Nothing substitutes for a personal evaluation and a face to face discussion of your options. Unfortunately without a examination I can advise you in general terms, however I hope you will find them helpful.
In general it’s best to be a your goal weight prior to surgery:
1) your abdomen (and other parts of your body) often will change size with weight fluctuations.
2) we all have internal fat (fat on our internal organs that pushes out the abdominal wall and not accessible to liposuction or abdominoplasty) and external fat (fat that we can pinch between our fingers that can be liposuctioned or surgically removed during abdominoplasty). Weight loss effects both and thus when you attain your goal weight we can optimally tighen your muscles and remove the excess fat and hanging skin.
3)Body Mass Index (BMI) over 30 and greater is associated with progressively slightly increased complications.
I would perform two stages for safety, pain control and overall I feel better long term result.
First Stage:
1)Extended abdominoplasty: removing all skin and fat between your pubic hair line (or lower) and your umbilicus (tummy button) which would remove most if not all of your rolls of abdominal skin.
2)tighenting your presumed separated muscles.
3)Liposuctioning your flank areas4)insertion non-narcotic paint pump for post op pain control
Second Stage (3-6 month latter)
1)lateral thigh and buttock lift
2)aggressive liposuction of abdomen, thighs and back
3)insertion non-narcotic paint pump for post op pain control
I believe you are a reasonably good candidate and will be very satisfied with your extended “tummy tuck” and its components as stated in above.
Sensation usually returns after liposuction. You most likely will have a area of decreased sensation just above your central abdominal incision (Similar to women after c-section).
I suggest you make out a list of your questions and select several nude “model” photos of what your desired goals/look would be and then schedule several different consultative appointments with experienced Plastic Surgeons who are Certified by the American Board of Plastic Surgery and who are ideally members of the American Society for Aesthetic Plastic Surgery (denoting by membership as having met additional criteria and a focus on Cosmetic Plastic Surgery).
Weight gain is quite normal and usually temporary. The physiology behind post operative weight gain is secondary to:
1)fluid retention- with any surgery there is some tissue damage and the body reacts by “hanging on to fluid” also called edema. Like when you sprain your ankle the area swells and as the tissue heals so does the ankle decrease in size. In abdominoplasty ( tummy tuck) there is a considerable amount of tissue resected, moved , streched and surgically manipulated. Thus, increased fluid retention.
2) with any physical trauma or surgery the body automatically release hormones that enhance fluid retention.
3)inflammation which is the body’s normal localized response also increases fluid retention.
4) continued trauma, infection, dependent positioning and immediate heat will only increase the swelling not help.
Thus, like you see with athletes elevate the area, apply ice, take some antiinflamatories and usually the majority of the swelling will resolve in 2-3 week with all swelling be gone in several months.
Unfortunately without a examination or photos I can only advise you in general terms, however I hope you will find them helpful.
Liposuction is often incorporated/included but not always necessary with a abdominoplasty to enhance the results.
Based on my experience I always offer complimentary liposuction of the flanks to better create a optimal contour of your tummy.
However it is not advised to perform liposuction of the upper abdomen at the time of abdominoplasty for fear of injuring the blood vessels that supply the lower abdominal tissue. This liposuction can often be completed under local anesthesia several months after healing of the abdominal incision.
Every Plastic Surgeon will perform a abdominoplasty a little differently depending on the patients anatomy and desires.
There are four types of abdominoplasties.
A-C All have horizontal
incisions and D has a significant vertical compotent.
A) mini- muscle tightened below umbilicus to pubic bone
B) standard- muscle tightened from breast bone to pubic bone
C) extended as in standard but incision longer to excise excess skin/fat in outer thigh area
D) fleur de lis- same as standard but in addition excess skin/fat excised in a vertical direction.
Please make a follow up a appt. with your Plastic Surgeon to address any and all of your questions.
I trust your Plastic Surgeons is Certified by the American Board of Plastic Surgery and is ideally a member of the American Society for Aesthetic Plastic Surgery (denoting by membership as having met additional criteria and a focus on Cosmetic Plastic Surgery).
