Tummy Tuck Procedure


 

Tummy Tuck or Liposuction? What is the Difference Between Tummy Tuck & Liposuction Surgery?

Liposuction refers to an operation that removes adipose tissue with the use of cannulas to improve body contour. Abdominoplasty is the repair of the abdominal wall (abdominal muscle plication) as well as the excision of extra / damaged skin for improved abdominal contour and skin tightening.

Liposuction procedure varies in duration depending upon how much work needs to be performed. Liposuction is an outpatient procedure with minimal recovery time. Incisions for the procedure are generally one quarter inch in length and are placed in inconspicuous skin folds. Liposuction will not change the appearance of the skin. The operation does not involve any skin removal or re approximation of abdominal wall muscles or skin tightening. The best candidates for liposuction surgery of the abdominal wall are patients with good quality skin elasticity and a moderate degree of diet and exercise resistant adipose tissue superficial to the abdominal wall muscle layer. Patients who are significantly overweight, have significant abdominal wall laxity, and/or have lost a significant amount of skin elasticity are not generally good candidates. It is important to realize that suction lipectomy is not a skin tightening method. When a patient is bothered by loose or extra skin the best procedure will be an abdominoplasty. This will remove the excess skin and also provide the best contour of the abdomen when dealing with loose, dimpled, wrinkled, strechmarks, and abdominal laxity.

Abdominoplasty surgical duration can vary from 3 1/2 – 5 hours depending on the patient and is also performed as an outpatient surgical procedure. Incision site for the abdominoplasty can be from hip to hip (for a standard tummy tuck) or extend into the back (for an extended abdominoplasty).

The “ideal” patient for tummy tuck surgery is one who has completed pregnancies, is psycho socially/emotionally/financially stable, has an excellent social support system surrounding him/her, is capable of arranging enough recovery time, does not smoke and who has reached a long-term stable weight. The tummy tuck operation involves removal of excess skin/adipose tissue of the lower abdominal wall and re approximation of the abdominal wall muscles that may have spread with pregnancies and/or weight gain/loss. Liposuctioning is often used as a tool during the tummy tuck procedure.
 
 
Liposuction risks include:

• Skin re-draping problems: liposuction is not an exact science and so the skin may not re-drape exactly after surgery.
• Asymmetry: differences between the areas treated may necessitate further surgery.
• Scarring: small scars may form where the incisions are made to allow for the liposuctin cannula. Scar revision may be necessary after everything is healed.
• Infection: rare and usually treatable with antibiotics.
• Bleeding: rare but may require surgical intervention.
• Deep Venous-Thrombosis/ Pulmonary Embolism: blood clots that form in the legs that may travel to the lungs causing difficulty with respiration and requiring hospitalization.
• Prevention is key using compression stockings and early ambulation.
• Need for revisionary surgery
 
 
Risk associated with Tummy tuck

There are risks associated with tummy tuck surgery; the majority of serious complications that may occur with tummy tuck surgery occur within the first 2 weeks. These may include deep venous thrombosis, pulmonary embolism, pneumonia, infection, bleeding, and even death. Fortunately, the potential for these types of major complications are very small, assuming
careful selection of a board certified plastic surgeon, board certified anesthesiologist, and fully accredited surgery facility. Other types of complications that are more likely include superficial incision line healing problems ( wound healing problems), seromas, abdominal wall asymmetry, abnormal scarring, unsatisfactory cosmetic results. Careful selection of plastic surgeon will help minimize potential risks associated with umbilical hernia repair as well.

Breast Implant Removal Options

Patients with breast implants may choose to remove them for various reasons, such as lifestyle changes, aesthetic reasons, and/or potential health complications they feel are stemming from their implants. There are three types of breast implant removal surgeries….

• Straightforward Breast Implant Removal:
This procedure consists of removing just the breast implants. This procedure is ideal for patients who are not experiencing any complications and would like to remove their implants for aesthetic reasons or lifestyle changes that resulted in them no longer wanting their implants. Straightforward implant removal is a fairly quick and simple procedure with a relatively speedy recovery. Another reason why patients would choose to just remove the implant rather than remove both the implant and the capsule is if the capsule is thin and delicate. Removal of a thin capsule can result in bleeding and possibly removal of the remaining breast tissue. If the capsule is not thick, calcified, or abnormal in any way, some believe removal does not need to be an option.

