Dr. Isakson has changed my life completely for the better. I have gone up and down in weight by more than 50 lbs, two babies, 1 c-section and numerous prior abdominal surgeries. To say my stomach had seen better days is an understatement. For only being 30, I was ashamed of my body. I underwent an extended tummy tuck, muscle repair, Lipo to the flanks, mons and submental area. At 6 weeks out, I have no pain anymore, back to normal anct and am healing nicely. My scar is already fading and I can’t wait to see how it progresses. Dr. Isakson is blunt but honest and is truly an artist with body sculpting. The amount of compliments I have already received is insane and I expect to look even better as the swelling subsides.
I am 57yo with 3 sons. Now a grandmother with 8 grandchildren- 6 Divas and 2 handsome grandsons. Been thinking about a tummy tuck but wanted to do my research and be well prepared. I've done the pre-op and got my supplies. Dr. Isackson in Augusta will be doing my surgery. Will keep you updated and post pics too.
Dear Modest244197, Thank you for your question! It is very thoughtful of you to wonder how to communicate this decision. For most surgeons, you probably don't need to actively inform them. If you decline to follow up or do not make any further appointments/bookings, they will understand that you do not intend for move forward. If you still have appointments or consultations booked with other surgeons than the one you have decided to go with, it is courteous to cancel those appointments rather than being a "no-show." You still do not need to feel obligated to tell them why if you do not want to! Good luck, and thank you for your concern about courtesy!
Dear what2do, Should implants go above or under the muscle? This is a classic question that involves a lot variables, including current available implant technology, your surgeons experience and preference. A conventional answer is that "it depends." It depends on how much "soft tissue" you have in the cleavage area, or upper pole, of your breast. If you have a reasonable thickness of tissue (breast and fat) between your chest muscle and your skin, your surgeon should be able to "hide" that implant under that breast tissue and leave your muscle alone. This allows for a fairly natural look relatively early in the recovery period, and does not involve muscle pain. Classically in the United States, women who have relatively thin "soft tissue" in the cleavage area would have implants placed below the muscle (pectoralis major) to help further conceal the contours of the implant in the cleavage area or upper pole of the breast. Early technology or very soft breast implants can have a very soft, natural feel but will sometimes show ripples or have some other unnatural appearance if placed above the muscle in thin women. The disadvantages to an implant under the muscle includes a recovery period that can look unnatural in the early phase until the muscle swelling goes down (drop and fluff phenomenon). There is also discomfort associated with elevating a muscle from its home, and a risk of "animation deformity." Current surgical techniques and available implant technology in the United States have changed over the past decade or two. We no longer have the same variety of textured implants available, but we now have surgical mesh, highly cohesive silicone implants, and fat transfer. Now we can place a slightly firmer silicone implant above the muscle (possibly with a little fat transfer), and avoid the risk of visible rippling in the cleavage. For many surgeons, textured implants and now surgical mesh is designed to avoid or treat a possible complication of breast augmentation (with or without a lift) - implant malposition. If the implant eventually migrates either too low or too far to the side, or both, we call that a malposition. There is an argument that an implant under the muscle faces more forces working to displace it down and to the side, although some surgeons feel the pec muscle provides some element of support. Staging the surgery - doing a lift first followed by an implant in a second surgery, can also reduce (but not eliminate) the risk of malposition. In my practice, mesh is used to either prevent or treat an implant malposition, particularly in women who have a lot of sag to their breasts or would like a larger implant. I frequently suggest patients consider firmer (more cohesive) silicone implants above the muscle if they have a reasonable amount of coverage in the upper pole of their breast (thinner or borderline women may benefit from small volume fat transfer). I tend to use more silicone than saline, especially if being placed above the muscle, or being placed at the same time as a lift. Believe it or not, there is even more nuance and detail that can influence what may be best for you! You are on the right track seeking opinions, and an in-depth consultation with a Board Certified Plastic Surgeon should help further clarify things. Make sure you ask plenty of questions!
Dear sarakingart, Dissatisfaction with certain parts of your body is very common after pregnancy. Similar changes can also be seen with rapid fluctuations in weight. It is difficult to assess you with photos alone, and you will likely benefit from a consultation with a Board Certified Plastic Surgeon. That being said, the best treatment for you will depend on what your goals are! A breast lift will help reshape and reposition your nipples, and reshape the bottom part of your breast. This will require scars associated with a lift. An augmentation will help add volume to your cleavage area, and also fill out some of the bottom part of the breast. These can be performed at the same time, but carry a higher risk of needing a revision or touch-up in the future. A tummy tuck will remove extra skin, and tighten muscles that may have permanently stretched with pregnancy again at the expense of a scar. This is a great time to do some liposuction, and many surgeons are finding ways of using that fat (augmenting your hips for example). Whether these procedures are right for you will depend on your medical history, your goals, your tolerance of scars and ability to manage your recovery. An in depth consultation with a plastic surgeon should help better understand what options are available, whether they can accomplish your goals, and whether the recovery is feasible for you (many surgeons do not want you lifting toddlers in the early recovery phase after a muscle repair).
Dear williamsdom, I think the best procedure for you will depend a lot on what your goals are. Lipo360 will take care of fat between skin and muscle, and adding some sort of energy device like J-plasma can help provide a little (but not perfect) skin tightening after liposuction. Liposuction alone will not fix the muscle separation and loosening of your abdominal muscles that comes from pregnancy and weight fluctuation. In my experience, when you already have extra skin, liposuction tends to make that worse. An umbilical hernia can probably be repaired during liposuction or a tummy tuck, but will involve a scar around the belly button either way! If your goals are a flatter, tighter tummy - that may be difficult to achieve with liposuction alone, and may require a tummy tuck. Similarly, a perfectly smooth back may be difficult (but not always impossible) to achieve with liposuction alone. A consultation with a Board-Certified plastic surgeon should help provide you with options available and how they can help achieve your goals!
