Cosmetic Surgery Tips

Secondary liposuction after tummy tuck

If you’ve had a tummy tuck, you may have been told that a secondary procedure is necessary to get rid of stubborn fat and skin that remains after your initial procedure. But what exactly is secondary liposuction? And what are the advantages and disadvantages of having it done?

In this guide, we review the aspects of Secondary liposuction after tummy tuck, upper stomach bigger after tummy tuck, how soon after tummy tuck can i get lipo, and pseudobursa after tummy tuck..

A tummy tuck revision is designed to correct and improve the appearance of the abdomen following complications and unwanted side effects from a previous tummy tuck. Depending on the degree of correction required, this procedure can consist of various types of surgery. If you are unhappy with your previous tummy tuck and are looking for among the best tummy tuck repair in Beverly Hills, premier plastic surgeon Dr. Feldmar is ready to assist. You’ll finally be able to enjoy a tighter, flatter, more attractive stomach.

Is a tummy tuck revision right for me?

A tummy tuck revision with Dr. Feldmar can correct virtually any unwanted effects created by a previous body contouring procedure. To give you a more detailed explanation, a list is provided below with a brief description of possible complications following a tummy tuck.

Excess fat – Excess fat after a tummy tuck often occurs when insufficient or no liposuction was performed during your procedure. This is the easiest complication to correct since liposuction of the abdomen is easily performed.

A poor quality scar – This may occur when the scar does not heal properly, usually due to inadequate closing techniques from a previous surgeon. Depending on the scar and the surrounding laxity of the skin surrounding the closed incision, a variety of methods can be employed to correct this unwanted blemish.

A scar located too high – When a previous procedure was poorly planned, it often results in over-excision of abdominal skin. This, in turn, creates a scar that is visible above the waistband of pants or a bathing suit. Too much residual skin – Conversely, a surgeon may be too conservative and leave an excess of abdominal skin. While the result is likely an improvement upon the original contours, this will leave a patient dissatisfied with his or her abdominal appearance.

An unattractive belly button – A belly button that has a poor shape or a visible scar or is otherwise unattractive should be corrected. While the rest of a patient’s stomach may appear lean and fit, this is virtually nullified if the belly button is disfigured in some way.

Pseudobursa – This occurs when two layers of scar tissue become separated by fluid and is often noticeable as a bulge or fullness above the horizontal incision of the tummy tuck.

Tummy Tuck Repair Consultation

If you are considering a tummy tuck revision, your next step is a private consultation with Dr. Feldmar. During this time, Dr. Feldmar will carefully listen to your personal goals for cosmetic improvement, ensuring he understands your exact desires. He will then examine your previous surgery and determine the exact cause of your dissatisfaction. In this way, he establishes his professional opinion regarding the best treatment options.

During your tummy tuck repair consultation, Dr. Feldmar educates you every step of the way. He makes you an intimate part of the process, and the two of you work as a team to determine the best course of treatment. With Dr. Feldmar, plastic surgery is a collaborative effort, and he will not move forward with surgery until the two of you are in perfect harmony. Dr. Feldmar and his incredible staff are eager to provide you with among the best tummy tuck revision Scottsdale has available.

Tummy Tuck Revision Recovery

As a tummy tuck revision often is a highly individualized procedure tailored to your unique body type, the recovery period will depend on factors such as the length of the incisions, the degree of correction, your age, and your general health and fitness. During your recovery period, you will be expected to adhere to several guidelines. These guidelines not only ensure the highest level of comfort, but they also help give you the best aesthetic outcome.

Abdominoplasty Revision Aftercare

A tummy tuck revision is performed as outpatient surgery, and patients go home shortly after the procedure. However, depending on several factors such as the complexity of the procedure, the availability of a caregiver at home or your personal preference-some patients decide to take advantage of a nearby aftercare facility. This helps ensure your personal attention and needs are looked after by Dr. Feldmar and his highly trained staff. In the interest of delivering among the best tummy tuck revisions Beverly Hills has to offer, Dr. Feldmar looks after every aspect of your recovery process.

Secondary liposuction after tummy tuck

What is secondary liposuction?

Secondary liposuction is a procedure that removes additional fat or skin from an area that was previously operated on. It’s usually performed around six months after your initial surgery, though it can be done sooner or later than that if necessary. The surgeon who performs your tummy tuck will also perform your secondary liposuction, as well as any other procedures he or she feels are necessary for optimal results.

Advantages of secondary liposuction

The main advantage of having secondary liposuction done after tummy tuck surgery is that it helps ensure optimal results. If there are still areas of loose skin or fat deposits, they can be removed with this procedure so that you get the best possible outcome from your tummy tuck surgery.