• Implant Removal With Capsulectomy:

This procedure consists of removing the breast implant, as well as removing the capsule surrounding the implant. This procedure can be a partial capsulectomy or total capsulectomy. A total capsulectomy involves removing the entire breast capsule from around the implant. A partial capsulectomy involves removing only part of the capsule. Since the capsule does not disappear on its own after the implant is removed, some patients opt to proceed with a capsulectomy. Sometimes during a partial capsulectomy when the entire capsule cannot be removed for whatever reason, the remaining capsule will be cauterized to sterilize the area and promote healing.

Implant removal with capsulectomy can expose patients to additional risks, such as bleeding, size loss, contour irregularities and other serious complications. In other words, any maneuver performed during surgery exposes patients to additional risk (morbidity). For example, attempting to remove very thin capsule densely adherent to the patient’s rib cage may expose the patient to significant bleeding and/or entrance into the thoracic cavity.

• Implant Removal En Bloc:
En Bloc breast implant removal refers to a procedure where the breast implant and the surrounding capsule is removed as a single unit. The procedures is performed such that the contents within the breast implant capsule do not come into contact with the surrounding tissues. Generally, the procedure requires a longer incision (6-7 centimeter) usually in the inframammary fold, in my experience. The procedure is more successful when capsules are thickened as opposed to when patients have very thin (normal) capsules. Also, sometimes complete capsulectomy is not safely possible; for example, breast implants placed in the sub muscular position may have a capsule that can be densely adherent to the patient’s rib cage. Removal of this posterior capsule can be potentially dangerous.

Generally speaking, unless the breast implant capsules have thickened (and/or are otherwise symptomatic), are associated with the ruptured silicone gel breast implants, or if the patient has concerns about “medical conditions” related to the breast implants, capsulectomy is not universally necessary. For these patients, En Bloc removal of breast implants is a good procedure.


Tummy Tuck or Liposuction?

Tummy Tuck or Liposuction? What is the Difference Between Tummy Tuck & Liposuction Surgery?
Liposuction refers to an operation that removes adipose tissue with the use of cannulas to improve body contour. Abdominoplasty is the repair of the abdominal wall (abdominal muscle plication) as well as the excision of extra / damaged skin for improved abdominal contour and skin tightening.

Liposuction procedure varies in duration depending upon how much work needs to be performed. Liposuction is an outpatient procedure with minimal recovery time. Incisions for the procedure are generally one quarter inch in length and are placed in inconspicuous skin folds. Liposuction will not change the appearance of the skin. The operation does not involve any skin removal or re approximation of abdominal wall muscles or skin tightening. The best candidates for liposuction surgery of the abdominal wall are patients with good quality skin elasticity and a moderate degree of diet and exercise resistant adipose tissue superficial to the abdominal wall muscle layer. Patients who are significantly overweight, have significant abdominal wall laxity, and/or have lost a significant amount of skin elasticity are not generally good candidates. It is important to realize that suction lipectomy is not a skin tightening method. When a patient is bothered by loose or extra skin the best procedure will be an abdominoplasty. This will remove the excess skin and also provide the best contour of the abdomen when dealing with loose, dimpled, wrinkled, strechmarks, and abdominal laxity.

Abdominoplasty surgical duration can vary from 3 1/2 – 5 hours depending on the patient and is also performed as an outpatient surgical procedure. Incision site for the abdominoplasty can be from hip to hip (for a standard tummy tuck) or extend into the back (for an extended abdominoplasty).

The “ideal” patient for tummy tuck surgery is one who has completed pregnancies, is psycho socially/emotionally/financially stable, has an excellent social support system surrounding him/her, is capable of arranging enough recovery time, does not smoke and who has reached a long-term stable weight. The tummy tuck operation involves removal of excess skin/adipose tissue of the lower abdominal wall and re approximation of the abdominal wall muscles that may have spread with pregnancies and/or weight gain/loss. Liposuctioning is often used as a tool during the tummy tuck procedure.


