Should I Get A Tummy Tuck Or Laser Skin Tightening?

Q: Dr. Eppley, I just wanted a consult to see if a tummy tuck or laser skin tightening would be an option for me. I had a child almost two years ago and lost over 60lbs.

Tummy Tuck abdominal reshaping Dr Barry Eppley IndianapolisA: The decision between a tummy tuck and another abdominal contouring option is often debated. However, you have said two things that helped define your tummy options, even without seeing pictures of it. (although that would also be helpful) The combination of having a child and losing over 60lbs had made the use of laser skin tightening an impossibility. Even at best, laser skin tightening may be able to tighten about 1 cm. (1/2 inch of skin) I suspect that the amount of loose abdominal skin that you have exceeds that by a considerable amount. Being between stretched by pregnancy and then losing that amount of weight, the elasticity of skin has been broken and its ability to tighten removed. A tummy tuck is undoubtably what you will really need to get the improvement in abdominal tightening that you desire.

Dr. Barry Eppley

Indianapolis, Indiana

Do I Need A Tummy Tuck For My Loose Skin?

Q: Dr. Eppley, I have wanted to have a tummy tuck for the last five years. I have had two children who were both born at over nine pounds. I am 5’ 7” and weigh 135 lbs. I have worked out a lot and got my stomach as toned as it can be. However I still have hanging skin if i lay on my side or bend over. I have no confidence when I have no clothes on.

A: A tummy tuck is often the only solution for loose skin on one’s stomach. Diet and exercise help with loosing fat but can not get rid of loose skin or tighten it up. Stretch out or loose abdominal skin is an irreversible problem short of surgery. Even women who are relatively thin and work out regularly find out that they simply can’t make this skin go away. Such a realization often drives them to seek out tummy tuck surgery. Whether one needs a full or partial tummy tuck depends on how much loose skin exists.

Dr. Barry Eppley

Indianapolis, Indiana

 

How Do I Know What Size Breast Implants To Get?

Q: Dr. Eppley, I am interested in having breast implants. I am currently a 34B and am interested in a full C or a small D cup. Also, I was previously 190 lbs and am now 135 lbs. I have a flabby area above my belly button which I would love to have tightened. I work out regularly, yet it just doesn’t seem to help. This area would be optional though, as my primary interest would be having breast implants. I saw the general fees for each procedure, and was curious if combining procedures offer any cost reduction. 

A: In answering your breast implants and tummy tightening questions:

Volumetric Sizing System for Breast Implants Dr Barry Eppley Indianapois1) When it comes to size of breast implants, I do not use the concept of cup size. While women understandably have that as a breast reference, implants come in volume (ccs) not cup size. And regardless of cups size or ccs, in the end all you really care about it how the breast looks…the number attached to it in that regard is not important as long as it looks the way you want. In choosing breast implant size in volume for any patient, I use a Volumetric Implant Sizing System. You can try on the various volumes and see how they look and then choose. I find this to be incredibly accurate which less to a very rare problem of patient dissatisfaction withe the outcome of their breast augmentation procedure.

2) Having lost 55 lbs, this raises the question of whether you have any loose breast skin or sagging. This is an important preoperative consideration since breast implants do not create a ‘breast lift’ effect and can make make a saggy breast look worse even though it is bigger. Seeing some pictures of your breast would help answer that question.

3) Your weight loss is also the source of the flabby area around your belly button. Since the belly button  is the only fixed point on the stomach, weight loss causes the skin around it to sag resulting in flabbiness and sometimes an actual upper belly button overhang. The only method to truly tighten loose abdominal skin is some form of a tummy tuck.

4) Your assumption is correct in that there is some cost savings when procedures are combined.

Dr. Barry Eppley

Indianapolis, Indiana

Do I Need Liposuction Or A Tummy Tuck?

Q: Dr. Eppley, I am not sure if I  need Lipodissolve or a tummy tuck. I have gained 15 pounds or more since I have turned 40 and now can not seem to lose it.  I am not sure what I need to get my clothes to fit right again. Does the lipodissolve work? How much is the cost between them? What is the diffenence? How much time will be needed off work for a tummy tuck?  Will the weight come back right away? The weight is around my middle, love handles and my thighs and butt.

A: Choosing between liposuction and a tummy tuck is a common dilemma for many women, although many times it is a more hopeful wish that liposuction alone will create the result they want. While I don’t know what you look like, I am absolutely certain based on your description that lipodissolve injections are not the answer. They are for very discrete small areas of fat which is not what you have. The question is only then whether it is liposuction alone or liposuction combined with a tummy tuck. Seeing a picture of your stomach would be helpful in answering that question. There is no doubt you need liposuction, it is just whether there is enough loose skin across the stomach to justify a tummy tuck as well.

Dr. Barry Eppley

Indianapolis, Indiana

 

Do I Need A Mini- Or Full Tummy Tuck?

Q: Dr. Eppley, I would like to get a tummy tuck and belly button reconstruction. I’m not sure what type I need. I workout approximately 5 days a week. I have a lot of scar tissue near my c-section scar that is bothersome. Would a procedure also help with the scars? What type do you recommend?

Tummy Tuck Options Dr Barry Eppley IndianapolisA: You are correct in your assessment that you would benefit by a tummy tuck. When it comes to tummy tucks there are really only two fundamental types; a mini- or limited and a full tummy tuck. The difference between the two is in the the location and amount of abdominal tissues removed. With uncommon exception, most women are better off with a full tummy tuck because it produces a better result, remakes the belly button and provides the best exposure for complete rectus muscle plication. As part of the tummy tuck, all scar tissue from the previous c-section(s) would be removed regardless of whether one gets a mini- or full version.

