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Extended Abdominoplasty Chosen by Major Weight Loss Patients
For patients who have lost significant amounts of weight, tummy tuck procedure may provide smoothing results. Following the procedure, excess fat deposits and inelastic skin may be removed, which are often hard to eliminate through diet and exercise.
For many patients, the standard tummy tuck procedure with a hip-to-hip incision will be sufficient to smooth their midsection and accent the results of their successful weight loss. However, for some cases, particularly those who have lost more weight, the tummy tuck procedure may be customized with a belt lipectomy to provide a greater reduction of excess skin and fat deposits, according to the popular and trusted plastic surgery website RealSelf.com.
Extended Tummy Tuck or Belt Lipectomy for Patients with Significant Weight Loss
The traditional tummy tuck procedure involves an incision made across the front of the stomach from hip to hip, generally underneath the bathing suit line. Excess fat, skin and tissue are removed and the muscles are secured. The skin is pulled down for a smoother appearance. In some cases, the navel is repositioned.
For patients with more significant weight loss, another incision may be made vertically up the center of the stomach, in order to remove additional skin. This is less common, as the resulting incision line is more visible.
For major weight loss patients, the horizontal incision does not stop at the hips, but wraps all the way around the body. The procedure is expanded to treat the back and sides in the same manner as a traditional tummy tuck. An entire belt of fat, skin and tissue is removed, resulting in the “belt lipectomy” procedure name.
According to the American Society of Plastic Surgeons, additional procedures that may be incorporated for patients with major weight loss include an arm lift, breast lift and thigh lift.
Tummy Tuck Vertical Incisions Unlikely in Most Cases
Patients undergoing a tummy tuck or abdominoplasty procedure will generally not require a vertical incision due to the high visibility of this location. In most cases, the surgeon will simply make their incision across the stomach just below the underwear line. For some cases, another incision will be made that encircles the belly button and allows for its repositioning.
The use of a vertical incision is only used when absolutely necessary, as these incision lines are more difficult to conceal with clothing that bares the midriff. According to the trusted plastic surgery website RealSelf.com, this incision is generally only used when patients have had significant weight loss, such as 100 pounds of weight or more.
Vertical Incision Used for Patients with Significant Weight Loss
As with other body contouring procedures such as arm lifts, thigh lifts or breast reduction, there are a number of variables that determine the necessary incisions for each patient. The significance of each of these variables must be balanced in deciding what incisions are necessary for the best result. According to the American Society of Plastic Surgeons, some of these factors may include:
- Amount of weight lost
- Elasticity of abdominal skin
- Previous surgical history
- Individual anatomy and tissue position
As a result of these factors, each patient’s incisions will be specifically dependent on their situation. Talking these factors over with your surgeon prior to the procedure will help ensure that your eventual result will best meet your needs.
Generally, vertical incisions are used as a last resort when any of the above factors play a significant role. When vertical incisions are determined to be necessary, the length of the vertical incision may still vary. In minimal cases, the incision may only extend to the bellybutton, but in cases with more significant skin removal required, the incision may extend several inches further upwards.
Tummy Tuck Procedures with a Hernia Repair Included
When having a tummy tuck procedure or mommy makeover, it may be convenient to add the repair of any hernias sustained as a result of pregnancy. The changes the body goes through during pregnancy and childbirth may often cause these hernias in addition to the aesthetic issues addressed by a tummy tuck.
While each case is different, speaking with your surgeon regarding your surgical options will help you to ensure the best possible treatment of your set of conditions. Some patients are eligible to combine these procedures, saving time and avoiding the need to do two surgeries and recoveries.
Hernia Repair May Be Needed Following Childbirth
Most childbirth-related hernias tend to be around the umbilicus and between the rectus muscles at the midline. This area is often easily accessed during a tummy tuck, and may be prepared very conveniently during the normal tummy tuck procedure. Choosing to combine the procedures often means that an open surgery will be more effective to handle both objectives, rather than a laproscopic procedure.