Liposuction risks include:

• Skin re-draping problems: liposuction is not an exact science and so the skin may not re-drape exactly after surgery.
• Asymmetry: differences between the areas treated may necessitate further surgery.
• Scarring: small scars may form where the incisions are made to allow for the liposuctin cannula. Scar revision may be necessary after everything is healed.
• Infection: rare and usually treatable with antibiotics.
• Bleeding: rare but may require surgical intervention.
• Deep Venous-Thrombosis/ Pulmonary Embolism: blood clots that form in the legs that may travel to the lungs causing difficulty with respiration and requiring hospitalization.
• Prevention is key using compression stockings and early ambulation.
• Need for revisionary surgery


Risk associated with Tummy tuck

There are risks associated with tummy tuck surgery; the majority of serious complications that may occur with tummy tuck surgery occur within the first 2 weeks. These may include deep venous thrombosis, pulmonary embolism, pneumonia, infection, bleeding, and even death. Fortunately, the potential for these types of major complications are very small, assuming
careful selection of a board certified plastic surgeon, board certified anesthesiologist, and fully accredited surgery facility. Other types of complications that are more likely include superficial incision line healing problems ( wound healing problems), seromas, abdominal wall asymmetry, abnormal scarring, unsatisfactory cosmetic results. Careful selection of plastic surgeon will help minimize potential risks associated with umbilical hernia repair as well.

 

Breast Implant Removal Options
Patients with breast implants may choose to remove them for various reasons, such as lifestyle changes, aesthetic reasons, and/or potential health complications they feel are stemming from their implants. There are three types of breast implant removal surgeries….

• Straightforward Breast Implant Removal:
This procedure consists of removing just the breast implants. This procedure is ideal for patients who are not experiencing any complications and would like to remove their implants for aesthetic reasons or lifestyle changes that resulted in them no longer wanting their implants. Straightforward implant removal is a fairly quick and simple procedure with a relatively speedy recovery. Another reason why patients would choose to just remove the implant rather than remove both the implant and the capsule is if the capsule is thin and delicate. Removal of a thin capsule can result in bleeding and possibly removal of the remaining breast tissue. If the capsule is not thick, calcified, or abnormal in any way, some believe removal does not need to be an option.

• Implant Removal With Capsulectomy:



Source: USH Journalism Studies

Source: Pinterest
This procedure consists of removing the breast implant, as well as removing the capsule surrounding the implant. This procedure can be a partial capsulectomy or total capsulectomy. A total capsulectomy involves removing the entire breast capsule from around the implant. A partial capsulectomy involves removing only part of the capsule. Since the capsule does not disappear on its own after the implant is removed, some patients opt to proceed with a capsulectomy. Sometimes during a partial capsulectomy when the entire capsule cannot be removed for whatever reason, the remaining capsule will be cauterized to sterilize the area and promote healing.

Implant removal with capsulectomy can expose patients to additional risks, such as bleeding, size loss, contour irregularities and other serious complications. In other words, any maneuver performed during surgery exposes patients to additional risk (morbidity). For example, attempting to remove very thin capsule densely adherent to the patient’s rib cage may expose the patient to significant bleeding and/or entrance into the thoracic cavity.


• Implant Removal En Bloc:


En Bloc breast implant removal refers to a procedure where the breast implant and the surrounding capsule is removed as a single unit. The procedures is performed such that the contents within the breast implant capsule do not come into contact with the surrounding tissues. Generally, the procedure requires a longer incision (6-7 centimeter) usually in the inframammary fold, in my experience. The procedure is more successful when capsules are thickened as opposed to when patients have very thin (normal) capsules. Also, sometimes complete capsulectomy is not safely possible; for example, breast implants placed in the sub muscular position may have a capsule that can be densely adherent to the patient’s rib cage. Removal of this posterior capsule can be potentially dangerous.

Generally speaking, unless the breast implant capsules have thickened (and/or are otherwise symptomatic), are associated with the ruptured silicone gel breast implants, or if the patient has concerns about “medical conditions” related to the breast implants, capsulectomy is not universally necessary. For these patients, En Bloc removal of breast implants is a good procedure.


