16 Essential Questions About Male Tummy Tucks
Are you a guy thinking about getting a tummy tuck? These are 16 questions RealSelfers ask the most -- and answers, too.
We sat down with Marina del Rey, CA plastic surgeon, Dr. David Stoker, and asked him the most essential questions about the procedure. Here are his answers.
Percentage-wise, how many males do you see in your practice compared to females for tummy tucks?
Probably 15 to 20 percent of my patients are males for this type of procedure. So, pretty significant. I perform hundreds of these operations a year.
Have you noticed an increase in the number of males requesting this operation in recent years?
Absolutely. There’s been a big increase in general in tummy tucks because there’s been an increase in massive weight loss. Traditionally, most tummy tucks (or TTs) that I performed were done on mothers who had multiple kids, and had loose skin and lax muscles of the lower abdomen from their pregnancies. Now, I have expertise on patients after weight loss. I got involved with The Biggest Loser TV show. A lot of people see that and call my office. The weight loss occurs in men and women in similar percentages. That’s where the large number of male TT’s comes from in my practice.
What are the most important questions that men should be asking themselves when considering this procedure?
Am I healthy? Am I fit? And am I near my ideal weight?
What happens if any one of those conditions isn’t met?
You need to make sure patients are healthy. Any male over the age of 40, I will have their internist provide medical clearance for them beforehand to make sure they’re fit for surgery. If there’s a question about any type of cardiac condition, we have to get cardiac clearance as well. Usually that’s not the case in this group though. Many times, they’ve worked hard to lose the weight, so they’re particularly fit.
What do you recommend people look for when they’re choosing a doctor for this procedure?
They need a board-certified plastic surgeon at a minimum. The surgeon should also have a large amount of experience in this particular procedure.
Are there things to do in preparation for the TT that you recommend specifically for men?
It’s pretty simple, really. If it’s because of weight loss, I want them to be as close to their ideal weight as possible. If they’re not, I have to make a case-by-case decision whether or not they’re optimal candidates for surgery, either based on pictures if they’re from out of town, or confirmation by physical exam.
Do you ever turn patients away who don’t meet the criteria for surgery?
Sometimes I have to turn them away. Today, my last patient – I was pretty excited about. I saw her eight months ago. She had already lost 130 pounds. But I told her she needed to lose another 50 or I wouldn’t operate on her. And she went home and she did it! She came back today, eight months later, and is now ready for two big stages of surgery. It always feels great when I do the right thing and patients respond and go out and take it to the next level themselves and ultimately get a better result because of it.
With women, it’s common to combine a tummy tuck with another procedure like a breast lift for a mommy makeover. For men, are there other supplemental procedures that are commonly performed at the same time?
Yes. There are some big ones. The first one is liposuction, typically of the flanks or love handles, and sometimes other areas as well. The majority of men get that as part of their procedure. The second procedure is something that I have incorporated into my procedure for both men and women, and it’s become really valuable. It’s called a public lift, and it tightens up the whole pubic area.
Can you explain a little more about why a pubic lift is so beneficial to perform at the same time?
In patients who’ve lost a lot of weight, or after multiple pregnancies, there can be a large amount of laxity in that area. For women, it can look like they have a large scrotum in that area and for guys, because the base of the penis is anchored there, it can actually… the penis essentially disappears. It’s not visible because there’s so much flesh hanging around it. As you might imagine, that’s very disappointing for those guys. So, when we do a public lift, it removes all that excess skin, tightens up the region and inner thighs, and has a profound impact on their anatomy, restoring it to another shape and size.
Why is lipo so commonly associated with TTs? What can lipo do that TTs can’t?
Lipo has minimal incisions. So in an area like the “love handles,” where patients have maybe a bulge of fat but not overhanging skin, they may not need that large incision to get a nice outcome. We might be able to get away with a tiny eighth-of-an-inch-long incision there, and accomplish a similar goal in the flank area.
What are some of the advancements that have been made in TT surgery over time?
Examples are combining TT with other procedures such as lipo, breast reduction, upper chest skin excision, or arm lift in a safe, effective manner. The pubic lift is something I thought of myself when it became obvious that many patients wouldn’t have a beautiful result if the public area were not treated simultaneously. Another advancement is in scar positioning, so it can be concealed. And designing it so that even if it’s visible when they take their clothes off, it’s not unattractive. The belly button is another area where there are a number of different techniques now for shaping that. I’ve evolved a technique that looks really natural.
How can people minimize their scars after surgery?
The most important elements of that are good surgical technique and planning. But after that I use silicone scar gels and special garments, and I also use steroid injections if necessary.
Compared to other procedures, how major is the TT surgery?
It’s the most dramatic plastic surgery that we perform. On a facelift, we remove four square inches of skin. On a tummy tuck, we might remove six square feet of skin. It’s profound, the improvement that we can create for these patients. It is always effective at giving the patient an improvement if it’s well done. But I’ve never seen it done more than twice. Most often it’s a onetime procedure.
Would ever you perform this surgery more than once on the same person?
Rarely. But I might if a female has a tummy tuck and then goes on to have a baby…or if a man loses a significant amount of weight. If he’s 300 or more pounds overweight and loses 200 pounds, probably he’s going to have so much extra skin in his way it will inhibit his ability to lose the rest of the weight. For some of those patients I’ll operate before they reach their final weight goal, and then again when the reach it.
How do you recommend patients maintain their TT results?
I recommend after that they bulk up their muscles to keep the weight off. Even when they’re not exercising as much in the long term, building muscle will help. In the short term, aerobic exercise is most effective for losing fat. The combination of diet and aerobic exercise is most effective.
Are the recommendations for maintenance the same for women and men?
Essentially. But guys in particular are able to build a lot of muscle in the weight room. And that muscle will burn calories for them even when they’re resting or at work. That’s the second stage of their body transformation that’s really important. Good habits with eating, and a large amount of aerobic exercise during the first stage, which is the weight loss stage. Then I recommend muscle building as the weight loss plateaus so that long term the weight loss is maintained without requiring an unrealistic amount of exercise every day.
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