Disadvantages of secondary liposuction

The main disadvantage of

Secondary liposuction after tummy tuck is a great option to consider if you’re looking to further enhance the results of your tummy tuck. Liposuction can be used to remove excess fat and skin that may have been left behind during the original tummy tuck procedure.

A secondary liposuction procedure can help reduce the appearance of any scarring or puckering that may have occurred around the transplanted skin in areas where it’s prone to settling or folding. It can also help prevent any remaining fat from becoming stretched out by gravity over time.

Secondary liposuction is a great way to get that “tight” look after a tummy tuck. It’s also a good option if you want to do some touch-ups in other areas.

The procedure is relatively simple: fat is removed from your abdomen, hips and thighs with a cannula. The fat is then purified and re-injected into your abdomen. This helps tighten the skin and give you that attractive contour again.

It’s important to note that secondary liposuction isn’t meant for weight loss or body sculpting—it’s purely for contouring purposes. If you’re looking for something more than just a lift, then secondary liposuction may not be right for you.

If you’re interested in learning more about secondary liposuction after tummy tuck, contact us today!

You’re on the right track if you’ve decided to have a tummy tuck. But as with any surgery, there are risks involved. One of these is that your waistline will change after the procedure, and if you’re unhappy with this, you may want to get a secondary liposuction procedure for your abdomen.

Before getting into the details of how liposuction works, it’s important to understand why it’s necessary in the first place. Liposuction is a type of cosmetic surgery that removes fat from areas such as the abdomen and thighs. It is often used in conjunction with other procedures like abdominoplasty or thigh lifts because it helps improve their results by removing excess skin and fat from these regions so they’ll look more defined.

This type of surgery can be performed in two different ways: subcutaneous (underneath the skin) or visceral (inside organs). Most surgeons prefer using subcutaneous liposuction because it leaves less scarring than visceral procedures do; however, both options are equally effective at reducing body fat deposits!

The main difference between these two types has to do with where they’re performed: underneath skin versus inside organs/muscles (such as ribs). Subcut

Tummy tuck surgery is a procedure that removes excess skin and fat from the abdominal area. It also can include removing excess skin from the upper part of the buttocks, known as the lower lateral fold. The procedure is usually completed using general anesthesia and lasts between two to four hours.

There are many reasons why someone might want to have a tummy tuck surgery. These include:

-Aesthetic reasons: You may not like how your belly looks after having children or you may be self-conscious about it.

-Cosmetic reasons: You may have a large amount of fat on your abdomen that makes exercise difficult and affects your confidence levels.

-Medical reasons: If you have an accumulation of fat around your midsection due to other medical conditions such as obesity or diabetes, then it may be necessary for you to undergo this type of surgery.

Secondary Liposuction After Tummy Tuck

If you have recently undergone a tummy tuck, you may be wondering if it is safe to undergo secondary liposuction. Secondary liposuction is a procedure where extra fat is removed from other parts of the body after your tummy tuck has been performed. Your surgeon will determine whether or not it is safe for you to undergo this type of procedure based on their assessment of your overall health and the results of your initial surgery.

There are some general guidelines that can help determine whether or not secondary liposuction is appropriate for you after your tummy tuck. If you are in good health, have had an uncomplicated surgery with no complications, and have lost significant weight since your last visit with your doctor, then secondary liposuction may be an option for you. You should also wait at least six months before undergoing secondary liposuction after having a tummy tuck procedure because scar tissue needs time to mature before undergoing further surgical intervention.

If your surgeon thinks that it would be unsafe for you to undergo secondary liposuction after having a tummy tuck due to any number of reasons (such as if they feel that there are too many scars from previous surgeries), then they

Secondary liposuction is a procedure that can be performed after a tummy tuck. It is very common for patients to have extra fat and skin that is left behind after their tummy tuck. This extra fat and skin can be treated with secondary liposuction, which can be performed at the same time as the tummy tuck or several months afterwards.

There are a few different types of liposuction that can be used to treat this excess fat and skin. The most common type of secondary liposuction uses ultrasound energy to blast away the remaining tissue. This procedure usually takes about 30 minutes, but it is not painful.

The other option is to use traditional liposuction. This involves inserting long needles into the skin and then suctioning out the fat through these needles. This option has been used in many cases but it typically takes longer than ultrasound energy because you have to move around your body with each needle insertion point.

Secondary liposuction is a common procedure that is performed after a tummy tuck. The reason for this is simple: if you’ve had a tummy tuck, your skin will be pulled tight and smooth. The skin has been removed and it’s not going back. If there is still fat under your skin and on top of your muscle, it will appear as bulging rolls around your waistline. This can be corrected with secondary liposuction.

There are many reasons why someone would choose to have secondary liposuction after having received a tummy tuck. The most common reason is that they want to improve their shape or remove more fat from certain areas of the body. Some people may have had liposuction elsewhere on their bodies prior to having a tummy tuck, and now they want to remove extra fat from those areas as well.