Source: The National Academies of Sciences, Engineering & Medicine

 

Before & After: Implant Removal 

 


 

 

Patient Testimonial About Her Breast Implant Removal Procedure
Patient Testimonal – Images Above With Implants and Then Without
I feel really good. I’m very happy. Going to gym is much each. No longer have big fluffy bags keeping me from laying on my tummy for exercises. I feel thinner, slimmer, although I’ve never been overweight. The implants always made me feel larger. Hoping to get a little more fluff although I don’t expect too much more since, if I remember correctly, I’m about the same size and shape I was prior to implants. Which, even so, is fantastic considering i had my implants for 10 years! No stretch marks. Right back to who I was before!

Physically though! I have to say, there has been some amazing improvements. No more back pain, no neck pain, no arm numbness, no “muscle” tugging. No achy breasts. The best hugs I can get!!! And oddly, the circulation in my hands and feet are just unbelievable. Who knew!?

 

“I am so extremely pleased beyond words with the result of my implant removal with a lift that Dr. Pousti did for me a little over a year ago.”

Dr. Tom J. Pousti is double board certified in plastic and reconstructive surgery and specializes in breast augmentation and revisionary breast surgery. With the amount of patients with breast implants growing the number of those wishing to remove their implants is increasing as well. More and more people are inquiring implant explanation surgery for a variety of reasons. Some interested in replacing the implants and some not.

No other photos on this page are of this patient

Patient Testimonial:

“I saw Dr. Pousti for removal of 10 year old implants with capsular contracture. He was very professional and knowledgeable. I had 4 consults before seeing him and he seemed to be the most medical as far as doing the overall best thing for my long term health vs trying to sell procedures. I was 100% sure that I wanted him to do my surgery during our first meeting. I had the surgery a month later and have been very happy. I feel better than I have in years. The follow up from his office is terrific. I was called daily for the first week to check and see how I was doing and if I had any questions. I just had my one month follow up with him and he said I was completely complication free and I could return to all normal activities. I see him again in 3 months. He said if I decide I want a lift or anything, that would be the time to start discussing it, but he hopes I will just be happy without needing more procedures.”

 


 

Patient Testimonial:

“When I was eighteen I underwent breast augmentation because I was insecure about my body. I felt that breast implants would give me the confidence I lacked and ultimately  make me happy. Bra shopping was a nightmare and when wearing a sports bra or bikini I was flat as a pancake. To my eighteen year old self I felt I was lacking something. Now eight years have passed and I am not the same person I was at eighteen. I am still young, but I feel fortunate to have discovered who I am and what I believe in, and what ultimately matters to me.  I have been married for four years to a man who loves me for me.  And just six months ago we had a beautiful baby girl. I had been thinking of having my implants removed for the last three years and being pregnant with them and breast feeding solidified my decision.
I had my implants removed three weeks ago and I feel liberated! Not only was my husband supportive of my decision, he also was encouraging throughout my appointments, surgery and the outcome of my body without implants.
I would encourage any woman who is toying with the idea of implant removal to do your research and come visit Dr.Pousti He is honest, professional and more than certified.”

Description

The removal of breast implants that have been placed either for cosmetic or reconstructive purposes is a surgical operation. Breast implant removal may be performed as a single procedure or combined with additional procedures such as: removal of scar tissue surrounding the implant, breast biopsy, removal of escaped silicone gel, secondary breast augmentation, and mastopexy.

What To Expect After The Surgery

Rest in bed is the order of the day, along with plenty of fluids and no aggravation. You will be permitted to shower, perhaps as quickly as two to three days post-op. Also, the chest will feel somewhat sore for the first few days. This should abate very quickly, and by the end of the first week you should be very comfortable.

Before / After Breast Augmentation / After Breast Implant Removal

Testimonial:

I grew up very insecure with my focus on fixing physical flaws, rather than working on my inner confidence and strength. I was 17 years old when I found a solution to what I thought was a problem. Throughout this journey I have had a spiritual awakening and came to the realization that I was born with all the necessary tools to live an abundant and more holistic life. These implants have been like training wheels and helped me love myself and I am ready to let go of them.