Be aware that many tummy tucks also incorporate liposuction as part of it to get a better overall result.. That could be liposuction of the flanks beyond the zone of the tissue excision or above the zone of tissue excision in the upper abdominal area.

Dr. Barry Eppley

Indianapolis, Indiana

Will A Tummy Tuck Fix My Pregnancy Figure?

Q: Dr. Eppley, I am interested in getting  tummy tuck.  At about this time three years ago, I had a miscarriage at five months. Unfortunately, my body never really recovered from all the changes it went through. In the last three years I managed to lose about half of the weight I put on. It seems that no matter how much I try I can’t get back to normal. I’m about to graduate college and start this wonderful new chapter of my life, but I’m afraid that being stuck with my pregnancy figure will keep me from fully enjoying it. I’ve attached a couple pictures of myself for you.

A: Based on your pictures, you have an ideal stomach issue for a tummy tuck and flank liposuction. With your body now, your stomach could end up completely flat and your waistline would have an hourglass shape from the liposuction. The trade-off for this abdominal and waistline change is the low horizontal scar that accompanies every full tummy tuck. This is an issue for every woman to consider that has not yet had children and may likely do so in the future. But besides the aesthetics of the scar, it does not prevent future pregnancies nor does it affect the ability to carry a child to full term.

Dr. Barry Eppley

Indianapolis, Indiana

What Body Contouring After Weight Loss Procedures Do I Need?

Q: Dr. Eppley, I am interested in body contouring after weight loss. I have 2 very large, deep atrophy dents, one on each hip from kenalog injections. I have arthritis and fibromyalgia in my hips. The pain is unbearable, and has left me disfigured. I also have lost 100 pounds over the past 3 years and have bags of fat instead of breasts. And I have a giant stomach that is all skin and fat that hangs dramatically.

A: Body contouring after weight loss, also known as bariatric plastic surgery, is commonly done today. When one loses 100lbs or more, as often happens with successful bariatric surgery or great personal diet and exercise efforts, many expected body changes occur. The large stomach deflates and become an apron that hangs over the waist line, the breasts lose their volume and hand down onto the stomach like two empty bags of skin, and the once larger arms and thighs sag. These common extreme weight loss concerns are treated with extended tummy tucks or abdominal panniculectomies and sagging breasts are changed with full anchor scar pattern breast lifts with implants in most cases. By getting rid of these tissue overhangs, combined with the weight loss, back and hip pain is often lessened. At the same time the large hip dents, which have occurred as a result of subcutaneous tissue atrophy from the steroid injections, can be treated by fat injections or even dermal-fat grafts depending on its depth and degree of skin tethering.

Dr. Barry Eppley

Indianapolis, Indiana

Can A Tummy Tuck And Buttock Implants Be Done At The Same Time?

Q: Dr. Eppley, I am interested in getting a combined tummy tuck and buttock implants operation. I won’t have the money for my surgery until April 2014. Is it a good option to have a consultation a couple months ahead or within a certain time frame prior to the surgery. Also how much approximately would it be to have both procedures at the same time?  Is there a discount for that or some type of deal for booking both at the same time?

A: I think it is always good to get accurate surgery and cost information way in advance of when any patient wants to do their surgery so they can plan accordingly. Doing it two or three months in advance is a good idea. I will have my assistant pass along some general cost information for a tummy tuck and buttock implants to you by tomorrow, although be aware that these are general numbers since I have no idea as to your exact tummy tuck needs.

Like all cosmetic surgery, bundling procedures together can result in a cost savings due to saving operating room and anesthesia charges. However, the combination of a tummy tuck and buttock implants done together would make for a really difficult recovery and this is not a recommended combination procedure. A tummy tuck and fat injections to the buttocks can be done at the same time but two muscular operations on opposing sides of the torso is not a good combination.

Dr. Barry Eppley

Indianapolis, Indiana

Will Liposuction Work For My Abdominal Problem?

Q: Dr. Eppley, How much for liposuction, specifically smart lipo, of the abdomen? Here is a picture of my abdomen. I am not interested in a tummy tuck scar and the recovery time. Thanks.

A: While I can understand why you would want to pursue some form of liposuction, it is neither the appropriate or effective contouring procedure for your abdominal problem. You have as much excess skin as fat as part of the loose abdominal overhang. Removing fat will only cause more loose skin and will not get rid of the overhang. It may likely leave your abdominal problem with no substantative improvement. While no one understandably wants a tummy tuck scar or the recovery from it, this is the only procedure that will be effective for your concerns. Do not waste money or effort on a liposuction procedure that will not work for you.

Dr. Barry Eppley

Indianapolis, Indiana

Do I Qualify For A Tummy Tuck?

Q: Dr. Eppley, Do I qualify for a tummy tuck based on my weight of 155 lbs at 5’ 6”? Also I would like to down size my 650cc saline implants to something considerably smaller.

A: Based on your pictures which show a double abdominal roll, you would definitely benefit by a tummy tuck which would eliminate that problem. You can also certainly downsize your implants and I will assume for now that you want to stay with saline implants. The one issue with downsizing is what will happen to the overlying breast tissue. You already have some breast tissue bottoming out and that will get more substantial with downsizing. I see the scars around the areolas which I presume is from a periareolar mastopexy with your original augmentation. To deal with these issues I would do an inframammary fold excision/tuck with your implant downsizing as well as possible a periareolar scar revision.

Dr. Barry Eppley

Indianapolis, Indiana