Tummy Tuck, Abdominoplasty, Panniculectomy, it doesn't matter what you want to call it, the result is a flatter, firmer stomach.

What Does a Tummy Tuck (Abdominoplasty) Do?

Tummy tucks are designed to fix abdominal wall laxity. Abdominoplasty can repair stretched abdominal wall muscles. The tummy tuck removes the excess skin and fat that accumulates on the lower belly. This part of the abdominoplasty is sometimes called a Panniculectomy. Whatever the name, the result is a firmer, flatter abdominal wall.

Tummy Tuck Timing – When to Get Your Abdominoplasty

There are several reasons for abdominal wall laxity, but having children tops the list. Pregnancy stretches the abdominal muscles and skin. Often the stretching is irreversible, and the skin and muscle remain loose, despite weight loss and working out. It may take several months for your abdomen to recover from child birth. Normally, maximum shrinkage is seen by your newborns first birthday. The best time to get a tummy tuck is after your are done having children. For more information about abdominoplasty, click on San Francisco Tummy Tucks

Another common reason for a tummy tuck is a history of being overweight. Weight gain, like pregnancy, stretches the abdominal wall. When the weight is lost, loose skin and stretched muscle may continue to be a problem. This occurs in more areas than the abdomen. Loose skin may affect the breasts, face, arms and thighs too. The best time to have a tummy tuck after Weight Loss, is when you have reached your goal weight. If you have had bariatric surgery for weight loss, it is recommended to wait one year after your weight loss surgery. This allows you to reach a stable weight, and gives your body time to adjust to its new physiology. For more information on plastic surgery that can help improve your appearance after weight loss, click on Post-Bariatric Plastic Surgery.

Mommy Makeovers

The Mommy Makeover is a combination of Tummy Tuck and Breast Enhancement. Since pregnancy affects the breast and abdomen, the mommy makeover is one of the most common combination surgeries I perform. Most commonly, Breast Augmentation, with or without a Breast Lift, is added to the tummy tuck. But sometimes, just a breast lift (mastopexy) or even breast reduction is needed. A mommy makeover may involve a smaller abdominal procedure when appropriate, so liposuction and mini tummy tucks (mini abdominoplasty) are always considered. For more information on Mommy Makeovers, click on San Francisco Mommy Makeover.

If you would like more information about the mommy makeover, tummy tuck, mini tummy tuck, liposuction, Breast Augmentation, breast lift, breast reduction or post-bariatric plastic surgery, make an appointment for a personal, private plastic surgery consultation. Give us a call at (925) 943-6353, or use the contact form on this page.

Tummy tuck before and after pictures. All three layers (skin, fat and muscle) of the abdomen are improved. Click on picture for more examples.

Many common tummy tuck questions came up during the show and even more questions were raised afterwards from the audience and in the emails that followed. The most common question asked was, “Who needs a tummy tuck?” I would like to share some of the reasons people have tummy tucks here.

First the disclaimer, when I answer general questions the answers are generally true; however, sometimes specific situations arise with an individual that leads to a different answer. While what you read on the San Francisco Plastic Surgery Blog, or on my personal web site (DrMele.com) is carefully designed to provide you with the information needed to learn about plastic surgery, it is important to actually see a Board Certified Plastic Surgeon before any specific course of action can be recommended. Every patient is different, and consequently every operation is different. A vital ingredient for a beautiful plastic surgery result is individualizing the plan to suit your specific needs.

Who needs a Tummy Tuck?

A tummy tuck tightens the abdominal wall. It improves three layers: the skin, the fat, and the muscle. The ideal candidate for a tummy tuck is in good shape and not too far from their goal weight. In order to be a candidate, you should need help in at least one of the following three areas that the surgery improves.

Loose Skin

Loose skin can be caused by pregnancy and weight loss. Both stretch the abdominal skin. If the skin is stretched too much, it cannot recoil. After pregnancy or weight loss, the skin may remain stretched and begin to hang. Unfortunately, in this situation, more weight loss does not help. Instead it leads to more loose skin.

A tummy tuck removes this loose skin from the lower abdomen, and tightens the skin that remains. This results in a smoother contour and better fitting clothes.

Excess Fat and Stretch Marks

Whenever I am removing excess lower abdominal skin, I can remove two other problems: excess fat and stretch marks. Excess fat that is below the belly button, is removed along with the excess skin. Women tend to put most the excess fat between the muscle and the skin, making it easy to remove. Men more often put excess fat behind the muscle, where it is not accessible. This internal fat must be lost with diet and exercise, and cannot be surgically removed.

Any stretch marks that are in this skin, are also removed. If the stretch marks are confined to the central abdomen below the belly button, the majority, if not all of them, can be removed with a tummy tuck.

Muscle Laxity

Babies and internal fat are behind the muscle layer of the abdominal wall. Because of this, pregnancy and weight gain also stretch the muscle layer. The muscle, and its case, can become overstretched to the point that the abdomen cannot be sucked in, not matter how strong the muscle layer. Tummy tucks allow me to tighten the case of the muscle and provide a smooth flattened foundation that can support the gut and keep it contents from pushing forwards.

