Bruce Carter, MD (retired)

If your stomach becomes quite flat when you lie down flat on your back, but bulges when you stand, then it is very likely that the muscle repair is not sufficient to keep your abdomin as flat as you would like.  An abdominal ultrasound could help determine if there has been separation of the muscle repair or if there is a fluid collection present.  Correction of the muscle separation would requitre another operation and the umbilicus could be corrected at the same time. Consuoltaion with a fuly trained and certified plastic surgeon will helpo you arrive at a decision.

A simple test that I use to demonstrate the value of the muscle repair is for the patient to lie down flat and examine the contour of their abdomen, then stand up without trying to hold anything in.  If there is a substantial difference between the two maneuvers, then muscle repair will result in a flatter stomach.   Most women who have had children will benefit from muscle repair.

An uncomplicated recovery is very much jeopardized if you continue to smoke and may exclude you from becoming a candidate for the abdominoplasty surgery.  This is a great opportunity for you to make a major lifestyle change and become a non-smoker.  For most people, who have no healing complications, return to full and unrestricted activity usually may be restarted in six weeks.

You can usually count on the answer when all the physicioans are in agreement. Small volume correctgions with fat grafting can often be done with only local anesthesia in the doctor's procedure room. 

The most natural breast is what you have now and the least natural is a very small breast with a very large implant.  Everything else is in between.  The larger the implant with a small amount of  breast tissue, the less natural the result will be.  It is important to match the base dimensions of the selected breast implant to your own personal chest and breast measurements.  Once the width of your breast is determined, then there is a range of volumes that may be selected.  Other considerations, in addition to the volume of the implant, are its shape, surface texture and what it is filled with. A shaped, textured, silicone gel implant is often a good choice to achieve a less operated look.  Consultation with a board certified local plastic surgeon will provide you with the information to make a considered decision.