However, there are several variables when it comes to hernia repair. The severity of the herniation and the specific location may contribute to a more complex procedure than what is described above. Diagnostic imaging will help determine these conditions, and will help your surgeon determine the best course of action.
For some situations, your plastic surgeon may wish to involve a general surgeon to handle more serious hernias, though the procedure may sometimes still be handled in one surgical session. In other cases, your surgeon may wish to split up the procedures to ensure the very best results for your body.
In the medical community, there much controversy over whether patients may be able to have a portion of the procedure covered by their insurance. Speaking with your surgeon regarding your medical and financial situation in detail will help you determine if there will be any financial benefit to this combination.
Some patients may also wish to combine their hernia repair with a full mommy makeover, which includes a breast procedure like breast augmentation or breast lift.
Incision Locations and Scar Management for Tummy Tucks
Tummy tucks, or abdominoplasties, are performed on an individual basis to ensure that your personal wishes and needs are met with the results. This may include variable incision locations and the number of incisions. When determining these factors, your surgeon may consider your medical history, location of treatment areas, and preferential swimsuit style.
In the tummy tuck procedure, the major incision is made from hip to hip across the front of the abdomen. The placement of this incision is based on unique personal anatomy and may often be hidden within swimwear. In addition, you may require a second incision to be made around your belly button.
Belly Button Scars Not Required for Every Procedure
According to the American Society of Plastic Surgeons, it may not be necessary for every patient to have an incision made around their navel. This particular aspect of the procedure is determined by the severity of the condition. For cases with excessive and inelastic skin around the navel, an incision here is highly recommended.
If you do not have excess or inelastic skin on your stomach, you may be able to avoid the navel incision. This is particularly useful for situations where excess fat deposits are localized around the sides, hips and lower stomach.
Tattoos are one option that many patients choose for concealment of their navel or stomach scarring. Several doctors on RealSelf.com advocate for this method of concealment, providing the scar has healed fully. Regardless, it is crucial that you discuss the matter fully with your surgeon. This ensures that you will be aware of any potential risk factors and the timeline of your complete incision healing and recovery.
The tummy tuck procedure is often combined with liposuction for a more effective result. It is also performed with a breast augmentation as a mommy makeover, or with a thigh lift for a lower body lift.
Saline or Silicone? And Other Important Implant Decisions
While the choice between saline and silicone is among the most important breast implant decisions, many women don’t realize that it’s just one among many choices that they’ll have to make. There are many different breast implant options available, and you’ll need to consider these factors before you can find the breast implant that’s right for you.
Saline and Silicone Breast Implants
Saline implants consist of a solid silicone shell filled with sterile saltwater. They can be prefilled to a certain size, or filled at the time of the surgery after being implanted. This allows greater choice and customization during your breast augmentation. Saline implants can be inserted by a smaller incision than silicone implants.
Despite all these benefits, however, saline implants may not feel as natural as silicone-filled implants if you lack sufficient breast tissue.
Silicone implants are filled with silicone gel. They come in a variety of sizes, either with smooth or textured shells. Because they come prefilled, silicone implants require a longer incision. They offer a more natural field and saline implants, but may rupture without your knowledge, so that regular MRIs after your breast augmentation surgery will be necessary.
Gummy Bear Implants
The most recent implant to hit the US market is the cohesive gel, or “gummy bear,” breast implant. Unlike other silicone implants, gummy bear implants can retain their shape when cut in half. Their texture and stability has resulted in the “gummy bear” nickname.
Proponents of gummy bear breast implants say that they:
- last longer
- maintain a better shape
- resist wear and tear associated with gravity
- are less likely to leak
Regardless of what type of breast implant you choose, it’s important to find a board-certified plastic surgeon who is familiar with the advantages and disadvantages of all different types of breast implants.
Bethenny Frankel Talks About Her Breast Surgeries
Most celebrities prefer not to discuss their plastic surgeries in public. But then again, most celebrities aren’t Bethenny Frankel. The 41-year-old talk show host recently discussed her experiences with cosmetic breast surgery on her Bravo TV show.