If someone is significantly overweight, it is the internal fat that prevents me from being able to optimally tighten the abdominal wall. If the abdominal wall cannot be maximally tightened, abdominal fullness will remain. In this situation, additional weight loss will improve the results.

The first two segments of the video are now posted on the San Francisco Plastic Surgery Blog. Here is the link to Tummy Tuck (Abdominoplasty) San Francisco Video – Part 1 of 3; here is the link to Tummy Tuck (Abdominoplasty) San Francisco Video – Part 2 of 3; and here is the link to Tummy Tuck (Abdominoplasty) San Francisco Video – Part 3 of 3.

After children (or weight loss) the breasts lose volume and the abdominal wall is lax.

Depending on what needs to be fixed, however, other procedures can be substituted. Sometimes a Breast lift is added to, or used instead of the Breast Augmentation. If the breasts remain too large after childbirth, a Breast Reduction may be more appropriate. The Mini Tummy Tuck can sometimes replace the full Tummy Tuck, and Liposuction is often used as an adjunct.

The combination of breast enhancement and abdominoplasty is usually performed after childbirth, but is also common after significant weight loss. In both instances the problems are similar. The breasts may lose volume and support, and the abdomen is often left with excess skin and muscle laxity. The Mommy Makeover restores lost volume and support to the breasts and tightens the abdominal wall (skin and muscle).

The woman pictured to the left is lucky. Although she has lost volume in her breasts after childbirth, her nipples remain high above the inframammary fold (the bottom of the breast). This means a breast lift is not needed. Instead, the lost breast volume was restored. Breast implants were placed behind the pectoralis muscle with a natural result.

Her abdominal wall had been stretched, resulting in loose skin and weakened abdominal muscles. There is a small amount of fat behind the lower abdominal skin, but this will be removed when the skin is tightened. Overall she is in good shape, and a good candidate for a Mommy Makeover.

Starting at the Top – Breast Augmentation

Before Mommy Makeover, the breast have lost volume and are smaller than before pregnancy.

After Mommy Makeover, breast volume has been restored to a pre-baby state.

Breast augmentation was performed to restore volume. The goal was to restore the lost volume, and just a little bit more. Smooth round implants where placed behind the muscle via a periareolar (below the nipple) approach. This gives a nice teardrop shape the the breasts. By selecting the appropriate size, a very natural appearance can be obtained.

Around the Middle – The Tummy Tuck (Abdominoplasty)

Before Mommy Makeover, the abdominal muscles and skin are over stretched.

After Mommy Makeover, the abdominal muscles and skin have been tightened.

The Bottom Line – Restoring Proportions

After children (or weight loss) the breasts lose volume and the abdominal wall is lax.

After Mommy Makeover, the abdomen is flat and the breast's proportions are restored.

The art of plastic surgery has a lot to do with proportions. By giving volume to the breasts and taking volume from the abdomen, an aesthetic balance is achieved. But, there is more benefits than just looking nice. Clothing fits better and the energy wasted on feeling self conscious can be used for more productive endeavours. Having children is something to be proud of, not looking like you’ve had children … priceless.

This is part two of two from an episode of KRON 4′s Body Beautiful with Vicki Liviakis that aired last month. This video discusses breast augmentation revision surgery, including before and after pictures and viewer questions.

Specific examples are shown. The first patient (shown below) had breast augmentation in her twenties. Years later, she had children and was not happy with the changes in her breast resulting from pregnancy and breast feeding. Before and after breast augmentation revision surgery pictures are shown. In her case a breast implant exchange and breast lift and were performed to adjust for lost volume and improve the shape of the sagging breasts.

A different patient had breast implant bottoming out. In her case the implants had fallen below the inframammary fold leaving the nipples high and flattening out the normal curve beneath the breast. Corrective beast augmentation surgery included breast implant implant exchange to adjust the volume, and the inframammary fold was reconstructed internally to raise the implant and form a distinct curve beneath the breast.

The caller in this video had a question about ruptured silicone gel implants that were placed in the 1970′s. If any breast implant has ruptured, it needs to be removed. Most frequently, a ruptured breast implant is replaced at the same operation. Silicone gel implants in particular should be removed sooner than later. A ruptured silicone gel implant, over time, can cause increased scarring and hardening of the breasts, as the body tries to wall off the free gel. If not treated promptly, this type of scarring can lead to further problems than may not be correctable.

Silicone gel filled implants placed before 1985 seem to have a higher deflation rate than the new silicone breast implants. In fact, the outer shell of silicone breast implants has changed twice since the 70′s. The first change, in the mid 80′s, was to decrease the rupture rate. The second change, in the mid 90′s, was to reduce gel bleed (the ability of the silicone gel to leak through outer shell without a rupture). Both US FDA approved breast implant manufactures, Allergan and Mentor, offer lifetime replacement of their implants should they fail, and often provide financial support should this occur within ten years of your breast augmentation procedure. For details of the Mentor and Allergan (Natrelle) Breast Implant Warranties click on the manufactures names. It is best to get the information direct from the manufacturer; however, the Mentor site has been going through some changes, perhaps with the merger with Johnson & Johnson, so if you can’t link there, JustBreastImplants.com also has information on breast implant warranties.

