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Category Archives: Abdominoplasty

Abdominal Rejuvenation Surgery

Fall and Winter are great times to consider abdominal rejuvenation surgery

Most surgical body contouring procedures require compression garments be worn four to six weeks postoperatively.  Why?  Because patients will maximize their outcomes.  Due to cooler weather in the fall and winter seasons, many of my patients often dovetail holidays such as Thanksgiving through New Years to gain extra recovery time without missing work or holiday events. Additionally, many women want to be well healed to look great on Spring break vacations to sport their new body contours.  

Here are a few considerations to consider as you explore body contouring surgery:

Having children, weight loss with or without bariatric surgery, aging skin, and previous open abdominal surgery with vertical scars can all contribute to diminished aesthetic appearances of the abdomen.  Additionally, other areas that can diminish the overall appearance of the torso may include unwanted fat contours of the posterior bra line, and posterior flanks (otherwise known as muffin top).  If surgical rejuvenation is something that a prospective patient is considering, then a detailed consultation with a plastic surgeon is necessary to determine the correct approach to yield the best results.  Many factors must be considered such as the quality and quantity of the skin to determine if the underlying fat excess can be adjusted with lipo- contouring alone or with the addition of surgical removal of skin to achieve a nice tight, smooth contour.

Expected improvements with Abdominoplasty:

  • Elimination of lower abdominal excess skin that may hang over the mons pubis (pubic area).
  • Correct abdominal wall integrity lost by separation of the rectus abdominus (front of the abdomen) muscles from pregnancy or congenital anomalies.
  • Contour the mons pubis and provide a sleeker appearance in swim wear and athletic or leisure apparel.
  • Contour excess abdominal fat contours in the upper abdomen and anterior flanks.
  • Create a youthful belly button.

Expected improvements of power assisted lipo-contouring of the posterior flanks:

  • Create a sleeker circumferential contour of the lower torso when combined with abdominal lipo-contouring or abdominoplasty to improve appearance in current fashion trends.
  • May enhance the hour glass silhouette often obscured when a women’s lower rib diameter and the pelvic rim diameter are the same.
  • Often is a great source of gluteal (buttocks) enhancement fat volume while further defining hour glass appearance.

Expected results of power assisted lipo-contouring of the posterior bra line:

  • Eliminates the back-bra line roll that detracts from the overall posterior aesthetics in swimsuits and fitted dresses.
  • May tighten somewhat loose skin in this area if tissues are appropriate for lipo-contouring alone.

Reverse Abdominoplasty, A technique to elevate and remove loose upper abdominal skin and positioning of the scar within the breast folds:

  • An excellent technique when the skin excess resides within the upper abdomen and not positioned hanging over the mons pubis.
  • Can be used in conjunction with a breast lift to provide added vascularized fat volume from the abdomen to fill the upper pole of the breasts in lieu of an implant.
  • May be a better choice on a woman who has upper skin excess with no diastasis rectus and never was pregnant.
  • Lower abdominal excess fat deposition can be lipo-contoured to leave a flat stomach.

 

What is a reverse abdominoplasty, and who needs it?

Reshaping the contour of the abdomen is frequently requested in my office consultations. The most common techniques are various forms of liposuction with or without an abdominoplasty. Another tool in our repertoire which can yield effective results is the “Reverse Abdominoplasty.” The classic indications for a regular abdominoplasty is a torso which has loose excess inelastic skin of the lower abdomen, abdominal wall rectus muscle separation (diastasis), and varying degrees of excess fatty tissue. The technique eliminates the excess skin and fatty tissue in the lower abdomen, reconnects the rectus muscle together to tighten the abdominal wall, and excess abdominal fatty tissue can be reshaped with liposuction to provide a pleasing shape. A Reverse Abdominoplasty is chosen for the individual who has loose excess skin in the upper abdomen, who generally does not have a full diastasis which is affecting the lower abdominal contour, and may have excess fatty tissue in the lower abdomen without skin excess. The technique is to start with incisions that follow the lower breast fold then cross the lower sternum to connect both sides of the abdomen. These scars generally hide very well even in two piece bathing suites. The full thickness skin is elevated down the abdomen preserving the vital blood supply on either side of the belly button. If upper rectus muscles need to be tightened this can proceed. Any abdominal fatty excess can also be corrected with liposuction at this time. The elevated released excess abdominal skin can be addressed in several ways depending on the needs of the patient:

1. If a women who has the upper abdominal skin excess and also desires rejuvenation of the breast the excess elevated skin of the abdomen can be utilized as a self-augmentation under the breast to provide added fullness and shape. This is often done in conjunction with a breast lift (Mastopexy) and can avoid the need and expense of an implant. I have even performed this procedure with a woman who many years ago had bilateral mastectomies for breast cancer and we reconstructed her with implants. She had experienced some weight fluctuation and was becoming very active and requested the elimination of her breast implants but still desired a smaller breast to remain. We utilized a reverse abdominoplasty skin excess, removed the outer skin, and placed it in her implant space to fill the void and added tissue volume and shape provided with fat grafting harvested from her back, thighs, and lower abdomen giving her a smaller but still reasonable breast shape.

