Abdominoplasty as part of a Mommy Makeover

BC3.001

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 

Body Lift: What is it?

BC2.001

A body lift is designed to tighten the skin of a patient all the way around their body. The improvements may be dramatic like the patient above. Patients who benefit from this surgery have typically lost a large amount of weight and have significant deformity from skin laxity. The body lift may address the lower body or the upper torso.

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

Abdominoplasty: What does the procedure involve?

BC2.007

An abdominoplasty (tummy tuck) procedure involves the following steps:

  1. Removing a large amount of lower abdominal skin (and stretch marks)
  2. Removing a large amount of lower abdominal fat
  3. Tightening the rectus abdominis muscles of the abdomen
  4. Redistributing the upper abdominal skin over the entire abdomen
  5. Creating a new belly button within the tightened abdominal skin
  6. Tightening the pubic area

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

 

Breast Augmentation: Where are the Incisions and Implants Located?

BAM Gallery2.003

Most plastic surgeons favour the infra-mammary incision location for most breast implants. The peri-areolar incision is made as a semicircle at the lower border of the pigmented areola. It does heal beautifully in most cases and uses the interface of the darker and lighter pigmented skin to camouflage the incision. For patients with small areolae, it may be preferable to use the infra-mammary incision, located underneath the breast. This incision also heals very well, and is especially useful for women with well defined creases under their breasts.

The axillary incision (in the armpit) is another option, but it’s better suited for saline implants than silicone gel. Because this access incision is a greater distance from the implant pocket, it’s less precise than the peri-areolar and infra-mammary approaches. Studies have confirmed that there is a higher implant revision rate using the axillary approach. Usually the axillary scars heal well, but they may still be visible when the patient wears sleeveless outfits. There is also a higher rate of breast implant infections with the peri-areolar and axillary approaches.

Patients frequently ask what effect the incision location has on maintaining nipple sensation after surgery. The answer is that the access incision usually has little effect on nipple sensation. Rather, it’s the size of the implant pocket that has the largest impact on nipple sensation. Large implants may require a pocket that stretches the nerves to the point that they do not function well, increasing the odds of impaired nipple sensation. Even so, the vast majority of my patients maintain normal nipple sensation.

Breast implants may be placed over or under the pectoralis major muscle. In the early days of breast augmentation, all implants were placed on top of the muscle. However, in recent decades, it has become more common to place implants underneath the pectoralis major muscle. The muscle covers the top half of the implant, providing additional thickness of coverage over the implant in the critical cleavage area. This makes it less likely that the implant edges or ripples will be visible when wearing a bra or swimsuit. Studies have also shown that the rate of capsular contracture is lower when the implants are placed under the muscle. Breast imaging to screen for breast cancer is more accurate when the implants are placed behind the muscle. For these reasons, I prefer to place implants underneath the muscle for most of my breast implant patients.

 

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

Abdominoplasty: What’s the recovery like?

BC3.004

Following a tummy tuck, patients should take at least 3-4 weeks to recover before returning to work. Normal exercise routines may typically be resumed approximately 6 weeks following surgery.

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

Breast reduction: Does your health fund cover it?

Untitled 3.005

Breast reduction surgery is considered to be medically necessary if a patient suffers from symptomatic macromastia. The typical criteria for health fund coverage of a breast reduction include: bothersome symptoms detrimental to quality of life, failure of medical therapy prescribed by another doctor, and removal of a minimum estimated weight of breast tissue.

Most health funds will cover this procedure for patients with these symptoms if they have attempted conservative medical treatment without success. The best way to determine if your procedure is medically indicated is in a consultation with me at the clinic.

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

Breast reduction: Are there different techniques and can it be combined with breast lift?

Untitled 3.003

Breast reduction surgery is designed to make the breasts smaller and lighter to alleviate the problems of symptomatic macromastia. However, the surgeon performing the breast reduction is the most important determinant of the quality of the result. There are many different techniques for breast reduction, and each surgeon has his or her own preferences based on experience and patient needs. Often, breast reduction is combined with a breast lift.

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

Abdominoplasty: Can the Caesarian scar be removed at the same time?

BC3.003

During pregnancy, skin may be stretched to the point that microscopic fractures form in the skin, or dermis, resulting in stretch marks (also known as striae). Caesarean section scars may accentuate fatty bulges by tethering the skin to the underlying muscles, causing the fat and loose skin to fold over the scar. The rectus abdominis muscles on the abdomen may become separated in the midline, creating a potbelly appearance. Fat also redistributes with age, becoming concentrated in the lower abdomen. The hourglass waistline of youth gives way to a larger midsection. That’s why many women choose abdominoplasty as part of their “Mommy Makeover” and as a bonus the Caesarian scar can be removed at the same time.

Although abdominoplasty (tummy tuck) can achieve dramatic improvements, it’s important to also consider adjacent areas of the body for optimal results. For many patients, liposuction around the waist and thighs will provide more comprehensive results. Mothers will frequently choose breast surgery as well. This combination of procedures completes their transformation back to the hourglass figure they once had.

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

Body Lift: What type of techniques are there?

 

BC2.003

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 

Breast Augmentation: What Are Your Breast Implant Options?

BAM Gallery2.001

 

The two main categories of breast implants are silicone gel or saline-filled implants. Silicone gel implants have been popular since the early 1960s, and they have gone through multiple generations of improvements since that time. Silicone gel implants have undergone rigorous studies which have shown they are safe and do not cause breast cancer nor connective tissue disorders.

The main advantage of silicone implants is that they feel more natural than saline implants. Gel implants are less prone to rippling than saline, which makes them particularly advantageous for thin patients. The current 5th generation of silicone implants are cohesive, meaning that the gel is viscous enough that even if the implant ruptures the gel tends to remain in the same place, a little like jelly. Previous generations, the silicone was more like thick maple syrup.

Saline (ie. saltwater) implants have a long record of safety too and are less expensive than silicone gel implants. They are generally placed when they are empty and filled once they are inside the breast pocket, so that the access incisions may be even smaller. When a saline implant leaks, most of the saline from the implant is rapidly and harmlessly absorbed by the body. The deflation is usually obvious, and the patient returns for removal and replacement of the saline implant. This may be done under local anaesthesia if the patient is an appropriate candidate. The primary disadvantage of saline implants is that they don’t look or feel as natural as the silicone gel implants. This is a particularly important issue for women who are thin or have decreased elasticity of their skin.

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