Body

 

ABDOMINOPLASTY

Abdominoplasty, or tummy-tuck, is a great way of eliminating excess skin and fat that can’t seem to go away with diet and exercise alone. It is often included as part of a mommy makeover, or after weight loss surgery. Of course, many patients only want their abdomen treated. There are different types of abdominoplasty, from a mini tummy-tuck to a full abdominoplasty. A mini tummy-tuck involves skin and fat only, and is designed to treat small deposits of skin and fat. The belly button, or umbilicus, is often left alone, and the procedure may not treat stretch marks and loose skin that exists at or above the level of the umbilicus. If you’ve thought about tummy-tuck surgery, call (949) 432-4730 to discuss your options with Dr. Zelken.

Full abdominoplasty includes repositioning your belly button to a new “hole” that is created in your upper abdominal skin when the upper abdominoplasty flap is re-draped. It also includes tightening of your six-pack muscles. The abdomen usually stretches out along the midline making the six pack more like parentheses than straight lines, and the skin is often stretched. There may even be hernias found on exam or in the operating room. By tightening the six-pack muscles like an internal corset and cutting out the extra skin, a significant improvement of abdominal contour can be achieved. Any hernias that are found will be repaired. Liposuction and liposculpture can address love handles and improve overall contour. Drains are almost always used in abdominal procedures but can be avoided in certain cases. Ask Dr. Zelken about the tubeless tummy tuck if you truly do not want drains placed.

Regardless of approach, complications and dissatisfaction can occur. Women who have a barrel chest or wide rib cage and women with deposits of intra-abdominal fat may not achieve the same result as a patient with a slighter frame. Wound breakdown can occur, especially centrally along the incision and at the umbilicus where blood flow is least and tension is greatest. If this occurs we often allow the breakdown to heal from the inside out, and revise the residual scar if necessary. If drains clog or fall out early, or you are too active too soon, it is possible to develop a seroma or fluid collection between your abdominal muscles and skin. These may go away without surgery. Also, a dog-ear (standing cone deformity) may result at the corner of one or both incisions. This may occur whenever an oval or ellipse is closed as a straight line and is more likely with a bigger resection. Dr. Zelken will do everything he can to avoid these; if a dog-ear persists beyond 3 months, Dr. Zelken will gladly revise it the Z Plastic Surgery procedure suite under local anesthesia.

To minimize pain, Dr. Zelken will provide a targeted nerve block using long-acting anesthetic at the end of the case. When you wake up, you may have little to no pain; this is expected to facilitate your recovery.

LIPOSUCTION

Liposuction, or suction lipectomy, is a term used to describe removal of fat from the body through a closed suction system. Liposuction can be used to collect fat for transfer to the breasts or buttocks, or can simply be discarded. Liposuction is truly an art, as the surgeon must be careful to control suction from various regions. If there is too much suction in one spot, contour deformities may result. Liposuction has been around for a long time, but more recent advances like VASER and ultrasound, and laser-assisted liposuction will help dissolve fat cells prior to sucking them up. Dr. Zelken prefers “power assisted liposuction”, or PAL. PAL uses a vibrating liposuction tip that facilitates suction of fat and allows for smoother, more controlled passes and a more refined result.

Common misconceptions about liposuction are that it is a weight loss procedure. Although as much as 5 liters of fat can be withdrawn in a single outpatient procedure, the operation does not lead to weight loss. It is a sculpting procedure. Liposuction will not address loose, overhanging, or inelastic skin. Abdominoplasty may be recommended during your liposuction consultation. Dr. Zelken will often refine his abdominoplasty procedure with liposuction, for example, to etch a six pack, take away love handles, or enhance your hourglass figure. Liposuction can be uncomfortable for days after the procedure and Dr. Zelken will encourage you to wear compression garments for up to six weeks. In many cases, your fat may be repurposed to improve facial contour, breast, or buttock volume. The Brazilian Butt Lift takes fat from areas you do not like and tranfers it to the buttocks, for example.

If you have saddlebags, love handles, “cankles”, or stubborn tummy fat that simply won’t go away, call (949) 432-4730 to schedule your consultation with Dr. Zelken today!

MOMMY MAKEOVER

Dr. Zelken agrees that 50 is the new 30. Increasing life expectancy, changes in societal norms, and improvements in healthcare and rejuvenation technologies may provide a second wind to parents approaching middle age. It is not uncommon for moms in their 30s through 60s to say or convey that their appearance is simply not on the same page as how they feel. This is particularly true for postpartum women whose body changed permanently after having kids. Whether it is a pooch under the belly button, stretch marks, loose skin when bending over, or sagging breasts, many women seek treatment to look more youthful, like they did before they had kids. Similar changes can affect younger women in their 20s and 30s who have lost significant weight in a short period of time; mommy makeovers can help women who are not moms.

Mommy makeover is a catchall phrase used informally by patients and plastic surgeons alike. A mommy makeover is not a type of surgery, but rather an assortment of surgeries to address the common signs of the aging postpartum or post-weight loss female form. Generally, it involves one or more operations of the breast, abdomen and trunk, arms, thighs, or a combination thereof. Many mommy makeovers include liposuction to enhance and prolong results. The best candidates are women who are done having kids, in good overall health and a stable weight. If more children are planned, it may be better to wait- particularly for the abdominal surgery, but this is not always the case. To discuss your candidacy, call (949) 432-4730 to schedule your appointment with Dr. Zelken today.

Starting from the top, breasts can be deflated, too big, or too small after having kids. Breast lifts (mastopexy) are often included in a mommy makeover, in combination with breast reduction or augmentation. The goal is to improve both the shape and volume of the breast; both change after childbirth. The abdomen usually stretches out along the midline making the six pack more like parentheses than straight lines, and the skin is often stretched. There may even be hernias found on exam or in the operating room. Abdominoplasty can treat both by tightening the six-pack muscles and cutting out the extra skin. Of course, any hernias found will be repaired. In less extreme cases, less aggressive mini-abdominoplasties can take out skin alone with quicker recovery and a shorter scar. Liposuction and liposculpture can address love handles and improve overall contour. Drains are almost always used in abdominal procedures but can be avoided in certain cases. Ask Dr. Zelken about the tubeless tummy tuck if you truly do not want drains placed.

Mommy makeovers, like most elective or cosmetic procedures are happy surgeries, but there are risks. These risks are similar to many major operations and can include infection, pain, and bleeding. When breast lifts and tummy tucks are performed, hundreds of stitches may be needed to close the wounds, so there is a risk of wound opening, bleeding, and fluid accumulation (seroma). Nerve pain can occur at any operative site, causing long-term pain. Most surgeons place drains at the time of surgery to avoid fluid collections. When liposuction is performed, it is possible to cause injury to the bowel and lung injury. Though uncommon, these risks, and even death, cannot be ignored.

Moms considering a mommy makeover need to establish realistic expectations. Surgery improves contour by taking away extra skin and fat. However, drastic changes may not occur in women who have fat buildup below the six-pack muscles, a protuberant belly and broad shoulders. This comes at the expense of several feet worth of scars along the lower belly and breasts. Scars cannot be avoided, though we have several tricks to optimize scarring during and after surgery. Whether you spend a night or more in the hospital is ultimately up to you and your surgeon, but is generally not necessary. Recovery can take up to four weeks or longer if there are complications like fluid collections. You may have up to four drains for three weeks. Moms who work a desk job usually go back to work after two weeks of recovery and up to six weeks later if the job is labor-intensive.