Andrew A. Hendricks, MD

       Congratulations on your 70 pound weight loss.  From your photos, I believe that you are a very good-to-excellent candidate for liposculture/ liposelection.  These terms refer to liposuction of not just one body area, but of composite body areas including the abdomen, lateral abdomen, flanks, back, and supragluteal areas.  The procedure removes only external body fat, not internal fat.  It also will not tighten abdominal muscles.  If your body fat is external and you have good abdominal muscles, you should receive an excellent result based on your photos.

       Abdominal etching procedures have been largely replaced by high-definition (hi-def) liposuction pioneered by Dr. Alfredo Hoyos of Bogota, Columbia.  This procedure produces a very natural "six pack" for men and "two pack" for woman.  This same technique can used on other areas of the body to produce better body definition.  It can be safely performed in a certified surgical facility under local tumescent anesthesia so no general anesthesia is required.  Hi Def procedures are sometimes performed with an ultrasonic device such as a Vaser prior to traditional liposuction.  The term for this is liposelection.  You can read more about high definition liposuction in Dr. Hoyos' book.

       Drains are routinely placed after "tummy tuck" procedures to prevent collections of fluid (seromas) and blood (hematomas).  Drains should not be left in for too long as they can lead to a wound infection.  Every cosmetic surgeon makes their decision to remove drain(s) based on their patient. Normally drains are removed when less than 30 ml (1 ounce) of fluid is drained off over a 24 hour period.  

      A new advance in abdominoplasty / tummy tuck surgery is the Avelar adominoplasty for small-to-moderate cases.  The Avelar procedure produces an excellent result and does not usually require drains.  

       Liposuction / Liposculpture can be used on virtually any area of the body to sculpt and remove fat.  Many woman want to enhance their buttocks which can be done by liposuction of excess fat with lipotransfer to the buttocks.  During this procedure, the buttocks are routinely sculpted on the periphery to enhance their shape.  Some men and woman have excess fat or enlarged buttock areas which can also be treated with liposuction directed over the buttocks.  It is important to liposuction over the buttocks in a deep plane to create a natural appearance.  Cellulite areas can also be corrected at this time.  You may need to get an opinion from another cosmetic surgeon   

      Each patient is different but you have several treatment options.  First, no treatment is required.  There is a slight risk of temporary problems with Botox for lower eyelid thickening.  A chemical peel (pure phenol or Baker-Gordon formula) will often help as will laser resurfacing but there is a down-time of of 10-14 days with a chemical peel and 5-7 days or more with laser resurfacing.