If you’re considering having secondary liposuction after having had a tummy tuck, talk with your doctor about what type of procedure would be best for you. They can discuss options such as Vaser Liposculpture or SmartLipo, which will give you more information before making any decisions about whether or not these procedures are right for you!

After your tummy tuck, you may be left with a layer of fat that is not easily accessible. This is the secondary fat that lies between your abdominal muscles and your skin.

This secondary liposuction can be performed to help remove this excess fat and contour your abdomen. It can also be used to remove any remaining deposits after a tummy tuck, which may be a more cost-effective alternative to abdominoplasty.

The procedure takes about 1 hour, and you will need to take at least 2 weeks off from work (although most people need more time). The results are immediate and dramatic, and you should expect to see them for up to two years after surgery depending on how quickly your body heals.

Liposuction is a popular procedure that can produce great results. It is often used after a tummy tuck, but it can also be performed on other parts of the body. The main goal of liposuction is to remove excess fat and contour specific areas. Some doctors also use liposuction to tighten skin where there are pockets of fat or loose skin.

After your tummy tuck, you may need additional liposuction in order to achieve the body shape that you want. This is especially true if you are carrying extra weight around your thighs and hips, as this will make the results of your tummy tuck less noticeable. If you have had a baby and want to lose the extra weight in your lower body, liposuction can help you get back into shape faster than dieting alone might allow for.

When choosing a doctor for any type of cosmetic surgery procedure, make sure that they are board-certified by the American Board of Plastic Surgery (ABPS) or by another board recognized by the American Board of Medical Specialties (ABMS). You should also ask about their training and experience with cosmetic surgery procedures similar to yours—this will help ensure that they know what they’re doing!

Secondary liposuction is a procedure used to remove extra fat that remain after a tummy tuck. It is typically used to remove small pockets of fat that are trapped under the skin around the belly button and above the pubic area. It can also be used to remove excess skin, which is sometimes referred to as “dog-ears” or “dog-ears flap”.

A secondary skin incision is made at either side of the midline from just above the pubic area to just below the belly button. The surgeon may lift up some of the abdominal muscles so that he or she has access to remove any remaining fat pockets or skin folds underneath them. If there is excess skin then it will be removed and excess fatty tissue will be removed from around it so that it does not bulge out again later on down the line once more weight loss has taken place over time after losing weight naturally through dieting and exercising more regularly etcetera then too often happens over time due to lack of exercise as well as eating too much fast food junk food etcetera causing obesity which causes health problems later on down

Secondary liposuction after tummy tuck can be a great option for those who have lost a significant amount of weight, but are still experiencing excess skin in their abdominal area.

If you’ve had a tummy tuck and are now ready to lose more weight, you may continue to have loose skin in the abdominal area even though you’re otherwise happy with the results of your surgery. This can be frustrating, especially if you feel like your clothes don’t fit properly anymore because of this extra skin.

In order to help patients with these concerns, doctors will sometimes recommend secondary liposuction as part of their post-operative care plan. The procedure removes excess fat deposits around the waistline and other problem areas, which can make it look like you’ve lost even more weight than before!

If this sounds like something that might interest you, talk with your doctor about their recommendations before getting started on any new treatment plans.

Secondary liposuction is a procedure that is performed after the tummy tuck surgery. The purpose of this procedure is to remove any remaining fat deposits in the abdomen and flanks. This secondary procedure can be performed at any time, but it is most commonly done within six weeks of the initial tummy tuck.

The main goal of secondary liposuction is to ensure that all of the excess fat has been removed from your body and that you are satisfied with your results. The longer you wait to have this done, the more likely it will be that some areas will have regained some of their fat deposit. If you have been told by your surgeon that there is still some excess fat left behind after your initial surgery, then secondary liposuction may be recommended for you.

Secondary liposuction can be an effective way to reduce the appearance of stubborn fat after tummy tuck surgery. However, it is important to understand that this procedure will not remove all fat from your abdomen, and it should not be viewed as a substitute for proper diet and exercise.

If you are considering secondary liposuction after tummy tuck surgery, here are some things you should know:

It’s been a few months since your tummy tuck surgery. You’re feeling great and your clothes are fitting better than ever. But when you look in the mirror, you notice that there’s some extra skin around your waistline, or even just a little flab that wasn’t there before.

  • The main risks associated with secondary liposuction include infection, bleeding and bruising. All of these risks are typically lower than those associated with primary liposuction because they are performed in an already surgically corrected area.
  • You should expect some swelling or discomfort during recovery. This will resolve within a few weeks but may take longer depending on how much fat was removed during surgery.
  • Secondary liposuction is often done at the same time as abdominoplasty (tummy tuck) so patients may experience additional pain and discomfort during this period as well as an extended recovery time due to the additional work being done on their body at one time.

