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Tummy Tuck Scars: Treatment, Timelines, and Scar Revision

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Tummy tuck scars are inevitable, just like with every surgical operation. Patients should realistically expect to have a scar after surgery but also expect it to fade and “remodel” over the twelve month after the surgery.    Although the surgery cannot be done without scars, the scars are planned to be as low on the abdomen as possible so as to be hidden by most clothing.   However, excellent plastic surgeons will know based off of experience how to best address scarring. Scars can be raised or recessed, or distinguishable in color and texture from surrounding healthy skin. They can also be more apparent due to their size, shape, and/or location on the body.

While people who have undergone a tummy tuck may not have a hand in the operation itself, they can play a role in reducing the overall appearance of the the scars.  But, following their surgeon’s post-operation directions to the proverbial “T”, is a must.

 

Types of tummy tuck scars

 

  • Complete tummy tuck scars
  • As the most common of the various tummy tuck scar types, it is defined by the longest incision made in any tummy tuck operation which is a somewhat horizontal line that spans across the lower abdomen from hip to hip.
  • A second circular incision is cut around the navel (belly button).
  • “Mini” tummy tuck
  • While not scar-less, there is no navel (belly button) incision made and no subsequent scar in the area.
  • However, there still is the lower abdominal incision which can vary in length and sometimes can be quite short. 

Ways to treat scars

 

Patients need to be vigilant when monitoring themselves and their bodies after an abdominoplasty (tummy tuck).  It is important to follow your surgeon’s post-operative instructions in regards to activity and cleansing.  Despite best efforts sometimes issues can develop after surgery.  Such things as a fever could indicate an infection.  Patients can develop bleeding or wound healing issues which are complications that need to be found and addressed, should they arise.  All these things can have an effect on the scars that form from the surgery.

 

Scarring timeline

 

Scars are typically most prominent within the first 3 months after surgery. Expect scars to look more reddish/purple and slightly raised in these first few months.  Over time, the reddish/purple discoloration fades and the scar should flatten.  This is a process that takes the body an average of 12 months to complete as long as there are no complications or hitches in the healing process.  This timeline can also vary depending on color of the skin of the patient and their genetic background.

Tips and remedies for scarring

 

  • Stay out of the sun – ultraviolet light exposure to scars can darken or change the final look of a scar
    • Use sunblock even on scarred areas that are covered by clothing
  • Listen to your doctor’s directions after the operations – they know your medical situation more intimately than anybody else
  • Avoid smoking; nicotine directly inhibits the healing process of wounds and scars
  • Applying such things as vitamin E, scar creams, baby oil, aloe vera or medical silicone creams topically may reduce the appearance of scars – consult your surgeon first before doing so
  • Compression garments can alleviate tension on the incisions, reducing the appearance of scars
  • Monitor your scars frequently – anything out of the ordinary may be a sign of a complication that may require closer evaluation
  • Massaging scars can help the scars heal with the most aesthetic results
  • Keep your spirits high. Some patients develop depression after surgery. TuckThatTummy is a wonderful online resource for anyone who may be coping with self-doubt 

Scar revision surgery

 

If tummy tuck scars are still severe after an extended period of time and after trials of the above mentioned remedies, patients can elect to have them treated with additional medical procedures.

  • Grafting involves removal of the scarred tissue and replacing it with skin cut away from another part of the patient’s body.
  • Laser treatment targets damaged scar tissue with high-energy light. There may be multiple instances of treatment needed before the desired degree of scar removal or transformation is achieved.
  • Scar revision/excision to remove the unsightly scar and re-closure of the skin edges

It’s a hard fact that scars simply cannot be entirely removed and surgery cannot be performed without the creation of some sort of scar. But with adherence to their doctor’s advice and consideration of all the options available, patients can have great results.

Posted in articles |

Dynamic Breast Deformity: What It Is, How To Avoid It & Fix It

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What is Dynamic Breast Deformity?

Dynamic breast deformity is a condition characterized by the movement of breast implants upon flexing of the chest muscles. Another common term for this is “implant animation”. Either way, this condition is commonly presented in cases where the breast implant is placed underneath the chest muscle (pectoralis muscle).

