Steven Yearsley, MD

After examining your pictures it seems to me that you have a long waist with a little bit of skin excess, but the major concern is the abdominal laxity. It may be a challenge to keep your scar as low as the average patient (without leaving a small vertical scar from moving the belly button hole), but it would take a physical exam by a plastic surgeon to know for sure.  A mini tummy tuck traditionally takes care of just the lower abdomen, doesn't detach the skin around the belly button, and does some focal muscle tightening as well. Some patients fit into a much more rare category, those with mostly a muscle laxity and a little bit of excess skin below the belly button. In those cases, I like consider a hybrid type of tummy tuck which combines the smaller scar of a mini tummy tuck, but I still tighten (plicate) the muscles all the way up to the Xiphoid using a long lighted retractor to look under the skin. This really is most beneficial in those who need minimal muscle work above the belly button (otherwise, patients might as well get the full tuck - I won't get into the technical reasons why except to say it has to do with re-draping the skin if muscles have to be pulled too far). Anyway, what I want to stress is that there MAY be other choices besides a full tummy tuck that can prevent your horizontal scar from riding high. But, again, nothing beats a surgeon examining you face to face and tugging on your skin for themselves to get a feel for what can be safely done. It's also great when they can draw diagrams to better explain the reasons for the operation they've helped you choose. Have a great day and good luck!

Thank you for your question. Redness of the skin after surgery can mean a few things, but it is very important to get on top of treating it if it is an infection. One of the more common infections is something called cellulitis, which is an infection just of the skin. It usually starts at a site of injury to the skin, so incisions are a prime candidate. We live in a world of bacteria around us, so this sometimes happens by chance. More often it affects a single breast, but as plastic surgeons we have all seen both breast involved as well. You don't have to have a fever or changes in blood work for it to be an infection either.  Another common cause for redness is an allergic reaction. This could be because of the surgical prep, the dressings, sutures, skin glue, etc. It can be red and warm like an infection, but often is more patchy or even rough on the surface. There are other reasons for the redness, but my best advice is to see your surgeon again face to face so he/she can get to the bottom of this. They are there to see you through your post-operative care and they invariably want you to do well! Call today. I hope everything works out for you.

It is not uncommon for patients to feel they haven't gone large enough, even when they have done all the work to be informed on their chosen size (like trying on implants in the office or doing something called the "rice test" at home). Simply put, trying on implants in a bra on the outside of your body isn't the same as when they are placed inside. Especially if placed under the muscle or in patients with a "tight skin envelope" to start, the tissues will often compress the implant and this can lead to lack of projection early on in some people. So, it's best to give it some time to settle into position, become more defined and to project into the cup. How much time? It's wise to wait about a year for final results. Some patient experience a "that grass is greener" phenomenon early on, thinking that if this size is good, then bigger is better. But a significant portion of those patients decide they like their size just fine if they wait. Most are grateful they didn't jump the gun and push for an early second operation (which is good, because the larger you go the greater the risk for needing revision surgery). So, in the end, if you did your homework and were sure of the size implants you wanted (and made that decision together with your plastic surgeon), then I suggest giving this more time. The best thing you can do, however, is to sit down with your plastic surgeon and have a discussion about your concerns. An informed patient is often a happy patient. Good luck!

It's best to ask your plastic surgeon if they are both comfortable in performing the procedure and what experience they have had doing it. In most cases, a small hernia is easily repaired by most plastic surgeons who are certified by the American Board of Plastic Surgery and who are actively performing tummy tucks. Some "facial plastic surgeons" may not have as much (or any) experience below the neck, so it's important to find this out. On the other hand, double board certification is not a necessity either. Good luck!

Sit down with your doctor and have a discussion about your concerns. With your history of seromas being drained, I'd certainly check you for a fluid wave first and then possibly an ultrasound, if needed. A fluid wave is seen when one side of the suspected seroma is tapped with a finger and it sends out waves across the abdomen, similar to ripples in a pool. If this is positive then treatment is likely needed. Also, even though swelling is expected for many months after surgery, the picture you have included seems excessive, so it is reasonable for you to bring this up with your doctor. I don't have any other of your history to go on, but consider bloating or constipation as well (or any previous GI disease for that matter).