Secondary Liposuction

You’ve got questions: How long will this last? Is it permanent? Should I get another surgery to take care of it?

The answer is yes—you should consider secondary liposuction after tummy tuck surgery. Not only will it help you get rid of those extra pounds and inches, but it will also help improve the appearance of scar tissue and give your body more definition.

When should I have the surgery?

It’s important to wait until your body has fully healed from your first operation before undergoing any further procedures. If you have any questions about whether or not you’re ready for secondary liposuction after tummy tuck, talk with your doctor about when they think it would be best for you to schedule another procedure.

upper stomach bigger after tummy tuck

Prospective clients often look at before and after pictures on the internet in order to best determine the right surgeon for them, and some tend to notice a bulginess that appears in the upper abdomen after a tummy tuck. This is a common result of several causes.

First, there can be a significant amount of fat in the upper abdomen after surgery. Surgeons tend to be conservative in performing liposuction on the upper abdomen, as taking away too much fat can cause significant problems with skin loss on the lower abdomen. Based on the patient’s anatomy, the location of the blood vessels is important in determining the degree of aggressiveness during liposuction. When dissecting, the surgeon must be careful with the blood vessels in order to protect the blood supply to the abdomen. It is a mistake to cauterize all the blood vessels that are going to the skin. For this reason, vessels should be preserved as much as possible. In some patients, the blood vessels are not always visible or tend to be cauterized in order to tighten the abdomen. In the event that there is no significant blood supply to the skin, liposuction is performed lightly, which can result in developing some fat after surgery. Patients must realize that surgeons cannot determine the location of the blood vessels or the amount of blood supply through physical examination alone to determine the thoroughness of the liposuction procedure.

Second, visceral fat is also a factor. Visceral fat accumulates around internal organs, including the liver, stomach, and bowels. It is no surprise that when a patient has a significant amount of visceral fat, there will be more resistance when it comes to tightening the muscle. Most of the internal organs are located in the mid to upper abdomen, in addition the abdominal muscle attached to the chest wall, which provide resistance when the plication is performed. For this reason, surgeons must be careful in tightening the muscles in the upper abdomen. This can cause significant changes in the patient’s respiration after surgery, creating metabolic changes due to a change in lung capacity. This is why surgeons advise patients to lose weight prior to undergoing a tummy tuck procedure.

how soon after tummy tuck can i get lipo

Unlike some body contouring treatments, Tummy Tucks are considered a highly invasive procedure, requiring an incision made from hipbone to hipbone. The invasive nature of the procedure results in a recovery time as long as 6 weeks, during which it is advised to avoid strenuous exercise and heavy lifting.

In many cases, surgeons can perform liposuction at the same time as the Tummy Tuck1, however this is not always the case and is considered on a patient-by-patient basis. Even if liposuction is done at the same time, often not enough of the fat is removed, which can lead to issues if any weight gain is experienced post tummy tuck.

Experiencing Weight Gain After a Tummy Tuck

Over time, if an abdominoplasty patient experiences weight gain, they will notice the increased fat in the upper part of the abdomen, usually from the naval up to just below the breasts, while the lower abdomen remains very tight and flat.

When situations like this arise, a minimally-invasive laser liposuction treatment can often yield the best results to remove the fat. Among the different types of laser lipo available, Smartlipo has been shown to help treat many patients who have encountered this very issue.

Undergoing Smartlipo After a Tummy Tuck

For patients who have undergone a tummy tuck, Smartlipo is a comparatively simple procedure. It is a minimally invasive surgery, and is done under local anesthesia and considerably less downtime than traditional liposuction2.

Smartlipo is a form of laser lipolysis, or laser assisted liposuction, in which the laser melts the fat before being suctioned from the body. It also allows for the use of very tiny instruments that cause the least amount of tissue trauma. In fact, most patients don’t even bruise.

pseudobursa after tummy tuck

Abdominal surgery is exceedingly common. General surgery, urology, gynecology, spine surgery, and bariatric surgery all have surgical procedures that require abdominal surgery. Because of this as well as the complexity of the abdominal wall, abdominal surgical complications are also common and can create both disfigurement as well as ongoing symptoms of pain. The case below is a video of a patient who developed abdominal pain and disfigurement after multiple abdominal surgeries. She had developed a pseudo-bursa which caused her abdominal pain and hernia laxity which also caused discomfort. Secondary to the above issues we decided to proceed with excision of abdominal pseudo-bursa and related scars and repair of ventral hernia without mesh.

