Tummy Tuck Palo Alto
This procedure is designed to remove excess skin, fat, stretch marks and/or repair the separated rectus (abdominal) muscles. A protuberant unattractive abdomen may develop for a number of reasons. Some of the reasons might include: age, pregnancy, previous surgery, obesity with massive weight loss, injury, lack of exercise or heredity. Sit ups can be ineffective and may actually further stretch and weaken the midline. Only surgical correction of this midline muscle separation (hernia) corrects the problem and realigns the muscles parallel again. Along with muscle repair, excess fat and skin or skin with stretch marks can be removed. The goal of this procedure is to produce a smooth flatter abdomen from the midriff to the pubis areas.
In a perfect world, we would all be our ideal weight prior to any surgery. However, those less than 50 lbs. over their ideal weight usually do very well and make safe acceptable candidates. Patients may even choose to add liposuction to other areas such as flanks (hips), back or thighs while undergoing the abdominoplasty procedure. The individual that is overweight by 50 to 100 lbs. can be a candidate, but might be limited to just the abdominoplasty or a panniculectomy.
Individuals that have had a significant weight loss are often left with loose hanging skin that we refer to as a hanging panniculus (apron of excess skin). It can be a real problem to camouflage under clothing. The removal of this skin is referred to as a panniculectomy. A panniculectomy can be performed alone or in addition to muscle repair. If a person is 50-100 lbs. overweight, an abdominoplasty may help to remove a large panniculus and make life easier. It can facilitate exercise, hygiene, relieve skin irritation, and give a brighter outlook for the patient. Often people with back problems find some relief from a panniculectomy or abdominoplasty.
The incision and resulting scar is kept as low and as short as possible to allow bikini wear. Every attempt is made to minimize the incision. However, it must be of sufficient length to remove stretch marks and excess skin. Mini tummy tucks are rarely indicated. Mini procedures often result in minor improvement and rarely please the patient or the doctor. In rare cases, a mini procedure can be used to tighten the muscles, but not to remove skin. Think about it, how much skin can be removed from a 4 or 8 inch incision? Not much! Nevertheless, if the main issue is muscle repair below the umbilicus, a simple mini tummy tuck will suffice.
For the conventional abdominoplasty, several layers of internal sutures are used to reconstruct the abdominal muscles from just under the bra line to the pubis. They are placed both vertically and horizontally in the tissues (fascia) surrounding the abdominal muscles to establish the best possible waistline. The original belly button is re-established in its original position and is fashioned to appear as it did prior to kids, age, and weight gain.
Pain Reduction and Draining
Before incision closure, a simple device to minimize pain is inserted under the abdominal skin. The 2mm filament is connected to a squeeze device that constantly sweats pain medication (Marcaine) in the surgical site. It has wonderfully reduced discomfort by as much as 80%. The device is removed after several days. Pain stays subdued even after removal.
Return to Activity
Patients can return to near full activity at 2 weeks. Returning to work requires 7-10 days. Sutures are removed in stages and are usually out by 2 weeks. A small abdominal binder is worn for the first 3 or 4 weeks. It is not mandatory, but it seems to enhance comfort. Special treatment with a silicone binder facilitates ideal incision healing.
Longevity of the Results
Abdominoplasty is a once in a lifetime procedure usually. Extreme weight gain or pregnancy can somewhat negate ideal results, but even then some benefits are maintained. Skin and fat that has been removed is gone forever. Muscle can, however, separate under severe stress, such as pregnancy
The abdomen contains many muscles. The two large central rectus muscles that are repaired parallel with an abdominoplasty are in ideal position for exercise. Exercise is important to maintain muscle tone. If muscle tone is not maintained, some abdominal weakness persists and the abdomen may not be as flat as it potentially can be. An ideal concave abdomen requires not only the abdominoplasty, but also exercise and weight management.