Encino, CA plastic surgeon George Sanders, MD has performed more than 10,000 procedures during his 30-plus years in practice, and the Harvard-trained surgeon says his number-one goal is to educate his patients on what plastic surgery can and cannot do. “I want my patients to be happy with the end result and part of that success starts before we ever go into the operating room,” he explains.
While advances in surgery have made some procedures easier on the patient to undergo, Dr. Sanders says there are still many misconceptions about tummy tucks and what really goes into these transformational treatments. “There are some significant improvements in body contouring surgery and patients often come in with questions based on what they’re seeing on social media or conversations they’re having with friends,” he says. “The best thing to do is schedule a consultation with a qualified surgeon to go over any questions you may have.” Here, Dr. Sanders shares answers to the top questions his patients have before and after a tummy tuck.
Do you have to be at your ideal body weight to undergo a tummy tuck?
“Sometimes patients will bring in photographs of a 20-year-old model, and they are a 55-year-old individual who’s a bit overweight, doesn’t exercise, but seeks to achieve this dramatic transformation. There are several issues with that, but probably one of the most important ones has to do with the type of fat that we’re able to address with a tummy tuck. It is the fat that is just beneath the skin. It’s not the fat around the organs, it’s not the fat that’s inside the muscle layer of the abdomen. We’re above the muscle in terms of our approach to fat. So, if you’re wanting to get the best result, we always encourage patients to try to achieve their ideal body weight or at least be within 10 pounds of it.”
How much fat can be removed?
“The fat we are targeting is in the upper abdomen. Many people come in who have a lot of fullness in the upper tummy, partly due to muscle looseness, which we correct with surgery. However, there may also be a significant amount of fat just beneath the skin in that area. We can only take out a certain amount of fat safely in that area at the time of the tummy tuck because of blood supply to the skin. The blood is not only coming from the upper part of the body, but it’s also coming directly from the muscle underneath. When we disrupt the part that’s coming from the muscle, because we lift the skin up, the blood supply we need is now coming from above. If we’re doing a great deal of liposuction, that would tend to damage that blood supply.”
Do I need muscle tightening?
“Not every patient needs to have muscle tightening. During some tummy tucks, we tighten the two large muscles on either side of the abdomen called the rectus muscles. When you’re pregnant, those muscles tend to get stretched apart. In many women, they do come back to a small distance, but if in people that have had multiple pregnancies that distance tends to remain stretched out and we call that a diastasis recti. In those cases, the muscles need to be corrected with surgical tightening. If there’s not a separation there, we don’t always need to tighten the muscle, so it’s part of the examination that we do beforehand.”
Will I be recovering for months?
“I always point out that for two weeks you’re going to pretty much be a couch potato. You’re going to be able to get up and do a little walking, but no exercise. After those two weeks, you’ll be able to begin driving a car and going out and about, but I discourage any type of significant cardiovascular exercise at that point. Give it four weeks before you’re doing cardio again. Then it’s six weeks before you’re totally cleared to do anything you want. The reason for that is when we tighten the abdominal muscles, we’re doing that with a suture that will hold things together for about six weeks. By that time, the body has formed scar tissue that will allow it to hold the suture. We need to give the body a chance to achieve strength which is why you must also avoid heavy lifting.”
Will my scar be bigger than my C-section scar?
“Another question that patients often have is, ‘How long does my scar need to be?’ Many times, they will compare it to their C-section scar and ask if they can have a scar of that same length with their tummy tuck. The scar associated with an abdominoplasty is typically longer if you’re needing to tighten the abdominal muscles. The second issue has to do with how much skin you take out in the up and down direction. In most tummy tucks, we’re taking out all the skin between the belly button and the pubic region and that has a certain length to it.”
Will you make me a new belly button?
“We don’t actually make a new belly button. What we do is cut around your old belly button, lift up the skin that allows us to tighten the muscle and then pull that skin down. Typically, the belly button opening comes all the way down to the area where we cut skin away, so that that opening is removed. Then, we bring your belly button out exactly where it was before we started surgery. So, it’s still your belly button, but because the skin around it is much tighter and firmer, it tends to look rejuvenated.”