’s heart.

“The cause of death is emboli-globules of fat that inadvertently enter the gluteal veins and swiftly make their way up to the heart and lungs, causing patients to arrest and die usually in the operating room during the procedure or in the recovery room shortly after,” Dr Papadopoulos said.

Tim Papadopoulos said women should research the procedure carefully.
Tim Papadopoulos said women should research the procedure carefully. Source: News Corp Australia

“These emboli are unique to the buttock area, as fat injections in the breast, face and thighs don’t produce this same phenomenon.

“The gluteal veins’ distinctive anatomy makes them especially vulnerable because they’re very big and thin, and only one tributary away from the inferior vena cava, which is the major vein in the body running from the pelvis to the heart.

“If a surgeon nicks one of these gluteal veins or they tear because of traction from pooling of fat beneath the muscle, it’ll act like a siphon, sucking in fat around it, and ultimately sending fat up into the heart.”

WHAT TO DO IF YOU WANT A BBL

Dr Papadopoulos said any patients interested in the procedure should research and trust only FRACS-qualified Specialist Plastic Surgeons at accredited and licensed facilities or hospitals. “You should ask to see before-and-after photos and ask for patient references,” he said.

“You, too, should stay informed on the issue, and when consulting with doctors, don’t hesitate to question their approach.”

To find a suitable surgeon search through the Australasian Society of Aesthetic Plastic Surgeons Member Database.

– Ben Graham 

Article Source: news.com.au

3 Tips to Consider Before Body Lift Surgery

Body lift surgery is a complex operation that requires a lot of information to be processed and considered. There are 3 main points that people interested in this procedure should keep in mind especially that this involved both a major physical and psychological recovery period.

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1. Make Sure You Have Appropriate Motivation & Realistic Expectations

Make sure you are doing the body lift surgery for yourself and for the right reasons and that you have realistic expectations.  Be aware that an improvement in the problem area may not necessarily translate to an overall improvement in your life or home situation.  You are bound to be disappointed with results of body lift surgery if your motivation is not intrinsic.
 Timing of your body lift surgery is crucial. Generally, it is not a good idea to have body lift surgery done during or immediately after a stressful period in your life e.g. divorce or death of a loved one. The additional stress of body lift surgery will undoubtedly be  more challenging to deal with if your emotional reserves are already exhausted. Take note that an improvement in your physical appearance will not necessarily translate to an improvement in your life situation.
 Lastly, keep in mind the end results as you go through the sometimes tough, emotional times after your body lift surgery.

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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.

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

Cosmetic Surgery tip #30: Supplement with a natural stool softener

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After surgery, many patients find that they are very constipated for several days which can cause discomfort.  Dehydration, narcotics and anaesthetic agents used during surgery all contribute to the digestive issue.  You can prevent this problem by eating a few prunes each day just prior to and after your surgery.  You can also take medical stool softeners like oral Dulcolax® or Microlax® enema for post-op constipation.

Photo Credit: Saul Steinberg “Masquerade”

7 things you should know about Rhinoplasty

1)  Cosmetic Plastic Surgeons can sculpt your nose and make it look better, but they have to work with what they are presented.  In other words, you need to reconcile desires with reality.  What do you want and what will my nose allow me to have?  It’s fine to provide your cosmetic plastic surgeon with photos of noses you like, but keep in mind that you may not always get what you want but actually what you need and what is in keeping with your framework.

2)  Perfect noses don’t exist after rhinoplasty.  It’s likely that you’ll still find flaws, possibly any bump on the nasal bridge or an uneven nostril.  Try to keep in mind that you’re going for improvement, not perfection.

3)  You may have “raccoon eyes” and look a bit like an Egyptian mummy for the first few days post-operatively.  If the nose needs to be broken, expect a splint over the bridge of your nose, possible packing in your nostrils and a pad taped under your nose to catch drainage.

4)  Don’t wear glasses/sunglasses for the first six weeks post-operatively, so that the nasal bridge can heal correctly.

5)  You may find this surprising but rhinoplasty is usually painless, especially if you stay on top of your medications.  You will, however, be tired and possibly nauseas.  Your breathing may have been improved if a deviated septum was fixed at the same me.  Sometimes, breathing may be made significantly worse after the procedure (this may result in a very nasal voice for a few weeks to months) but generally improves once the swelling subsides.

6)  What most people find amazing who have had a rhinoplasty is how many family members and friends won’t notice you’ve had anything done despite having your nose reshaped and many weeks recovering.

7)  Right after your new nose is revealed, you don’t look exactly like yourself and that can feel strange and you may feel a sense of disappointment.  You need to give things me to settle down: usually 70 % of the result is seen at 3 months and typically you have to wait 12 months for the final result.

Thanks for reading!

 

Dr Tim – Sydney Cosmetic Plastic Surgeon

www.cosmeticculture.com.au
www.drtim.com.au