Abdominoplasty
Tummy Tuck
The abdomen is the area of the body where excess body fat accumulates most commonly. As a person’s weight fluctuates, the skin stretches to accommodate the extra fatty tissue. Unfortunately, when people successfully lose weight, the abdominal skin typically does not shrink to the body’s new shape; instead, the skin hangs in loose folds. The abdominal muscles can also become loose, particularly in patients who have been pregnant. This problem can be incredibly frustrating for those who are committed to looking and feeling their best, and it typically cannot be resolved without surgery. An abdominoplasty (commonly known as tummy tuck surgery) is performed to remove this excess skin and tissue for a smoother abdomen. Patients who need less extensive treatment may opt for a less invasive mini-abdominoplasty instead.
New and improved liposuction abdominoplasty (tummy tuck)
The tummy tuck procedure has evolved and improved since the procedure was first tried in 1899.
The standard technique, which has been with us for about 30 years, consists of a horizontal incision in the lower abdomen. The skin and fat is lifted up off of the muscle. The belly button is saved by cutting around it. The muscles are tightened and the skin and fat flap is brought down and trimmed off.
This is still a fairly standard technique in most plastic surgery practices. It has a couple of problems that make this method rather risky.
First, there may be insufficient blood getting to the lower central skin after the procedure and this can result in an area of dead skin which can create a hole. This might take weeks or even months to heal up with intensive wound care. Liposuction at the same time as this technique makes this problem worse. As a result we avoided liposuction at the same time. This resulted in residual abdominal fat that would need liposuction as a second procedure.
The second is that there is a large space under this flap that needs prolonged drainage tubes and often drainage fluid will accumulate there after the drains have been removed. This is called a seroma, and the fluid needs to be removed by new drains or needles.
The results have been amazingly good. The fat is gone. The stomach is tightened more than we could before. Healing is great. Drainage tubes come out in a week or less. Recovery is quicker. Pain is less. We use a long acting local anesthetic to help numb the surgical area for several days. Skin numbness is less. Seromas have all but been eliminated. We also use a product that immediately seals the skin incision. No dressing changes are required and showering is permitted. Return to normal activities is much quicker.
Recovering from Tummy Tuck Surgery
In the early stages of tummy tuck recovery, patients should be prepared to rest at home for the best outcome. Frequent walking about the house in a stooped position is encouraged to minimize risks of blood clots. Some discomfort is normal, but this can be controlled with pain medication. Patients recovering from abdominoplasty will have surgical drains in place for a week in order to control swelling by draining away excess fluid.
It is always important for tummy tuck patients to wear a surgical support garment throughout the recovery process in order to minimize strain on the incision site and help the skin adhere more closely to underlying structures. Most of our Stockton / Modesto tummy tuck patients are able to return to work within a month of surgery and resume more intense exercise within six weeks.
Benefits of a Tummy Tuck
There are many important benefits associated with abdominoplasty. Most importantly, tummy tuck patients enjoy a smoother, firmer, shapelier abdomen. After abdominoplasty it is easier to fit into clothes, particularly swimsuits. There is a small amount of weight loss associated with the tummy tuck procedure, though it is not chiefly a weight loss treatment. Almost invariably, our tummy tuck patients report feeling more confident about their appearance.
Alternatives to Tummy Tuck Surgery
SculpSure – Non-Invasive Body Contouring
SculpSure non-surgical body contouring helps you achieve a natural-looking, slimmer appearance in problem areas such as the belly, love handles, back, thighs and under the chin, with a treatment plan that’s customized to your desired results.
Achieve a natural looking, slimmer appearance without surgery or downtime.
Even with diet and exercise, most people have stubborn pockets of fat that seem impossible to lose. WarmSculpting™ body contouring treatments are able to target and can reduce fat cells safely in just 25 minutes without affecting the skin’s surface. There is no recovery time following treatment, so you can resume your daily activities immediately. Most patients need multiple treatments to achieve optimal results. ✓ Customizable Treatment Plans ✓ Over 90% Patient Satisfaction Rate ✓ FDA Cleared Device ➤
Breast Augmentation
Choices Before Undergoing Breast Augmentation
Before your breast enlargement procedure, you have some important choices to make. During your pre-surgical consultation, Dr. Silverton will explore all the available options with you to ensure that you choose the treatment that best meets your needs. You decide on saline-filled or silicone gel breast implants, settle on the right size and shape for your implants, and explore the different alternatives available for incision location and implant placement. The decisions you make will be based on your goals, medical history, and plans for the future. It is also important to take into account factors such as your lifestyle and plans for future breastfeeding and childbearing in addition to your aesthetic goals.
