Longview Tummy Tuck doctors

There are 3 main anatomic components to consider in determining whether a tummy tuck surgery is a good option for a patient:

• Skin
• Muscle
• Fat

If there is excess skin (often noted by patient) and laxity of the abdominal muscle (noted by the surgeon), then one can consider tummy tuck surgery, as this procedure will reduce the lower abdominal skin excess (by resecting the skin from suprapubic region to just past the umbilicus in an elliptical fashion) and will tighten the abdominal wall musculature. This condition is usually present after pregnancies or significant weight loss.

On the other hand, if fat is the main component present, with minimal skin excess, then tummy tuck surgery is not the right option to consider. In such condition, if the fat is resistant to proper exercise and dieting regimen, then liposuction can be considered.

At times, all 3 components may be present - that is - excess skin, lax muscle and fat. Although it is tempting and often requested by patients to address all 3 components via tummy tuck surgery and liposuction of the abdomen, for anatomic and physiologic considerations (blood supply preservation to promote proper healing), aggressive liposuction of the central abdomen is usually not performed in conjunction with a full tummy tuck surgery. However, liposuction of the flanks/hips can be performed concurrently with tummy tuck surgery to enhance the overall abdominal contour.

At times, a surgeon may recommend a mini-tummy tuck surgery (which would only remove part of the lower abdominal skin) with more aggressive liposuction. Because the tummy tuck surgery is more limited in a mini-tuck, it maintains more blood supply and thereby a more aggressive liposuction can be performed concurrently. However, less skin will be removed.

Other important points of consideration include scarring. Scarring is often extensive (hip to hip), and although scars may improve with time, they are permanent. It is a trade-off - for the reduction in skin, a scar is given.

Although every measure of proper principles of plastic surgery may be enforced, there is always an element of unpredictability when it comes to scar maturation, some of which is inherent to the individual patient. Truthfully speaking, some people just simply scar better than others. Previous scars may offer some clue as to the scarring nature - e.g. - if someone ALWAYS develops hypertrophic or keloid scars - then it is most likely that poor scarring will be expected post tummy tuck surgery as well.

There are measures to facilitate better scarring post surgery - whether it is in the form of laser, massage, steroid injections, silicone sheets, OTC ointments, etc - be sure to speak to your surgeon about the various options. Also, realize that scar maturation process may take up to a year (or even longer) before the final appearance of the scar is evident, but this is not to say that appropriate interventions may not be instituted at various times to improve the overall outcome.

Another question regarding scarring that often surfaces is the placement of the scar. Ideally, we would all like to give the shortest, lowest, and symmetrical scar as possible. However, scar placement is often dictated by the anatomic considerations - i.e. - the nature of skin redundancy. A person may have more fullness or excess on one side than the other, one side may be higher or lower than the other, one side may extend further around than the other, etc, etc, etc. And depending on what is seen (and hence what is needed), the surgeon will determine the scar placement (its width and location).

Personally, I illustrate on the patient where the scar is to be placed, how long it is expected to be, and if applicable telling the patient that one side may be higher or longer than the other side (showing the patient why this is needed). I think patients need to know what to expect in terms of their scar, as this is such an important element of tummy tuck surgery. And because of the disclosure and extensive discussion prior to surgery, scarring becomes less of an issue in my practice, as we minimize "surprises."