Cassandra has left a new comment on your post “Endoscopic Abdominoplasty”:

I am 5 months post full tummy tuck and although my upper abdomen is still intact, my lower abdominal muscles seem to have have way again.

I can for the most part suck the bulge in, but with relaxation or bending over it protrudes again. It seemed to be very flat up until now, w the exception of normal post op swelling.

I did have wound complications just below my belly button which bought me a wound vac for 6 weeks.

My wound has been closed for 2 months now. Any suggestions on what caused this or how to fix it?

I’ve tried to make an appt and they can’t see me for another 3 weeks and I have been told it’s just swollen and it will take a year to go away. This was told to me over the phone.

Any advice is greatly appreciated!!

Repairing the lower half of the abdominal wall (re-tightening the muscles) can be accomplished alone or in combination with other tummy tuck revision procedures. At its simplest, the scar from the wound healing issue you discussed can be excised (removed) and access gained to the lower abdominal wall. Doing so is dependent on the looseness of the skin below your belly button. The other option is to undergo a full tummy tuck revision. In doing so the tissues all the way to the rib cage are freed. This will allow the entire abdominal wall to be tightened appropriately, the scar removed, and the incision lowered. The other issue you may want to evaluate is the possible presence of a pseudo-bursa. This can sometimes masquerade as lower abdominal fullness. If you would like you can contact my office and they can have you email photos and set up a phone consult.

Plz help have very hard knot from bottom of panniculectomy incision to pubic area on left side..has been oozing pinkish thick fluid..right side isn’t hard or painful. I’m 3 wks post op

Sorry to hear about your healing issue. There is definitely something occurring with your healing that should be looked at. Hardness near or at the incision area after a panniculectomy is not uncommon since swelling and healing can create this. The pain that you are experiencing and the drainage are indicating that something else may be occurring. It may be that you have some fat necrosis and the body is trying to take care of that. I would seek follow up with your plastic surgeon to get an idea if you should be doing something else in terms of wound care or if surgical exploration would be beneficial.

A tummy tuck can be a powerful plastic surgery procedure. It can provide an incredible amount of improvement in the shape and appearance of an individual’s abdomen and make a significant impact in the confidence and sense of well-being of a person’s body image and self esteem. It is also a big decision and one that should be researched thoroughly.

Although the final result of any tummy tuck procedure is in part related to where each patient starts (amount and quality of loose skin and fat), there are qualities that most great tummy tuck result will have. In the end, you’ll want to have the right tummy tuck done by the right tummy tuck surgeon, at the right time. To help you navigate the consultation process I have listed five of the best tummy tuck result qualities to look for and discuss with your plastic surgeon.

#5 Symmetry and contour

Although there is no perfect symmetry when it comes to any part of the human body there is a level of symmetry that is needed in the abdomen and waist area to make the tummy tuck result appear both natural as well as aesthetically pleasing. Look at before and after photos with a “wide lens” and let the general shape and appearance of the abdomen and waist communicate to you if enough symmetry is present. The sides (flanks) as well the transition of the abdominal tissues from above the incision to below the incision should flow seamlessly. Contour should be smooth without lumps, bumps, indentations, or noticeable transitions.

#4 Tummy tuck incision location, shape, and quality

The tummy tuck incision appearance is one of the main concerns for most patients considering a tummy tuck. Examples of bad tummy tuck incisions are easy to find. Great tummy tuck incisions should go unnoticed. Thin, symmetric, low, and high quality should be descriptors of a good incision. As you can see, the length of the incision is not particularly important in terms of incision quality since the incision length is largely dictated by the amount of loose skin present. The incision should match the patients’ body type and clothing preferences.

#3 Shape and appearance of the belly button

The belly button will definitely be the one part of the tummy tuck that cannot be covered when wearing a bikini, so it has to look good. Natural, aesthetically, pleasing, and without any tell tale signs of being operated is key. When evaluating before and after photos take a look at the belly button. If the belly button is aesthetically pleasing, if it looks natural, and if it matches the persons body then it is likely the other details of the tummy tuck design and completion are probably also good.

#2 Tummy tuck shape

Thin, flat, tight, and narrow. These are some of the words that I like to use to discuss an aesthetically pleasing tummy as well as a good tummy tuck result. There is a combination of factors that can come together to accomplish this including liposuction, removal of excess skin, and tightening of the abdominal wall. In the end, a tummy tuck should result in a narrower waist that flows well and is aesthetically pleasing as well as a flat or significantly improved side profile from ribcage to pubic bone. Narrower from the front and flatter from the side–that’s basically the improvement a tummy tuck should provide from the shape standpoint.

#1 Harmony

Everything about the tummy tuck and waist should flow and appear as one. This one encapsulates a little of all of the above. When looking at before and after photos of a tummy tuck everything should just make sense. The result should just tight enough, not too tight and not too loose. The tummy tuck result should provide waist narrowing. Not too narrow and certainly not a boxy shape. The abdomen should compliment the thighs and breasts and should make sense when everything is viewed from afar.

