Tummy Tuck

There are two important reasons to spend time reviewing before-and-after pictures when considering plastic surgery. The first is to determine what procedure, if any, actually serves to improve your undesired appearance. The second is to distinguish which surgeon performs the best work.

There are many procedures discussed on the web and touted by the cosmetic surgery community and media as aesthetic dream-makers. Often, however, they are not. Be skeptical and use before-and-after pictures to determine which procedures will actually address your concerns. If an operation works well, there will be thousands of pictures demonstrating its success. If it's hard to find good before-and-after pictures of a procedure used for the problem you're trying to address, then it probably doesn't exist. Remember to be honest with yourself about your appearance when evaluating web pictures. The mirror lies. We recommend that you take pictures of yourself and set them in front of your computer while you do your research. Make sure that the "befores" look like you and then determine what procedures work. Just because the media or some web site states that fat injection to the buttocks will lift the butt, that doesn't make it so.

Second, once you've identified the best operation for you, it's easy to determine which surgeons achieve the most natural and attractive results. All people are hard-wired to appreciate natural attractiveness. Fortunately, it's easy for you to identify who can meet your highest expectations simply by reviewing before-and-after photo galleries.

Find a plastic surgeon who specializes in cosmetic surgery and preforms hundreds of tummy tucks per year. Many plastic surgeons perform cosmetics surgery procedures such as tummy tucks. But few specialize in the cosmetic, rather than reconstructive side of plastic surgery and dedicate their entire practice to aesthetic procedures. Because Dr. Vath and Dr. Wolfe practice cosmetic plastic surgery exclusively, they perform hundreds of tummy tucks per year and can assure each patient that she will get the most beautiful aesthetic transformation possible.

Seek a surgeon who upholds the proper credentials including certification by the American Board of Plastic Surgery (ABPS), membership in the American Society of Plastic Surgeons (ASPS) and the American Society of Aesthetic Plastic Surgeons (ASAPS). Learn more about selecting a surgeon here.

Your tummy tuck procedure will be performed in our AAAHC certified Apex Surgical Facility in Golden, Colorado. Apex is owned and operated by Dr. Wolfe and Dr. Vath, and is used exclusively for aesthetic surgery patients. Anesthesia is used to ensure that you feel no discomfort and that your breathing is maintained and controlled for the duration of your procedure. We use only board certified anesthesiologists, including Dr. Joseph Carpenter, the medical director of Apex Surgical Facility. Learn more about the Apex Surgical Facility here.

Perhaps the most important criteria for choosing a plastic surgeon is your intuitive sense of comfort with the physician as a person. Cosmetic surgery is an emotional and personal experience. After all of your research into credentials and before/after pictures, ultimately, you must feel good about trusting the plastic surgeon to care for you and your aesthetic results.

Although exercise can reduce tummy fat and strengthen the abdominal musculature, it does not flatten the muscles nor tighten lax skin. After aggressive work-out regimens, women often find themselves frustrated over their inability to flatten their tummies stretched out from weight loss or pregnancy. Fortunately, an abdominoplasty manages these problems.

Except in rare circumstances, Dr. Vath and Dr. Wolfe do not employ drains with tummy tucks. Surgical drains are a source of discomfort and anxiety for many patients following a tummy tuck. In a traditional tummy tuck procedure, drains are used to prevent fluid accumulation in the "open space" created between the abdominal flap (skin and fat) and the muscle. Through the use of progressive tension sutures, Drs. Wolfe and Vath can eliminate this space, as well as securely advance the flap with tension distributed over a broader area. Patients can not feel these sutures so they are not even aware of their presence. After a few months, they dissolve leaving no foreign material whatsoever in the body. This technique prevents seroma formation (fluid build up) as there is no longer any space in which fluid can accumulate.

There are many advantages to having a tummy tuck without drains. The recovery is much easier: there is no cumbersome management of tubes hanging from the body, no pain from drain sutures pulling on the skin, and no fear and possible discomfort associated with their removal. Additionally, because the tension is spread out rather than concentrated at the wound closure site, there is a decreased risk of other complications such as a wide or hypertrophic (raised) scarring. Furthermore, Drs. Vath and Wolfe believe that the absence of drainage tubes going through the skin after a tummy tuck reduces the risk of infection and the need for antibiotics.

Denver Abdominoplasty Surgery Patients Have New and Improved Option

Liposuction is usually not needed to achieve the flattest results but is often used adjunctively to address fatty excess in other areas such as the hips or thighs.