Types of Breast Implants
Ideal Implant
The Ideal Implant is the newest type of implant on the market. It is technically a saline implant, but unlike traditional saline implants, it is designed with a complex multishell structure. This design makes these implants structurally stronger than traditional saline implants, and makes them feel much more natural, and less like “water balloons”. Essentially, the Ideal Implant combines the ease of mind of a saline implant with the near look and feel of a silicone implant. It really is an Ideal Implant!
Silicone Breast Implants
Early silicone gel breast implants were not as good as today’s breast implants. They were eventually abandoned in favor of saline-filled implants. Today, advances in breast augmentation technology have made safe silicone-gel-filled implants available, giving our breast implants patients a choice between saline and silicone breast implants.
Modern silicone implants are safer than earlier designs because they do not leak or rupture easily. While both saline and silicone implants produce excellent results, many patients choose silicone implants because they consider them to have a more natural look and feel.
Saline Breast Implants
Saline implants, on the other hand, give more flexibility during breast enlargement surgery, as they are inflated after being implanted, but they have the disadvantage of feeling ripply in some people. They are full of saltwater and go flat if they break. Today’s silicone gel implants are very safe and feel better than saline implants. They are filled with cohesive silicone gel. So, in addition to feeling better, the silicone does not come out if they break.
Size and Shape
Implant size is one of the most important considerations for our breast augmentation patients when planning breast enlargement surgery. Smaller implants tend to look the most natural, while larger implants offer the most dramatic breast enhancement. When choosing the ideal size of your breast implants, it is important to consider how larger breasts might affect your lifestyle. Extremely large implants can get in the way of certain athletic activities, such as running, and some women who choose larger implants may experience other problems due to the increased implant weight.
Shape is also important. Breast implants are available in both round and teardrop shapes. Today, most women prefer round, smooth implants, because of their better appearance and softness. Dr. Silverton uses breast implants in a variety of widths and projections to achieve each patient’s desired appearance.
Incision Location and Implant
Breast implants can be placed through a choice of incisions. Dr. Silverton uses the infra-mammary incision (incision under the breast) and the peri-areola incision (around the lower part of the areola). Your shape is important in deciding on the choice of incision and whether a lift (mastopexy) might be required. There are advantages and disadvantages with both choices, and the details will be discussed in detail at your consultation.
Silicone implants require a slightly larger incision than saline filled implants. Sometimes they must be placed through incisions located in the crease beneath the breast known as the infra-mammary fold. This location allows for longer incisions but may leave more visible scars in patients with smaller natural breasts.
Because they can be filled after placement, saline implants can be implanted through smaller incisions in a wider variety of locations. Dr. Silverton prefers to avoid the incision in the armpit.
Dr. Silverton generally prefers to place breast implants behind the chest wall muscle rather than in front. The procedure to place the implant behind the muscle generally produces a better visual result. The scar is better and the long term shape usually holds up better. This option is also less likely to interfere with mammograms in the future and minimizes the likelihood of complications such as rippling and capsular contracture.
The Breast Augmentation Procedure
Breast augmentation usually takes between one and two hours to complete and is typically performed under general anesthesia administered by our board-certified anesthesiologist. After anesthesia has taken hold, the appropriate incisions and places the breast implants. Once the implants are in place, he carefully closes the incisions with dissolving sutures and secures the treated area with a light dressing and a comfortable bra. Patients recover under the supervision of skilled RNs and there is usually minimal discomfort. Patients are able to return home, or to a local hotel if they live some distance away, after they have recovered in the recovery room.
Recovering from Breast Enlargement
Recovery time varies for patients depending on how the breast augmentation procedure was performed. In most cases, our patients have their implants placed behind the chest muscles. For the first 24 to 48 hours after surgery, most patients experience mild discomfort, which can be controlled with pain medication. During this time, it is important to relax and get plenty of rest for the best result.
Bandages can usually be discontinued within 7 to 10 days. Breast enlargement patients leave our surgical center wearing a comfortable bra. No compression bandages are required. Within a week most patients can buy a bra of their own selection at a store of their choosing. The breast implants settle into place over the next several weeks and the breasts soften. It is best to avoid exercise and other strenuous activity for about six weeks. Surgical scars may take several months to fade, and they never disappear completely. However, they are typically subtle and most patients consider this a small price to pay for breast enhancement.
