Plastic surgery Body enhancement articles

I get many patients who come into my Baltimore office requesting a Tummy tuck. The Tummy tuck will give a much flatter tummy, and if they get liposuction around the love handle area, a drastic reshaping of the entire midsection. But the biggest drawback is the scar. It goes most of the time from hip bone to hip bone. Invariably, I get the question, can we do a Mini Tummy tuck? The patient is hoping to get most of what she needs with a smaller scar and a less involved surgery. What is the difference between the Tummy tuck and the Mini Tummy tuck?

One question I always clarify: What is the labiaplasty procedure is designed to do? Does it enhance sexual experience, improve the appearance of the vagina, or both? Since the procedure is a type of ‘vaginal rejuvenation,’ there is a lot of confusion from the media as to what exactly the goal of the procedure is. Furthermore, many gynecologists equate vaginal rejuvenation mainly with sexual enhancement. However, for most plastic surgeons, the purpose of the Labiaplasty procedure is to improve appearance only. Let’s review the media sound bites from both gynecologists and plastic surgeons…

Exparel is a long acting local anesthetic which is injected into the operative area at the end of the procedure. Like the pain pump, it focuses just on the operative area, and does not disseminate to the entire body like a narcotic does. The function of the Exparel is to numb the area of surgery so you do not feel pain. With cosmetic surgery, patients only need the one injection, and the pain control lasts for about 3 days. Similar to the pain pump, patients take fewer narcotics post operatively, because the pain is more controlled.

Recently, a patient came to me for a second opinion. She was an attractive, dark skin Hispanic female who had had Liposuction to the saddlebag area along with a tummy tuck and a breast lift. The result was great, but the patient was unhappy. She had a small waist, and a nicely defined hourglass figure. Her hips were curvy. Now why would a patient be unhappy with a ‘good’ result?

In 2006, I gave a lecture on the Body lift procedure to other surgeons in my hospital. In gathering the information for my talk, two things struck me when reviewing the literature published by other physicians. In summary, the current literature concluded that: 1) Surgeons are still reporting complications with the Body lift procedure. These complications include wound separations and seromas 2) Plastic Surgeons are still “learning about the procedure” My impression is that surgeons are having these problems because they do not use the Lockwood technique of body lifting. I use the Lockwood technique and feel very confident with the procedure and my results. Let me give you a brief history about the Body lift procedure, and how Dr. Ted Lockwood evolved the procedure.

As a senior (a little over 60 years old) I had given continued thought and prayer to having Breast reduction surgery for a number of years (at least 30 or more). In the past few years the thought and prayers became more and more on my mind and approximately 2 years ago I went as far as having a consultation with a plastic surgeon. I don’t know if it was my frame of mind or exactly what all the reasons were, but I was not comfortable with the surgeon, his staff, or even the thought of continuing on with this surgery. I didn’t go back for a 2nd visit…

Cosmetic surgery is not just for your face, breast, and body. Your hands age too. As we grow older, there is a change of fat distribution in the body. For example, the face tends to lose some volume in certain areas, and the midsection of the body tends to gain fat. Another one of the areas which loses fat is the hand.

The question of whether to have a Tummy tuck or Liposuction is a very common one from my Baltimore patients. The two procedures address different problems. Liposuction deals only with fatty tissues, whereas Tummy tuck deals with muscle, skin, and fat. If you have loose skin,  liposuction will not address this. Some patients are candidates for liposuction only, some for Tummy tuck only, and some could have either procedure, depending on their priorities.

I asked the patient if he be interested in a procedure to tighten the muscles that was not described anywhere in the literature (this was early 90’s!) but that I could perform a surgery using techniques I was comfortable with? He agreed, signed the informed consent, and I did the procedure by making an incision around the belly button for access to the deeper tissues. The procedure went so well I immediately felt bad for all those patients on whom I had done a traditional incision to treat this problem. So if I could do this going above the belly button, why not do it for muscle separations below the belly button?

I once had a patient who wanted a revision of her Liposuction. I have seen her already several times and she is unhappy about small areas on her hips. The small bulges are above and below the panty line so the indentation of the panties on the skin magnifies the defect. She recognizes that the result is an improvement on what she had before but these small things are irritating her.

I’m sitting here waiting for my next case, a Mini Tummy Tuck. It is a natural tendency to want maximum results for minimal effort. That is why the words “mini facelift”, mini this and that, are so popular today. The main thing to remember about these procedures is that they are limited versions of the original procedure designed for patients with a minimal defect. Be aware that mini procedures can also mean mini results. Not everybody is a candidate, but some are.