Why Do Plastic Surgeons Utilize The Submuscular Method If Dynamic Deformity Results?

When the breast implant is placed underneath the muscle, this is called a submuscular breast augmentation. Some plastic surgeons utilize this method because they feel it may sometimes achieve a better appearance for the patient. This is because the muscle “hides” the implant by providing an extra layer of tissue over it.  This practice originally began when the the only implants we had available in the United States were saline implants.  The saline implants had a tendency to show rippling under the skin and the muscle helped to hide some of that.  Now a days, we have much better silicone implants that don’t have as much of an issue of rippling.

Although the implant is placed underneath the muscle, the implant is not fully covered by the pectoralis muscles. Therefore, when the muscles are contracted, the implant has the potential to move up and outward. This is why the condition is often referred to as “implant animation”.

Is There A Different Breast Augmentation Method To Avoid Dynamic Deformity?

At Chau Plastic Surgery, our board-certified plastic surgeons use a technique called the subfascial breast augmentation.

The subfascial breast augmentation carries the benefits of both the subglandular (over the muscle) and submuscular (under the muscle). With the subfascial method, the implant is placed over the muscle but underneath the sheet of connective tissue that covers the front side of the muscle, called the fascia.

By utilizing this method, the implant can still take advantage of being “held” in by the fascia, similarly to how the muscle holds the breast implant in place with the submuscular method. Unlike the submuscular method, however, when the pectoralis muscles are flexed, the implant does not “move” since it is not being contracted upon.

Why Don’t All Plastic Surgeons Utilize The Subfascial Breast Augmentation?

The subfascial breast augmentation is only utilized by board-certified plastic surgeons who have extensive training and experience with this technique. At Chau Plastic Surgery, the subfascial method is our preferred way to perform breast augmentations because of the lasting results and great aesthetic appearance that our patients gain from this procedure.

Before asking your plastic surgeon if they can utilize this technique for your breast augmentation, you will always want to make sure to ask for before and after photos or case studies with this technique. The subfascial breast augmentation takes great skill to execute correctly, and experience with this specific technique is necessary to produce great looking, lasting results.

What If I Already Have Dynamic Breast Deformity?

If you have had a submuscular breast augmentation in the past and are experiencing “animation” of your breast implants, you should consult with a board-certified plastic surgeon as soon as possible.

Often times, your augmentation can be transferred to a subfascial placement of the implants and resolve this issue.  However, consulting with a board-certified plastic surgeon will ensure that your individual case will be reviewed and the options presented will be unique to your individual situation.

To get a professional opinion from Dr. Bruce Chau or Dr. Barak Tanzman, reach out to us today for a free consultation!

 

Posted in breast implants |

Plastic surgery For The Post Bariatric Patient – Is it covered?

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I see a lot of patient’s in my practice that have undergone bariatric weight loss surgery and now have excess hanging skin.  A common question is:  what, if anything, is covered by my insurance?

First, it is important to recognize that there are many different insurance companies out there each with different plans and criteria.  That being said, many insurance companies follow what Blue Cross Blue Shield use as their criteria for what that they consider medically necessary.

The procedure that may be covered is called a panniculectomy.  This is the removal of the excess hanging skin to the lower abdominal region.  This typically does not include tightening the underlying abdominal muscles or attending to the loose and excess skin above the belly button area.  As for the other procedures such arm lifts, chest lifts, breast lifts and thigh lifts, these are no covered by insurances.

If you still have large sized breasts even after weight loss, then sometimes a breast reduction will be covered if you meet the criteria.  It is important that with so many different insurance plans out there, that you first call your insurance company or look online to see what their criteria may be.

Secondly, find a plastic surgeon that participates in your insurance plan and schedule an appointment to sit down and talk with them about your concerns and what your individual options may be.

Posted in post bariatric surgery |

Plastic Surgery After Bariatric Surgery: Timeline and Things To Know

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Bariatric surgery for weight loss has become increasingly more common in the past 10 years with dramatic weight loss results.  One of the issues that patients are having to deal with after weight loss surgery is all the excess and stretched out skin.  In my practice I see and operate on many patients that have lost large amounts of weight either by diet and exercise, through surgery, or both.