Her journey with breast surgery didn’t begin until her early 30s, but Frankel says that she experienced issues with her breasts as early as teenagehood.
“I was in high school and probably about 30 pounds heavier and my boobs used to sag. They were bigger and they were saggy. They would almost like touch your stomach, when you feel like it’s hot and sweaty. I could’ve put a diet Coke can underneath and hold it because they were heavy and saggy.”
Frankel managed to shed her extra weight in her late 20s and early 30s. Unfortunately, like many women who undergo weight loss, she found that this resulted in her breasts shrinking in size. This left her with excess skin on the breasts. “They were small. They were nice. They were probably like a C, but they were really still saggy,” Frankel says.
After consulting the doctor about getting a breast lift, Frankel decided against the procedure, because she was apprehensive about unwanted scars. “I felt self-conscious that as a single woman going out and meeting men. I felt like I would be scared. So, he said put a small implant in it and it will lift it. I ended up with a D, and I didn’t feel like it was right on me. I felt kind of sloppy.”
However, as the years wore on, Frankel grew increasingly dissatisfied with the state of her breasts. After several years, she returned to the doctor to have her implants removed and breasts lifted. She says that the procedure has made a huge difference in her bodily appearance and self-confidence. “I did feel much better. I felt like I was a little hotter, you know, a little perkier.”
“Fanny Pack” Lipo Featured on The Doctors
They’re called problem areas: parts of the body where fat endures despite your best efforts at diet and exercise. One of the worst problem areas is your lower back, just above the tailbone, which often carries a fatty deposit popularly known as the “fanny pack.” Fortunately, with liposuction, you can fight back against the pack. One woman’s journey through weight loss and surgery was recently profiled on The Doctors.
“I’ve been overweight for most of my life and I recently lost 70 pounds and I feel amazing,” says Christina, who appeared on the hit ABC show.
“Even though I’ve lost all this weight, I still have a problem area which I call my fanny pack. It’s the little area of fat that’s just above my butt. I have so many pairs of jeans that I wish that I could wear but the only things that will fit me are leggings. Fanny packs are not flattering and I’m ready to get rid of mine.”
Technically known as the lumbosacral fat pad, the fanny pack is usually impossible to remove with diet and exercise alone, says Dr. Travis Stork. After everything else had failed, Christina sought the help of a cosmetic surgeon to remove her fanny pack with liposuction.
Liposuction to remove a fanny pack is a relatively quick plastic surgery that can take place under local anesthetic. After liposuction surgery to remove the fanny, the fatty deposit is gone for good, as long as you maintain a decent exercise regime to avoid gaining more weight. Liposuction that targets problem areas is often performed after major weight loss.
Christina’s recovery after her liposuction was relatively fast and comfortable. She wore a compression garment for about a week and was able to return to regular exercise within 10 days.
Exercise May Prevent New Fat From Forming After Liposuction
A recent study by researchers from the University of São Paulo has revealed that exercise after liposuction surgery may do more than simply maintain the results of the procedure. According to the study results, which were published in The Journal of Clinical Endocrinology & Metabolism, a lack of exercise after recovering from liposuction can cause an increase in harmful visceral fat.
The Brazilian researchers, who wanted to learn about the health benefits of exercise after liposuction surgery, followed 36 women in the months after they received the liposuction to remove abdominal fat. The women all admitted to not having engaged in regular exercise before the surgery. Two months after their liposuction surgery, half of the women were asked to begin a regular exercise routine, working out three times per week.
Four months after the surgeries, the researchers found that all of the study participants still had flatter bellies. However, the women who had not exercised experienced an increase in visceral fat, which did not develop in the group that had exercised.
What is visceral fat?