Tummy tuck surgery has one of the highest satisfaction rates of any elective cosmetic procedures. Because of this, tummy tuck surgery continues to be one of the most common plastic surgery procedures. Below are five facts about tummy tuck surgery.

During your tummy tuck surgery, you keep you belly button. That is, in the normal full tummy tuck surgery process, your belly button is not removed. You also don’t get a new belly button. Rather, your belly button is released from the abdominal skin and then brought back out through the skin that is pulled down. Our belly button is like a straw with one opening on the surface of our skin and the other end inside our abdomen. The “straw” is maintained and it’s then brought out through the new skin that now overlies it during the tummy tuck process. What makes one tummy tuck belly button look better than another is how the incision is made initially, how the opening is made when bringing it back out, and how the belly buttoned is sutured back up.

People often talk about loose muscles and the need to repair them with a tummy tuck. If you think about it, muscles are designed to flex and extend. Therefore, pregnancy or weight loss will not lead to a change in the muscles themselves. What people often notice is the looseness of their abdominal wall. Since the muscles are wrapped up in connective tissue it’s the connective tissue that is loose and it’s the connective tissue that needs tightening during a tummy tuck procedure. Muscle repair, therefore, is really more like connective tissue repair. Doing so during a tummy tuck will repair rectus diastasis and tighten the abdominal wall.

Many patients ask me if the fat that is removed during a tummy tuck will appear somewhere else on the body after the procedure. The answer to this question is if weight is maintained, no new fat will appear. If weight is gained, the body will distribute that weight evenly based on your genetics like it always did but less will go to the abdomen since there are fewer fat cells there.

Some patients think that how low the tummy tuck incision can be placed depends on their body. There is some truth to that, as someone a small amount of skin looseness will have more difficulty in pulling the upper abdominal skin all the way down to the pubic bone. There are modifications that can be done however that can still make this happen. In my practice I always mark the incision super low near the pubic bone and use the techniques that are available to allow the upper abdominal skin to be pulled down and maintain a low abdominal incision.

Hi I lost weight about 8 years ago and have managed to keep it off , I am wanting tt surgery as my tummy is a little saggy and flabby, I am 32 and a size 10-12 and I am worried about having the muscles stitched because of the pain afterwards and the recovery.My question is does loosing weight at a younger age mean my muscles might not be stretched enough to need stitching”

Congratulations on the weight loss. Muscle tightening only needs to be performed when the abdominal wall is loose and both front and side profile improvements would be seen with abdominal wall tightening. Although there is some additional discomfort with muscle tightening it can be made better with long acting numbing medication such as Exparel which I routinely use. You and your plastic surgeon can make this decision together. I would say that it is better to have it done if possibly needed since it will provide a better overall result and going back in and doing so at a later date would cost more both financially and in terms of recovery time.

Anolost weight about 8 years ago and have managed to keep it off , I am wanting tt surgery as my tummy is a little saggy and flabby, I am 32 and a size 10-12 and I am worried about having the muscles stitched because of the pain afterwards and the recovery.My question is does loosing weight at a younger age mean my muscles might not be stretched enough to need stitching

Rectus Diastasis, Ventral Hernia, And Belly Button Outies: What Are They, When Do They Occur, And How Are They Fixed?

There is a lot of confusion about the various abdominal type hernias that can occur. In this blog post we will review the most common type of abdominal wall hernias, how they most frequently occur, and how they can be repaired.

Lets first start by discussing what a hernia is. There are medical definitions of a hernia but we can simply describe it in a way that makes sense for everyone in the real world. A hernia is a weakening in that part of the body. Think of it as a bubble in a car tire. That part of the tire is weaker and the air pressure inside can push out that area more than the rest. This “weakening” can result from the thickness of the tissue getting thinner or it can be from the tissue losing its strength. The second part can be thought of as a new versus an old rubber band. The old rubber band has the same thickness but is not as strong as it used to be and therefore stretches out further with the same amount of force applied.

What is Rectus Diastasis?

Rectus Diastasis: The space between the rectus abdominal muscles, commonly referred to as the six-pack muscles, has increased. This occurs when the connective tissue holding the six-pack muscles near one another stretches and thins. When this occurs, the six-pack muscles drift farther apart from each other because the oblique muscles, the muscles on the side of our abdomen that that go more side to side, pull the six-pack muscles away from each other—each towards its own side. This process essentially results in a mild hernia or bulge in the abdominal wall. This hernia can be called a ventral hernia (more about this next) but since there is no discreet break of the connective tissue it has been labeled rectus diastasis. They are really one and the same, only to a different extent.