One of the most common questions that I find patients have is how long after losing weight do I need to wait until coming in for a consultation?  I tell them that it is important that your weight loss has stabilized and that you are not losing significant amounts of weight each week or that you have gotten to near your goal weight.  I explain to them that if they are still losing large amounts of weight, it is not a good time to evaluate their body, as it is still going through changes.  Usually about one-year after their weight loss surgery their body weight has stabilized and they have been maintaining their diet and exercise program.  This or just a few months prior is a good time to seek consultation and begin planning your cosmetic procedures.

Posted in post bariatric surgery |

Top 5 Questions To Ask Your Plastic Surgeon

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If you’re thinking about getting any type of plastic surgery or cosmetic surgery procedure done, doing your research before visiting your doctor is a must. Here are the top five questions that you should always ask when consulting with any plastic surgeon.

  1. Ask about your surgeon’s board certification – It is important to know what your surgeon’s training comprised of and whether they are board certified. It is important to ask in specific if they are board certified in plastic surgery.  There are physician that will advertise that they are board certified but not disclose in what discipline.
  2. Ask to see their before and after photos for the specific procedure that you are interested in.
  3. Ask your surgeon what hospitals he/she operates at or is allowed to operate at. This is  important  as hospitals strictly monitor surgeons’ outcomes and board certifications.  Even though your surgery may not be taking place in a hospital it is important to know that he does have privileges to perform plastic surgery cases in a hospital.
  4. Ask your surgeon if they have any previous patients that you can contact and ask questions about their experience.
  5. Ask your surgeon how many of the procedure/s that you are interested in they do each year.
Posted in patients |

Tummy Tuck Or Liposuction: Which Is Right For Me?

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In this week’s blog we will discuss who is more suited for a tummy tuck and whom is more suited for liposuction.  I like to explain to my patient’s that there are basically two opposite ends of a spectrum with all types of body types in between.  At one end of the spectrum are patients with little to no fatty tissue underneath their skin and just excess skin… these patients are best suited for a tummy tuck.  On the other end of the spectrum are patients without excess loose skin and just excess fatty tissue under the skin.  These patients are best suited for liposuction.  However, most of the population fits into some grey area between these two extremes.  Depending on how much loose skin there is or how much excess fatty tissue is present, might depend on which procedure is recommended.  There is an option, for my patients, to combine both liposuction and a tummy tuck at the same time.  This is for patients that have some loose skin as well as some extra fatty tissue under the skin.  The best way to know what procedure is best for you is to come into the office for an evaluation, so that your surgery is tailored to you and your individual needs.

Posted in liposuction, tummy tuck |

Sculptra Aesthetic – Advantages Vs. Other Treatments

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Many of you may have heard about Sculptra Aesthetic® but may still be unsure of what it is, what it does and who would benefit from it.  Sculptra is what we in the plastic surgery world term a “volumizer”.  Which means exactly like it sounds… it provides volume.  This is an injectable solution, made of a form of lactic acid, that can be injected in the office to give more volume to certain areas of the face.  Over the past years, the thought process behind evaluating the aging face has been undergoing dramatic changes.  As we get older, not only does our skin become more lax, but we loose volume to our face in the form of bone and fat.  We have found that with injections of Sculptra® we can help to restore some of that lost volume as well as help stimulate collagen production in the skin.  Plastic surgeons have realized that many of the wrinkles in the face and the general “aged” face appear because of this combination of lose in volume and skin laxity.  Sculptra aesthetic® is unique in its actions to address both of these problems and feel completely natural to the touch.  So now… instead of just filling in lines such as the nasolabial folds, we can address the underlying problem which is often the loss of volume to the cheeks and mid face while at the same time helping the skin look younger and more youthful.  If you think about it… many young faces have prominent nasolabial folds but their face still looks youthful… so why should patients walk around with less deep nasolabial folds and still have an aged look to their face?