These are fatty deposits that surround the internal organs, especially the liver. They lie deep within the abdominal cavity and can often go undetected; unlike subcutaneous fat, they cannot be pinched. Visceral fat has been linked to a number of health issues, including:
- metabolic disturbances
- heart disease
- diabetes
- breast cancer
- gallbladder problems
The researchers concluded that “if one should choose to undergo liposuction, it is very important [to] exercise after surgery.” Of course, preventing an increase in visceral fat is only one among many benefits of regular exercise
It’s commonly believed that liposuction is a miracle weight-loss strategy, but this couldn’t be further from the truth, as this and other studies attest. Liposuction is a surgical procedure designed to remove fatty deposits in places that have not responded to diet and exercise. Although often used for body contouring after major weight loss, it is no substitute for a healthy lifestyle.
Liposuction Doesn’t Reduce Obesity-Related Health Risks
The belief that liposuction can help to reduce the risk of obesity-related health problems is a widespread misconception. In fact, liposuction cannot reduce the risk of high blood pressure, high cholesterol, and similar conditions. Liposuction is a cosmetic procedure that can remove persistent fatty deposits that have not responded to proper diet or exercise. This myth was recently highlighted in a recent post on the ASAPS website.
Two Types of Fat
People have two types of fat: the time that lies just beneath the skin, and the time that lies deeper within the body. The former is the type of fat that is targeted through liposuction, while the latter presents the greatest obesity-related health risks.
Subcutaneous fat. Located beneath the skin in parts of the body such as the abdomen, thighs, and hips, subcutaneous fat is the tissue that is targeted through liposuction. It’s easy to identify by appearance.
Visceral fat. Located deeper within your abdomen, visceral fat lies close to your internal organs, such as the liver, heart, and lungs. It’s almost impossible to identify by appearance.
According to a study published in the New England Journal of Medicine in 2004, female patients who underwent liposuction experienced no positive changes in their cholesterol levels, blood sugar, or blood pressure. However, another study indicated that some liposuction patients experienced a reduction in triglycerides and white blood cells, which are both indicators of heart disease and other health problems.
As a result, while the possible health benefits of liposuction are still being investigated, you should not count on liposuction as a substitute for healthy diet or exercise. If you’re considering liposuction, or other types of body contouring surgeries, you should make sure that you have attained a stable, healthy body weight. This can help to ensure that your results will last for many years.
BMI vs. Waist-to-Height Ratio
Bye-bye, BMI. While this measure of body fat and associated health risks remains in widespread use, its days may be numbered, according to a recent article by WebMD Health News. Recent research suggests that your waist-to-height ratio is more accurate in assessing your body fat and health risks. It’s also easier to measure than BMI, so that people looking to lose weight can put away their calculators.
Body mass index (BMI) is based on ratio of weight to height. It has been used for over 150 years to assess whether someone may be underweight or overweight. It requires you to take your weight in pounds and divide by the square of your height in inches. This method has been widely criticized as being cumbersome, especially since you have to multiply by another number whenever using non-metric units (such as pounds and inches).
But that’s not the only problem with BMI. Bodybuilders and athletes with significant muscle mass are often shown as “obese.” This is because muscle weighs more than fat. People who are exercising to lose weight are often surprised to find that they gained some weight in the short term, because of muscular development.
New research shows that your waist-to-height ratio might be more useful in determining your health. By reviewing 31 studies, researchers found that waist-to-height ratio proved to be more accurate than BMI in predicting health risks such as high blood pressure, diabetes, and heart disease.
Taking your waist-to-height ratio is easy. For the most accurate measurement, you should place the tape measure at the level of your belly button. Ideally, your waist measurement should be half or less of your height. If your waist is more than half your height, you may want to consider modifying your diet and exercise regime.
Many overweight individuals are pursuing weight-loss surgeries that can help them shed excess pounds when diet and exercise have not helped. After bariatric surgery, patients often benefit from body contouring surgeries that remove excess skin. These include the arm lift, breast lift, body lift, thigh lift, and tummy tuck. Liposuction is also sometimes used to better contour problem areas.