What is a Ventral Hernia?

A ventral hernia is an abdominal hernia. The “ventral” part comes from the description of where it occurs. Ventral refers to the front part of the abdomen and makes the assumption that the most “front” part of the abdomen will be in the middle of the abdomen. So, ventral hernia refers to a hernia in the middle of the abdomen along the connective tissue between the six-pack muscles. Sometimes you may hear “ventral incisional hernia”. This is a hernia in the middle of the abdomen from a prior abdominal surgery—hence the “incisional” part.

What is an “outie” belly button?

An “outie” belly button is also known as a belly button hernia. A belly button hernia, in turn, is a weakening of the connective tissue under the belly button. Think of it as rectus diastasis or ventral hernia just under the belly button. When this occurs, fat from inside the abdomen usually pushes up into the belly button stalk and lifts the deep part of the belly button making an “innie” into and “outie”.

So how are these types of hernias repaired?

There are two main ways to repair a hernia.

Products that can be used generally fall into either synthetic mesh or natural products such called acellular dermal matrix (ie animal or cadaver skin). This is sometimes done when the tissues are not strong enough to hold their own repair or as additional reinforcement.

Whenever able, the use of the bodys own tissues is preferred. The idea is mush like repairing a rip in a pair of jeans. You can sew the edges together or you can use a patch to plug up the tear.

Regardless of what method is used, access to the hernia is needed. This is where things become interesting. Large incisions can be used for direct access but they should be avoided unless the incision actually makes the area look better. That is, a large vertical incision can be used to fix a ventral hernia if tissue is also removed and tightened at the same time. Otherwise, smaller incisions hidden in the belly button or in the bikini area are used to repair rectus diastasis, ventral hernias, and “outie” belly buttons (belly button hernia).

The following are some photos of what an endoscopic hernia repair and an umbilical hernia repair look like.

Recently Kylie Jenner (of the Kardashian fame) admitted to getting lip filler injections to give her lips a fuller, poutier appearance. Although this is not so much of a surprise it did stir some emotions and thoughts about plastic surgery, youth, and the idea of inner beauty and self-growth that I wanted to share with everyone.

First. Medically speaking, there is no reason why a teenager could not get filler in their lips. The physical indications as well as the possible side effects are the same as those for an adult. The bigger question revolves around the delicate balance of self-image, self-esteem, and the importance of these aspects to youth in general.

If filler is deemed “appropriate” in a 16 or 17 year old, where is the line drawn for aesthetic improvements in youth that are still in the process of defining their self image and their inherent self worth. Certain plastic surgery procedures such as otoplasty (correction of prominent ears), breast reconstruction in young women that have the absence of one breast, or the reduction of overly large breasts is largely accepted by both plastic surgeons and most in society. They are seen as correcting something that has developed abnormally and often times severely impacts the mental and emotional well being of young adults that feel they are somehow “abnormal”.

There is a slippery slope of sorts in terms of plastic surgery and youth. I believe it is in the best interest of society in general for the parents, the child, and the plastic surgeon to take a broader approach to these issues and include discussion pertaining to mental well being in the present and in the future, counseling, self esteem/self worth, and the broad impact that plastic surgery decisions can have on these aspects of a person immediately but also in the future to come.

Tummy tuck surgery can be a daunting journey to embark on for many. As part of my abdominoplasty practice I feel that providing a place for patients to share their experience and advice would be invaluable. I encourage both current and future tummy tuck patients to ask questions and share their advice. I have and continue to learn from each of my patients. I know that the wealth of knowledge from all of my tummy tuck patients will be a source of comfort and guidance to patients that are considering tummy tuck surgery. I am excited to have an additional means of keeping my patients informed. While my website provides in-depth information on the tummy tuck procedure, my blog is a way for me to connect with my patients on a more personal, candid level. I look forward to sharing information with you and hearing your feedback.

“Hi Dr Repta I had a TT, w/ muscle repair in Feb 2015 and since then have had to get drained every other month from a seroma above my bellybutton. Now I’m scheduled to do laser lipo to hopefully get the seroma to heal as and close what do you think about this?”

Sorry to hear about your recovery. A long standing seroma certainly increases the chances of having a pseudo-bursa. If you feel:

In the area of the seroma this may be an indication of a pseudo-bursa. I think laser liposuction of other forms of liposuction can remove fat and disrupt scar tissue but obviously it will not result in removal of scar tissue. I have found in my practice that once the symptoms and diagnosis of pseudo bursa is present only excision of the pseudo bursa results in full relief of symptoms.