 

With all this being said, although Sculptra Aesthetic® can provide significant results to the face, it is not the solution for all patients and is often used in combination with other non-surgical or surgical cosmetic procedures.  To learn more about this product and to see if you are a good candidate for Sculptra Aesthetic®, call my office to schedule a complimentary cosmetic consultation.

Posted in sculptra |

What is Voluma?

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This week’s blog is all about a relatively new product on the market called Voluma®.  This product is from the company Allergan that many may already know of because of their other popular products like Juvederm® and Botox®.  Like Juvederm®, Voluma® is a type of filler made from hyaluronic acid, which is a sugar naturally found in the body.  Similar to Juvederm®, Voluma® is used to provide volume to the area in which it is injected.  It is currently used to provide volume to the midface and cheeks.  The hyaluronic acid molecules in Voluma® are slightly larger than that found in Juvederm® and therefore can provide more volume to a given area.  As the face ages, we loose volume in our cheeks and mid face.  Voluma® injections into these areas can help to restore the volume that has been lost and help to enhance ones cheekbones.  The injections are relatively painless and can be done in the office.  The most common side effect if any, might be some bruising at the site of the injection.  Because of the way the product is manufactured, it can have visible effects for up to 2 years.

I have seen remarkable results with this product and have had many happy patients.  If you think you might be interested to learn more about this product and see if you are a good candidate for it, call my office to schedule a complementary cosmetic consultation.

Posted in voluma |

Breast Lifts: What You Need To Know

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Breast lift surgery is a very common procedure for the breasts.  But what is a breast lift and when would someone need one???  With time, gravity, or breast feeding, the breasts have a tendency to drop/droop.  Some may notice that the nipple starts to point down to the ground instead of pointing forward.  This is mostly a skin issue.  Which means… that the skin to the breasts have stretched and are allowing the breast to hang too low.  This may also happen after significant weight loss or breastfeeding, in which you might loose volume to the breasts and now there is “too much” skin left.  Depending on how much excess skin needs to be removed and tightened, depends on the types and amounts of incisions that need to be placed to the breasts.

There are three most common incision patterns that are used for breast lifts:  periareolar incision (an incision around the nipple areolar complex for minor lifts), periareolar incision with a vertical incision (aka the “lollipop” incision because the incision travels around the areola and then travels vertically down the lower underside of the breast towards the breast fold; for more skin removal and tightening), and finally the Weiss pattern or “anchor” incision (which looks like the anchor of a ship, which has the same pattern of the lollipop lift with an extension of the incision line that travels in a crescent shape in the under fold of the breast; for the most skin tightening).  Depending on how much skin laxity or how much of a lift you might need, depends on which incision pattern you surgeon may suggest.  There are cases that a patient may need a lift and also want more volume to their breasts and in these cases, a lift can be paired with an augmentation to give more breast volume and tighten the skin at the same time.  We will talk about that scenario in a future blog.

Posted in breast lift |

Above Or Below The Muscle: Which Breast Augmentation Is Right For Me?

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When it comes to having a breast augmentation there are two options: saline vs silicone.  There are also options as to where the implants can be placed.

If saline implants are used the only option is for placement behind the muscle.  Saline implants, if not placed behind the muscle, have a tendency to show rippling under the skin.

If you choose to have silicone implants, then you have the option of placing them behind or in front of the muscle.  Placing the implant in front of the muscle has many advantages.  In my eyes, it makes more sense to place the implant in front of the muscle, since this is naturally where breast tissue is found.  I feel that a much more natural look can be achieved this way as well.  The postoperative pain is usually less than that if placed behind the muscle.

It also avoids what is called “dynamic deformity”.  This occurs in breast augmentations that are placed behind the muscle.  When the pectoralis muscles contract they move the implants upward and laterally.  There is still debate on whether the capsule that forms around all implants is more or less likely to get thick and be an issue down the road depending on whether the implant is placed in front of or behind the muscle.

I feel that the benefits of placing the implants in front of the muscle in breast augmentations with silicone implants far out weight those for placing them behind the muscle.  Most patients are good candidates for this as long as they have at least  “A”cup size natural breasts.

Posted in breast implants | ← Older posts