Posts Tagged ‘abdominoplasty’

Why not combine several procedures at once? Maybe not.

Monday, April 4th, 2011

Many people want to have more than one surgery done at the same time. After all, it seems like a good idea – you only go to sleep once; you only have to recover once; you take less time off work and it costs less. Good idea, right?

The answer is: Sometimes.

There are downsides too. Combining procedures increases the surgery time and that carries several risks. These risks include the possibility of blood clots in the leg. A piece of this clot can break off and go the lung and block the blood vessel as it gets narrower than the clot itself. That can suddenly cut off a vital amount of lung tissue from it’s blood supply. This can cause breathing difficulties, and even be fatal. This risk increases with longer surgeries, where the blood circulation is slow and blood clotting naturally increases. Prevention is much better than treatment, which is long and complex. One way to avoid this problem is to control the length of time you are in surgery. Sometimes it is better to be cautious and split the procedures up into more than one surgery.

So how long is too long?

Most people agree that out patient cosmetic surgeries should be kept to 6 hours or less, if possible. This time limit varies with the procedure and the patient.

Here are some conditions which increase the risk. Overweight patients have an increased risk – body mass index (BMI) greater than 30 is a warning sign. Smokers have a significantly increased risk. Older patients have a higher risk. Having diabetes carries extra risk. Having a tummy tuck is slightly riskier that other procedures. Taking hormones, such as birth control pills, can arguably increase the risk. Having certain diseases at the same time can increase the risk so much that you probably should not be considering cosmetic surgery at all – cancer, heart disease for instance.

There are several things that can be done to minimize the risk, in addition to shortening the surgery time. These are designed to increase the rate of blood flow in the legs, or lessen the amount of blood in the legs. Wearing a tight (TED hose) stocking during and after surgery minimizes the volume of blood in the legs. Wearing a device that massages the blood along the legs works well during and after surgery. Walking about frequently starting right after surgery helps. Never sit with your feet hanging down and don’t stand still. Elevate your legs when at rest and wiggle your toes and ankles as much as you can remember and never cross your legs, is also good advice. Lastly, there are blood thinners that can be administered.

Other risks from longer procedures includes more blood loss. So it is important not to start the procedure already anemic.

… and don’t forget – 6 hours continuously with no breaks is a long time. What about surgeon fatigue?

Liposuction Abdominoplasty (tummy tuck with liposuction)

Saturday, August 8th, 2009

Liposuction abdominoplasty (tummy tuck with liposuction) has become such a huge success that I hope that patients will come from further away than my usual Stockton, Lodi, Manteca, Modesto and Tracy areas.

The combination of liposuction and abdominoplasty has produced the best results for this procedure that I have ever seen. In addition complications are much less. Recovery is much quicker for Modesto liposuction patients.

I am continually surprised to see how great the results of liposuction abdominoplasty are.

Looking for your comments

Thursday, July 2nd, 2009

This blog is mainly about plastic surgery and cosmetic surgery in particular. I intend to put out articles that both inform you and stimulate you to add your own thoughts. Please ask questions. Please disagree as you feel appropriate.

I will answer you if you ask me about breast implants, breast lift, breast enhancements, breast reduction, tummy tucks of all types and also liposuction. As you know my practice is well known for excellent results in these areas.

I am fascinated by these subjects as well as all questions related to beauty and would be happy to enter into a spirited conversation with you. I will even digress to non plastic surgery subjects if you want me to. Let’s talk about the economy, weight loss, life changing situations, poltics, health care and art.

I invite you to participate.

Liposuction Abdominoplasty – a new advance in the technique for tummy tucks

Sunday, June 21st, 2009

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. 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.

I have been doing a better technique recently which seems to have solved these problems. Research has shown us that the blood supply for the lower abdomen comes through deep blood vessels in the upper outer portion of the abdomen. If this area is preserved then healing problems become rare or non existent. Liposuction can be done at the same time and healing still remains very good. So now we can do complete liposuction of the abdomen and then go ahead and do a modified tummy tuck to preserve these blood vessels.

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 pain pump to automatically numb the surgical area with local anesthetics for about four days. Skin numbness is less. Seromas have all but been eliminated. Return to normal activities is much quicker.

If you are extremely thin and you do not need the liposuction we can omit it and do the rest of the new and improved technique.

I have been very encouraged and excited by these results. If you are thinking about getting a tummy tuck done please make sure that you find out more about this technique first. I would be happy to schedule a consultation to tell you all about it. Please call our liposuction Modesto facility at (209) 323-2979 for an appointment.

My practice is in Stockton, but many patients come from all the surrounding areas, such as Lodi, Modesto, Manteca and Tracy and beyond.

Cosmetic Surgery Statistics for 2008

Sunday, March 29th, 2009

Here are some interesting facts as reported by the American Society for Aesthetic Plastic Surgery. I am a member of this society.

From 2007-2008, there was over a 12 percent decrease in the total number of cosmetic procedures. Surgical procedures decreased by 15 percent, and nonsurgical procedures decreased by almost 12 percent.

The top five surgical cosmetic procedures in 2008 were: breast augmentation (355,671 procedures); liposuction (341,144 procedures); eyelid surgery (195,104 procedures); rhinoplasty or nose reshaping (152,434 procedures); and abdominoplasty or tummy tuck (147,392 procedures).

The top five nonsurgical cosmetic procedures in 2008 were: Botox injection (2,464,123 procedures); laser hair removal (1,280,964 procedures); hyaluronic acid (1,262,848 procedures); chemical peel (591,808 procedures); and laser skin resurfacing (570,880 procedures).