Testimonial:

Dear Dr. Pousti and staff:

In 1995, when I was 25 years old, I had my first set of saline breast implants put in.  Because I was always barely a size A cup, it was something that I had wanted to do as long as I could remember.  I was pleased with the results until the day I was in a car accident and one of my breast was damaged.  Because of this, in 1998 the implants had to be removed.  I had originally wanted them just removed without replacing them, however, the doctor at the time (not Dr. Pousti) talked me into removing and replacing the implants instead of removing them only.  I had a very difficult surgery as well as recovery.  I have regretted ever since then that I let the doctor talk me in to new implants.  They have since been uncomfortable; I have not been able to sleep on my stomach; as a runner, it has been hard running with the implants, they have been in the way; and I just have not been able to wear anything that I wanted without it being too tight in my chest and too big in my waist.  I was just a different person when I got the implants, and implants were not fitting in with my lifestyle any longer.  I had been beyond ready to go back to my natural body for a long time.  Finally, fourteen years later, when we were finally in a position where I could have them removed, we began to research and pray that we would find a great surgeon.  Due to the fact that I had such a horrible experience with my last surgery, we wanted to find a doctor that we could trust and one in which we would feel comfortable.  In Dr. Pousti and his staff, we found much more than we could have ever imagined or hoped for.  We have been so blessed that we found Dr. Pousti.

I would like to thank Dr. Pousti and his staff so much for all that they have done and continue to do for me even though my surgery is over.  While I was researching and looking around for the best surgeon that could perform my surgery, I kept coming back to Dr. Pousti.  I was impressed with the extremely large amount of positive comments that were on many websites. Fact is, honestly in all of the many reviews that I read through, I did not come across even one negative comment.   Also, his own personal website was amazing and filled with so much information about any surgery that you could possibly think of.  Once I went in for my first appointment, I knew for sure, no question that I wanted Dr. Pousti to perform my surgery.   Dr. Pousti, from the very first appointment made me feel beyond comfortable.  He and his staff explained everything and answered any question that I had, and I had many.  I had such a negative experience due to a very bad surgery in the past, and felt very very anxious.  Dr. Pousti took so much time to help my husband and me to feel as stressed free and relaxed as possible.  This amazing Dr. and his staff has called me everyday since my pre-op appointment just to check in on me, making sure that everything was ok and to rest any worries that we may have had as they knew that I was extra anxious. Since my surgery, they have continued calling and checking in on me to make sure that all was well.  They even called on both Saturday and Sunday.  From my first appointment until today, which is a week today since my surgery, Dr. Pousti and his staff have just gone above and beyond what they needed to do; way more than I have ever experienced from any other doctor’s office.

If Dr. Pousti and his staff were not enough, the Surgery Center where he preforms his surgeries is absolutely top of the line.  Again we were astonished and amazed at the treatment that we received there.  Dr. Pousti shared with them my concerns, and the staff from the Surgery Center went above and beyond what they needed to assure me and help make sure I was comfortable. They called me the night before and listened to my concerns.  The next day they were perfectly punctual, and everything went according to schedule.  Dr. Pousti and the staff from the Surgery Center were there by my side the whole time.  They even held my hand as I drifted off to sleep.

My husband and I will always be thankful and blessed that we found Dr. Pousti to perform my surgery, and we would not hesitate for even one second to refer anyone who is looking for a plastic surgeon to Dr. Pousti.  He is truly a one of a kind Dr. with a one of a kind staff.  We searched form many other doctors, and Dr. Pousti was like night and day compared to the others that we visited.  We are absolutely sure that anyone who does choose him will be extremely satisfied, thankful, and blessed.

Extremely Grateful

PS:  A side note from my hubby —

It was very important as we searched for a doctor that we found one in whom I could feel safe in trusting my wife’s care too.  Dr. Pousti and his staff were very professional with high quality and standards which exceeded our expectations.  Thanks for taking care of my wife.

God Bless

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Pousti Plastic Surgery
8851 Center Drive, Suite 300
San Diego, CA 91942
Phone: 619-466-8851
Fax: (619) 466-8858
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619-466-8851