Liposuction is generally not helpful in creating the flattest abdomen during an abdominoplasty. The fat beneath the excised skin in the lower abdomen is completely removed with the skin. When indicated, some excess fat in the upper abdomen can also be trimmed to create a more even, thinner contour. Occasionally, if there are significant fat pockets over the lower ribs in the upper abdomen, liposuction of these areas can be helpful.

It is very common that women will add adjuvant liposuction to other areas of the body while undergoing an abdominoplasty. Common areas include the hips, flanks (love handles), outer thighs (saddlebags), inner thighs, and back. This can be added very safely to improve the overall body contouring achieved during surgery.

The need for a tummy tuck is the result of an inflation and deflation of the abdominal tissues, usually from pregnancy or significant weight loss. Once a woman undergoes an abdominoplasty, the tummy will not stretch out again to any considerable degree, unless there is another inflation and deflation. Therefore, it is fair to say that the results of a tummy tuck are permanent. Although the abdomen will slightly relax over time, there will not be the need or desire for another abdominoplasty.

Mini-tummy tucks are generally inadequate after pregnancy or weight-loss. Many patients inquire about a mini-tummy tuck in hopes of minimizing their cost, recovery time and scarring. Good candidates for a mini tummy tuck are rare, as most patients with abdominal laxity are much better candidates for a full tummy tuck. With a mini tummy tuck, a much smaller area of skin is removed, and only the muscle in the lower abdomen is tightened. The skin around the belly button is not released from around the belly button which prevents its tightening. The scar is somewhat shorter in length than that resulting from a full tummy tuck, but not usually considerably different. Occasionally, a patient will come in for a consultation with mild, isolated lower abdominal skin laxity without any muscle laxity or loose skin around the umbilicus. In these cases, the mini may be appropriate.

A woman need not be ideal body weight to get great results from a tummy tuck. Although losing weight prior to having plastic surgery can allow for a more attractive transformation, not everyone can reach ideal body weight. The majority of any planned weight loss should be shed prior to surgery. But once you've maximized your efforts, or stabilized, plastic surgery can be considered to manage tummy rolls or skin laxity, and stretched, separated abdominal muscles. Some of the most gratified patients are somewhat overweight prior to undergoing tummy tuck surgery. At the Center for Cosmetic Surgery, we believe that success after cosmetic surgery is measured by a patient's happiness with the aesthetic changes that can be safely accomplished- not the realization of some idealized, societal version of beauty.

Tummy Tuck surgery is not a means for weight loss, but rather body contouring. Most patients lose less than five pounds after the removal of belly fat and skin. However, there is typically a marked change in their size and contour.

The skin and underlying fat is removed between the pubic area and the belly button. Care is taken to remove the precise amount of tissue to allow for a tight, flat abdomen. The belly button is left attached to the muscles in its natural location.

With the removal of skin comes any involved stretch marks as well. If a woman's stretch marks are isolated to below the belly button, usually they are completely excised during an abdominoplasty.

The rectus muscles are sewn together to internally flatten the tummy. The muscles separate and round out during pregnancy contributing to a "pouchy" look. To fix this, dissolvable sutures pull the edges of the rectus abdominus muscles together from sternum (breast bone) to pubic bone. No cutting of the muscle is required to accomplish this.

Sequential tension sutures are placed to tack down the fat and skin to the muscles. This avoids the use of drains and evenly distributes tension prior to final closure. Then the fat and skin at the resulting scar location are sewn together to create a low, thin, symmetrical scar. Finally, the umbilicus is inset into the overlying skin in its natural location.

The scar from an abdominoplasty must ultimately reside in the perfect location. Preoperative planning and precise markings ensure that during closure of the tummy skin, the opposing forces of the upper and lower wound margins leave the scar at the bikini line. At the Center for Cosmetic Surgery, Dr. Vath and Dr. Wolfe pay close attention to creating a fine line, symmetrical scar in the most hidden location.

The appearance of the belly button is critical to the overall natural beauty of a tummy after an abdominoplasty. During a tummy tuck, the belly button is released to allow the skin around and above it to shift downward and achieve an evenly tight and contoured look. When the belly button is inset into the new skin that has moved down over it, special care must be taken to give it a funneling, puckered appearance. Dr. Vath and Dr. Wolfe use a technique of suturing the fat around the new hole overlying the belly button down to the muscle, delivering the surface skin down to the original umbilicus. This is distinctive from simply pulling the belly button up through the hole and sewing it in place which creates a flat circle at the tummy surface and looks unnatural.

Through muscle tightening and the placement of sequential tension sutures, a nicely contoured, feminine abdomen is achieved.

Limiting scar length is a worthwhile goal, but not at the detriment of contour. The skin excision must be carried far enough to remove the proper amount of tissue and prevent puckers called dogears.