Q: Anonymous said… Hi Dr. Repta, I had a TT in Jan 2014 no drains. Appx 10mo post op I noticed a vertical bulge appx 4″x1.5″ to the left of my belly button. My surgeon first thought pseudobursa, but further review of pictures said fat deposit above the muscle in that area. My weight has fluctuated appx 5lbs, is it possible that is the contributing factor? How can it be resolved? Surgeon did lipo on hips… rather lumpy. Nervous about having a lumpy stomach as well!

A: Hello Anonymous. Although fat deposit can be a possibility the fact that this occurred 10 months after your tummy tuck and the fact that it developed in a linear fashion suggests the possibility of a pseudo-bursa. CT scans do not always show the presence of a pseudo-bursa. Without an exam its hard for me to guide you through the process but I would discuss the circumstances of how this developed and the fact that it may still be a pseudo-bursa with your plastic surgeon. He/she can help discuss and plan out what the best course of action will be going forward.

Sorry to hear about your DIEP breast reconstruction recovery. If you have a pseudobursa surgery is likely going to be the most definitive treatment. Time, massage, and PT may help but in my experience, significant resolution of the symptoms associated with a pseudobursa is often only accomplished by surgical removal. I do not know if the presence of a pseudobursa would also result in some of the numbness that you have described. Sometimes, the abdominal closure part of the DIEP flap can result in damage to nerves to the front of the thigh. Its a little unusual with the typical placement of the incision of a diep flap dissection but it is possible. Since the abdominal component of your surgery was part of your breast cancer reconstruction, exploration and repair of whatever is the cause of your abdominal symptoms should be covered by your insurance carrier. I do not know what type of insurance you have or whether you have out of network benefits, but if needed my office may be able to help you pre-authorize any revision surgery you may need if you choose to do so.

Q: Anonymous Lynda said… Dr. Repta, I had a double mastectomy with immediate combined DIEP/SGAP reconstruction two years ago. After a very active left hip drain was removed six weeks later, the incision developed a seroma that I had drained a couple times, approximately three months following the procedure, but I have always felt a numbness and fullness from my hip incision and down my outer hip/upper leg area, even after my revision surgery. I am confident it is a pseudobursa and it is beginning to pull on my hip joint and is becoming somewhat restrictive, but I dread undergoing another surgery. Will active tissue release or some form of PT that breaks up the scar tissue be effective, or is the only real fix to have it surgically removed?

Understanding the different types of and treatment options for abdominal hernias.

There are many different types of abdominal hernias that can occur. The most common abdominal hernias include:

Common causes for abdominal hernias include:

Ventral Hernia

A ventral hernia is a hernia that occurs in the middle of the abdomen vertically between the rectus abdominus muscles (six pack muscles). The best way to imagine and understand this type of hernia is to envision a long, skinny football shaped weakness oriented vertically (up and down) in the middle of the abdominal wall.

A ventral hernia can be caused by any of the above sources that been listed, but the two most common is pregnancy and prior abdominal surgery. Often, weight gain and weight loss in addition to either surgery or pregnancy also is a factor.

Repair of a ventral hernia can be performed by suturing the muscles back together, or by using some sort of mesh. I prefer to bring the healthy tissues back together as this is truly the only real hernia repair that allows the patient to regain their core strength. Sometimes a ventral hernia can be more subtle, without a definite border to where the hernia starts and stops. This is seen more often after pregnancy and is often called rectus diastasis. Repair of correction of ventral hernia and rectus diastasis is often similar in terms of bringing together the healthy tissue layers. When the hernia is too big to do so, component separation, where the muscle layers are separated, can be performed and/or the use of acellular dermal matrix can be used to reinforce the repair.

Umbilical Hernia

An umbilical hernia is a hernia or weakness of the abdominal wall near the belly button. This is one of the most common types of hernias to be born with and one of the most common types of hernias to develop as a result of weight gain or pregnancy. Umbilical hernias are commonly referred to as an “outie belly button”.

General surgeons typically like to use mesh plugs to repair the hernias while Plastic Surgeons usually like to repair the hernias but bringing together the healthy borders of the surrounding tissue. An umbilical hernia can be repaired via a small incision around the border of the belly button or via a larger incision if a ventral hernia or a tummy tuck is being performed at the same time.

Incisional Hernia

An incisional hernia is a weakness or separation of tissues where there has been a previous incision made. Many abdominal surgeries can result in an incisional hernia. Fortunately, most abdominal surgeries are now performed laparoscopically with small incisions. Occasionally, and abdominal surgery to remove an infected gallbladder or appendix or to treat problems with the liver, pancreas, or colon is needed. When these types of large incisions are used there is a risk that the tissues will either thin out at the incision site or the incision site tissue pull partially apart. Repair of these incisional hernias usually proceed by using the existing incision and bringing together the healthy borders of the tissue. Incisional hernias are often the type of hernias that can benefit most from the use of mesh or acellular dermal matrix.

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