Questions and Answers About Breast Augmentation
Will Augmentation Help Correct Sagging Breasts?
Breast augmentation changes the shape of your breasts by increasing their volume. If your breasts are sagging, you may want to combine augmentation with a breast lift The two procedures enhance the appearance of the breasts in different ways, and a combination may be what you need. In your consultation he can explain how each of these procedures, or both of them, can benefit you.
Will I Be Able to Breastfeed After Breast Augmentation?
With careful placement of breast implants, augmentation will not affect a mother’s ability to breastfeed. If this is a concern for you, bring it up in your consultation He may suggest a particular approach to the procedure, placing the implants behind the chest wall muscle, for example, or the choice of incision location. Studies of breast milk in mothers with implants have shown no effect on the quality of the milk produced, whether they have silicone or saline implants.
How Long Do Breast Implants Last?
While breast implants often last for 15 years or more, implant manufacturers do not consider them lifetime devices. Implants can rupture, requiring replacement or removal. Your breasts will also naturally change over time, as may your ideal body image. When considering breast implants, it’s best to think of them as an enhancement for the next 10 or 15 years, after which you may choose to have them adjusted or replaced.
What Problems Can Occur After Breast Augmentation?
All cosmetic surgery involves some health risks, including the possibility of infection or complications from anesthesia. Breast implants have two other risks to consider, as well.
- They can rupture, which may require replacement or removal. When a saline implant ruptures, it deflates harmlessly. This is a cosmetic concern, as the breasts will no longer be the same size, but it is not a health risk. When a silicone implant ruptures, the effect may not be visible, but you will need to have the implant and the leaked gel removed within a few years to avoid possible health problems. The FDA advises women with silicone implants to have an MRI three years after placement and every two years after that.
- An issue called capsular contracture may occur. With this condition, hardened scar tissue forms around the implant. Corrects it by removing the implants and giving the breasts time to heal.
Breast Reduction
Oversized breasts can be a source of profound discomfort and insecurity for many women. Large breasts can limit clothing options, make exercise difficult, and generally make women self-conscious about their appearance. A renowned plastic surgeon, performs breast reduction to decrease the size of the breasts in order to achieve a more proportionate figure and reduce the back and neck pain often associated with larger breasts. As with other breast surgeries, including breast augmentation and breast lift, breast reduction can enhance one’s appearance.
About Oversized Breasts
Uncomfortably large breasts may be caused by several different factors. Whatever the cause, breast reduction can help correct the condition. For some women, large breasts are simply hereditary. Others gain breast volume due to pregnancy and breastfeeding. A hormonal imbalance due to a medical condition or medication could also be the culprit.
Women with overly large breasts often suffer from insecurity and discomfort. In addition, many of these women experience constant back and neck pain. It is common to suffer from indentations and bruising on the shoulders from bra straps. Many also have difficulty exercising because their breasts get in the way.
Breast reduction is typically performed using an anchor-shaped incision that runs around the areola, along the underside of the breast, and down the inframammary fold beneath the breast. Excess skin and tissue are then removed through this incision. Adjusting the position of the breast to account for its new size and then carefully closes the incision, leaving the breasts more proportionate to the rest of the body.
Recovering from Breast Reduction
Though breast reduction is an outpatient procedure, it is still a major surgery requiring weeks of recovery. It is normal to experience some discomfort during the first days of recovery, but medication can be prescribed to help control it. Before leaving our surgical center, breast reduction patients are fitted with a post-surgical support bra to be worn throughout the recovery process.
Most patients will spend a few days resting after surgery. Swelling and bruising are to be expected during the first few days after surgery, but will subside with the help of surgical drains to remove excess fluid. These drains are typically removed three days after the breast reduction procedure. It is a good idea to partake in some light activity, such as walking, as soon as possible after surgery, as this will help speed the recovery process by promoting circulation. However, breast reduction patients should avoid bending over, straining, and heavy lifting for at least three weeks after surgery. Most patients are able to return to work within a month depending on their work responsibilities and physical condition.
Male Breast Reduction – Gynecomastia
If you are male and are embarrassed about the size of your breasts, please be reassured that you can be helped. Many times the treatment is as simple as liposuction.
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