2. The Reverse Abdominoplasty could be incorporated as part of a treatment plan to tighten the upper abdominal contour. After the incision and elevation of the abdominal excess loose skin, the surgeon can remove the undesirable portion and fixate the remaining tissue to the rib fascia of the lower breast fold to avoid the scars from migrating inferiorly thus preventing the exposure of the scars on the upper abdomen. I have used this as a primary surgical procedure for women with loose skin of the upper abdomen that would not respond favorably to liposuction alone. I have also used this as a secondary procedure on women who have previously had an abdominoplasty with good results but over time the lower abdomen has maintained its results yet the upper abdomen has become loose and has excess as a result of weight changes, sun exposure, and of course gravity. The excess skin can be removed providing a nice tight appearance to the whole abdomen.

3. Another situation for the reverse abdominoplasty is for a women with loose upper abdominal skin combined with previous augmentation mammoplasty in which the implants have become mal-posed and have drifted inferior and lateral to the correct position. In this case the excess elevated tissue can be utilized as a autologous (meaning from your own body) soft tissue sling to help reposition and stabilize the implant similar to an Acellular Dermal Matrix (ADM) graft without the significant added cost of the product to provide long lasting results.

One of the aspects in my profession of plastic surgery I am most proud of is the innovative nature of the field. We take problem sets that patients present to our office and we create unique methods that achieve a sound result with the least amount of surgery and the lowest costs to ensure successful and happy patients. The Reverse abdominoplasty is an example of one of these off shoot procedures which fills a vital niche in my practice.

Jay H. Lucas, MD
Board Certified Plastic Surgery, MOC 2012
The Lucas Center, Plastic Surgery
Knoxville, Tn.
thelucascenter.com

Natrelle 410 Breast Implants

There are many different kinds of breast implants in the market right now, and it can be confusing for anyone to know what is best. That is why Dr. Lucas is here to help you sift through all the clutter and introduce the latest breast implant.

The FDA recently approved the Natrelle® 410 highly cohesive, anatomically shaped silicone-filled breast implant for use in augmentation, breast reconstruction and revision surgeries. These gel implants provide an important new alternative to traditional round implants for women. It is designed to mimic the slope of the breast and hold its shape over time while remaining soft to the touch.

The FDA approval of the Natrelle® 410 gel implants was based on an extensive review of various data and studies, including pre-clinical device testing and clinical data from Allergan’s 10-year prospective, multi-center pivotal study. It involved nearly 1,000 women who have undergone breast reconstruction, augmentation or revision surgery.

During your consultation for breast surgery with silicone gel implants, Dr. Lucas can discuss which implant options are right for you. Natrelle® 410 implants with the highly cohesive gel offer a shaped profile alternative to a round devise which might be right for you.

If you have any questions about this breast implant or any others, please contact The Lucas Center of Plastic Surgery at 865-218-6210.

Dr. Jay Lucas is a board-certified plastic surgeon located in Knoxville, TN. He has a decade of experience performing a variety of cosmetic surgeries, and his unique educational background at some of the nation’s most prestigious medical centers allows him to perform cutting-edge plastic surgery procedures for his patients. This includes face lifts, breast augmentations, tummy tucks and rhinoplasties.

A Lift That Gives You a Lift

At The Lucas Center, we think of cosmetic surgery as more than just a procedure. It’s a lift that gives you a lift! Boosting your confidence is our goal, from the first phone call to your outpatient care. Dr. Lucas is known for his precision and will prioritize your wants and needs each step of the journey.

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Get your confidence back! If you feel good, you are going to shine in every aspect of your life. Plastic surgery will give you a lift in multiple ways. A study revealed that 87% of patients were satisfied with their surgical improvements, including an overall boost in confidence and positive experience with the specific procedure. To learn more about how Dr. Lucas can help you feel and look your best, watch this abdominalplasty testimonial:

[Source:  http://www.surgery.org/consumers/plastic-surgery-news-briefs/plastic-surgery–lift-give-lift-infographic-1051301

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