Tummy Tuck Before & After Case 1
An augmentation/mastopexy is offered when goals include both breast lift surgery and breast volume maintenance or augmentation.
The further the nipple/areola needs to be raised to reach the goal position, the higher chance of wanting a revision (~30% in some series), or even planning a 2-stage surgery from the outset.
Here, a modest 250cc implant placed under the muscle added upper pole fullness while avoiding an “overdone” look.
A tummy tuck was also done to remove excess skin from the lower abdomen and tighten the abdominal wall.
She is seen at 4 weeks post-op, with scars and swelling continuing to improve every day!
Tummy Tuck Before & After Case 2
2 months after fleur-de-lis tummy tuck.
Re: Recovery — I keep tummy tuck patients for observation overnight.
This helps with pain control, care of drains as needed, early walking, and receiving a blood thinner shot 8 hours after surgery.
The biggest risk I worry about is a blood clot (DVT) that can travel from the legs up to the lungs and heart. It’s the most serious complication of surgery, and I treat it with the utmost respect and care.
Rarely, bleeding can also occur that requires returning to the operating room. Staying in the hospital minimizes potential problems with too much activity, and makes it easier to return to the operating room as needed in those rare cases.
Drains are used on a case-by-case basis. Some patients seem to swell more, and with the liposuction fluid, a fluid collection may need to be drained off historically in about 1 in 8 patients. Drains are a little annoying, but almost always don’t hurt at all on their way out!
Return to work depends on whether it’s a desk job or requires heavier lifting or activity. For most, 1 week seems right, though people are tired for 4-6 weeks overall as their body works on healing itself.
Return to full exercise and activity is at 6 weeks.
Tummy Tuck Before & After Case 3
This mother of 4 had extra skin and a diastasis – or separation – of the rectus muscles that make up the six-pack.
Tummy tuck with excision of 2.5 pounds of extra skin, repair of the diastasis, and some targeted liposuction, helped to improve her contour and confidence.
She is seen at just 4 weeks, with swelling set to improve further over the next several months. Her belly button is healing nicely with a natural appearance.
Tummy Tuck Before & After Case 4
A tummy tuck and liposuction together are a powerful way to contour the trunk.
This beautiful woman in her 40’s had over 80lbs of weight loss and 5 previous children. She had loose skin after her weight loss. She also had moderate diastasis recti, or widening of the fascia between the six pack muscles.
Panniculectomy involves just the removal of the pannus, the skin that hangs over the waistband. The skin around and above the belly button do not change after that surgery.
Abdominoplasty additionally includes repair of the diastasis and tightening of the skin all the way to the rib cage. A modest amount of liposuction was also performed to smooth her contour.
The dimpling and swelling will continue to improve over the next several months, as absorbable sutures disappear over time, and her circulation heals.
Tummy Tuck Before & After Case 5
Yes! I have patients every week asking whether I do breast and body contouring, too, as my website and social media is being updated.
Here is a sneak peek at a recent patient 4 weeks after a fleur-de-lis tummy tuck and mastopexy.
She was interested in increasing her cup size to go with her lift, without use of an implant. Targeted liposuction was done at her waist and flanks, and this fat then transferred to her breasts for a beautiful and natural lift and fill.
Seams and scars are necessary with any surgery to tailor the skin. A bespoke plan is designed for each and every person based on individual goals and anatomy.
At 4 weeks, she can now return to light cardio with her Peloton, and at 6 weeks return to full weights!
Tummy Tuck Before & After Case 6
A tummy tuck and liposuction is a commonly performed procedure to improve a patient’s body contour.
This woman in her 20’s had loose skin and stubborn weight from a hormone imbalance that was now stable.
I offered an abdominoplasty to remove redundant skin, and liposuction of her abdomen and flanks to improve her contour.
For women who have had children, diastasis recti is usually present to some degree, where the edges of the six pack in the middle spread apart. For these patients, repair of the muscle and fascia is done like an internal corset.
An overnight stay for comfort and safety is recommended. Drain tubes are sometimes used to help smooth and speed recovery. Return to work is usually at 1 week, and return to full activities at 6 weeks.
This patient is seen at 3 months. Swelling and scarring will continue to improve until ~9-12 months.
Tummy Tuck Before & After Case 7
He lost over 100 pounds and was ready for some contouring.
His main goals were improving his gynecomastia (overdevelopment of breast/chest tissue in men) and the extra skin of his abdomen.
For the gyencomastia, when there is a greater amount of skin to remove, I favor an incision hidden along the natural inferior fold of the pectoralis.
The nipple/areola remain attached to a dermal pedicle, and that helps to minimize the chance of pigment loss, and is more reliable than free nipple graft.
I was also able to remove loose skin, ncluding old surgery scars on his abdomen.
Some tightening of the core muscles was done, with more focus on tailoring towards a more masculine V-shaped torso than a feminine hourglass.
In addition to fitting more confidently in clothes, he can more comfortably exercise and go about his daily activities.
As a reminder, a tummy tuck is NOT a primary weight loss procedure. The intra-abdominal fat we all have around our organs is a no-fly zone. For that, weight loss through diet, exercise, medication, and/or bariatric surgery is needed.
Tummy Tuck Before & After Case 8
Early result after panniculectomy/tummy tuck for a man with a moderate amount of visceral fat (deep to the muscle, around the organs).
A tummy tuck is a skin redraping procedure, and not a primary weight loss surgery.
That said, this gentleman is happy to be free of his overhang, and its recurrent rashes and malodor. Clothes fit better, he’s smiling and confident, and ready to take on the world.
Tummy Tuck Before & After Case 9
She lost 120 pounds after a weight loss surgery, and had been stable for at least 6 months – the minimum required to be covered by most insurance companies for panniculectomy.
Here, we additionally repaired a diastasis recti, and also redraped skin from above the belly button down below.
A common question is what happens to the belly button?
It remains attached to the abdominal wall, and is brought back through the skin that has been smoothed out.
You can see a much more natural appearing belly button after surgery after removing the excess skin and releasing the fascia attachments to the skin around it.
Tummy Tuck Before & After Case 10
When do I offer a fleur-de-lis style tummy tuck?
When a person has significant skin stretch and laxity in a horizontal (side-to-side) direction, in addition to vertical (up-and-down), then we begin the discussion.
This does add an additional scar that can be good quality but still be visible. The tradeoff is more narrowing and contouring of the waist, with maximum skin and fat removal.
Healing and recovery is similar to a traditional tummy tuck.
Tummy Tuck Before & After Case 11
A tummy tuck can help reduce rashes and discomfort, particularly in the hotter months and with exercise.
The skin and fat removed is all outside of the abdominal wall muscles and fascia. The fascia is usually cinched, and any diastasis recti repaired, but the intraabdominal volume can’t be changed.
The contour depends on:
- The volume and pressure pushing outwards
- The tone, strength, and length of the muscle and fascia of the trunk.
- Then the fat and skin outside of that.
I can help with number 3, but the first 2 are taken care of in the kitchen and the gym.Processes are key! I’d recommend Atomic Habits by James Clear to gain some insights on getting your mind right, to then get the body right. (A patient told me that.)