The World’s Greatest Tummy Tuck

I have had the good fortune to do an incredible number of abdominoplasties (tummy tucks) in my career as a board certified plastic surgeon so far.  I passed 1000 tummy tucks done as an outpatient in my private offices at Yager Esthetics, with 119 in 2010.  As I reflect on my experience and all that I have learned, I wanted to share with you what makes for the world’s best tummy tuck.

Most of my tummy tuck patients have had children, and desire to correct the loose skin, stretch marks, and lax muscle left behind.  More than half also elect to do liposuction of the back as well.  Other popular combinations usually involve breast surgery.  Others come after gastric bypass and massive weight loss.  But what makes some results better than others?

I find that the best results have 4 common factors, and I try to put them together as often as possible.  They are the result of careful study, and not all are in the surgeon’s control.

First is that after surgery, you should not look like you had a tummy tuck, you should simply look great.  The signs of an obvious surgery are upper abdominal fullness and a flat area below the belly button, a flat stomach with a fat back, no curve to the waist, and an unnatural looking belly button.  While the belly button is a tiny fraction of the work, it is what generates most complaints after an abdominoplasty if it is not done right.  I always tell patients about potential unnatural results on there consult, such as the need for back liposuction, umbilical hernias, or if weight loss is needed.

Next is a scar that is too high or that sticks out of the underwear.  I always mark my tummy tucks with the patient wearing the style of panty they want to wear after surgery to insure it is well hidden in case the scar does not completely fade.

Thirdly, patients who have a good support system of positive friends and family around them.  The recovery takes time, and doubts creep in.  Having someone tell you you look great really helps.  A jealous spouse or a mean spirited friend can ruin even the best surgical results by insensitive comments.  If you have negative people in your life, you are better off without them.

Lastly, as a plastic surgeon, I have to be there for each patient to support them, listen to them, and do everything possible to make the tummy tuck experience a positive one.  It is an honor to be chosen to reconstruct the human body, with all the hopes and dreams of my patients riding on the result. 

I wish to thank the 1000 plus tummy tuck patients I have taken care of for their confidence, and hope to see the next 1000 at Yager Esthetics soon.

The Plastic Surgery Diet

At Yager Esthetics, patients often ask me if there is a special diet they should follow after liposuction or tummy tuck surgery.  While the short answer is that they can eat what they want, a sensible and healthy approach to diet and portion control is essential to maintaining the best shape.

While I do not claim to be a nutritionist or registered dietician, I thought I would pass along some healthy eating guidelines to lose or maintain your weight.  I do not endorse any particular diet plan, and favor learning how to eat regular food both at home and in a restaurant so you can follow these principals forever.

To increase your body’s metabolism, you have to keep it working all day long.  Skipping meals is the worst thing to do, as your body just slows down thinking it may never be fed again.  I recommend eating every three to four hours in a sensible way.

In the morning you need a sensible breakfast, such as Special K with fruit, an egg white omelette with veggies, or a whole grain toast with preserves and coffee or tea.  In between breakfast and lunch, have a low fat yogurt with 100 or less calories and a piece of fruit and space them out.

For lunch, I prefer a protein the size and thickness of my palm with a starch (rice, potato, etc)  the size of my fist without a thumb.  I can have as much veggies as I want, like a salad, but very little dressing on the side.

In between lunch and dinner, another yogurt and fruit.  Dinner is the same guideline as lunch.  After dinner, 2-3 hours later, I allow myself a dessert of 100 calories or less of any type.  I often find it difficult to eat so much in a day.  At work, sometimes frozen food are convenient if you read the labels, keep fat calories to 25% or less, and keep it under 500 calories.

Throw in a little exercise 2 to 3 times a week, and you are well on your way to a healthier new you!  If you need more help, call us and we will recommend a nutritionist or weight loss doctor to help you.

How to Be a Great Plastic Surgery Patient

You often read articles about how to select the best plastic surgeon, or what the latest techniques are with the most fabulous results.  You do your research, check board certification by the American Board of Plastic Surgery, talk to patients and see before and after photos.  You have selected the perfect doctor, so you are done, right?  Not exactly.

When I agree to operate on a patient at Yager Esthetics, my patient and I BOTH sign the consent forms, because it is an equal partnership agreement.  I agree to do my best to perform the surgery safely, expertly, and with my patients best interest first.  My patients also have responsibilities in order to achieve the optimal outcome.

Patients have to be 100% honest with their plastic surgeon.  Hiding a medical condition, or lying about not smoking can be harmful not only to your results, but to your health.  I have many patients with diabetes, high blood pressure, asthma, and other conditions on whom I happily operate.  The difference is that I can order the proper testing to keep them safe, and talk with their doctors to assure that it is safe to proceed.

Patients must follow the post operative instructions given by their doctor.  How you listen and follow directions can be the difference between a great result and a complication.  No driving for two weeks means no driving for two weeks.  Instructions are usually given to avoid damaging your surgical outcome.  If you are thinking about breaking one of the rules, call the office and ask the reason for the rule first.  It might change your mind.

So, continue to be careful in selecting your plastic surgeon.  Also, try to be the best patient you can be, and your chances of a great result will be much higher.

Is Laser Surgery Better for Hispanic Patients?

Many patients come to Yager Esthetics after seeing an ad or hearing a television report about some type of laser that can magically eliminate stretch marks or scars, or tighten loose skin so you do not need surgery.  It sounds almost too good to be true.  Unfortunately, it IS too good to be true.

Lasers can do many things in medicine, even cosmetically.  Every year, advances really do occur that make them safer and more effective for patients.  They are not, however, magic.  I hope to demystify lasers for you a bit in this column.

You can cut with a laser as you can cut with a scalpel.  Both incisions leave a scar.  There is no evidence that laser incisions heal better.  In Hispanic skin, I feel the laser is more dangerous, as the heat it generates can cause hyperpigmentation (darkness) in the surrounding skin.  Advantage, scalpel.

Lasers do not remove stretch marks.  There is as of today no treatment, be it cream or laser or magic wand, that can erase a stretch mark from skin.  While early pink ones are easier to fade than old white ones, they do not disappear.  Again, in Hispanic skin, the risk is creating stretch marks with dark spots (manchas) around them.  The only current way to get rid of stretch marks 100% is to remove the skin that contains them.  For example, if your stretch marks are all below the belly button and you have enough skin, you can do an abdominoplasty, or tummy tuck to remove that skin.

Lasers are effective in permanently reducing unwanted hair.  Hispanic patients must seek out doctors with a lot of experience treating latin skin to avoid burns, darkness and other complications. The darker your skin, the greater the danger.

Please do not think I am anti laser – they fascinate me, and I have incorporated them in my practice.  I will continue to follow the advances, and add them when they are safe and effective for my Hispanic patients.