Additional Breast Augmentation Revision Videos

Breast Implant Revision – Part 1

Breast Implant Revision – Part 2 (You are here.)

Breast Implant Revision – Part 3

Breast Implant Revision – Part 4

Thanks for visiting the San Francisco Plastic Surgery Blog.

Breast augmentation revision surgery is sometimes necessary even in the best of hands. Revision surgery can range from simple, like changing breast implants after deflation or changing sizes, to more complicated, like when treating breast ptosis (sagging) or capsular contracture. The best way to reduce your risk of needing breast revision surgery is to choose a qualified Board Certified Plastic Surgeon.

If you need breast revision surgery, choosing a well trained Board Certified Plastic Surgeon with a broad experience in breast enhancement surgery is the best way to get a satisfying result. By choosing a Board Certified Plastic Surgeon who specializes on cosmetic surgery, you get a doctor who is well trained and well rehearsed in a wide range of treatment options.

Breast implant revision in San Francisco is no different than in other areas of the United States. Sometimes the results of the breast augmentation where just not what was expected. Other times, the result were great and either the breasts change, the implants change or the desires change. When these situations arise, breast augmentation revision surgery could be your best option to get back into the shape you want.

This is part one of two from an episode of KRON 4′s Body Beautiful with Vicki Liviakis that aired last month. This video discusses breast augmentation revision surgery. Part two will include more discussion, before and after pictures and viewer questions.

The best way to be certain your plastic surgeon is appropriately trained to perform breast augmentation surgery is to make sure that he or she is a Board Certified Plastic Surgeon. By choosing a Plastic Surgeon who is a member of the American Society of Plastic Surgeons (ASPS), you can be certain that their credentials have been verified. ASPS members are held to higher standards in ethical care of patients and continuing medical education requirements. ASPS standards are above and beyond those required by State licensing boards and hospital credentialing committees.

A small percentage of ASPS members are also members of the American Society for Aesthetic Plastic Surgery (ASAPS). ASAPS members are ASPS members who specialize in the cosmetic side of Plastic Surgery. ASAPS members must meet the standards of ASPS, apply independently for membership to ASAPS and demonstrate a commitment to cosmetic plastic surgery both in education and in patient care.

ASPS is the largest plastic surgery specialty organization in the world. Founded in 1931, the society is composed of board-certified plastic surgeons who perform cosmetic and reconstructive surgery. ASAPS is the leading organization of board-certified plastic surgeons specializing in cosmetic surgery of the face and body, and I am proud to be an active member of both.

Next time I will talk more about the reasons for breast augmentation revision surgery and how a qualified Plastic Surgeon can help.

Additional Breast Augmentation Revision Videos

Breast Implant Revision – Part 1 (You are here.)

Breast Implant Revision – Part 2

Breast Implant Revision – Part 3

Breast Implant Revision – Part 4

Thanks for visiting the San Francisco Plastic Surgery Blog.

Part three of three for the Mommy Makeover segment from NBC Bay Area’s, KNTV, Living Well with host Peggy Pico.

On this show we discussed the Mommy Makeover San Francisco, focussing on breast augmentation, tummy tuck, mini tummy tuck and liposuction. I previously posted two excerpts from the show. The first is on Breast Enhancement (Breast Augmentation) and the second covers Belly Enhancement, tummy tucks and mini tummy tucks. This segment will discuss liposuction. The full Living Well show is also available on line. To view the entire episode just click on the NBC Bay Area Living Well logo above.

This video discusses liposuction. The most broadly effective type of liposuction is tumescent liposuction. A liposuction cannula is used to demonstrate how liposuction is performed. Most liposuction is performed on an outpatient basis, and usually a compression garment is used for a few weeks after surgery. Before and after photos are also reviewed.

I hope this provides some new information on liposuction. If you would like more information on Liposuction San Francisco, click here to visit the Liposuction page on DrMele.com.

Part two of three for the Mommy Makeover segment from NBC Bay Area’s, KNTV, Living Well with host Peggy Pico.

On this show we discussed the Mommy Makeover San Francisco, focussing on breast augmentation, tummy tuck, mini tummy tuck and liposuction. I previously posted an excerpt from the show on Breast Enhancement (Breast Augmentation) on the San Francisco Plastic Surgery Blog. This video discusses Belly Enhancement, tummy tucks and mini tummy tucks. The third segment will discuss liposuction. The full episode is also available on line. To view the Living Well episode in its entirety, just click on the NBC Bay Area logo above.

This video discusses the types of tummy tucks available: the traditional tummy tuck (sometimes called abdominoplasty or panniculectomy) and the mini tummy tuck (a combination of tummy tuck and liposuction). For laxity of the abdominal wall that begins above the belly button. the tummy tuck is still the most effective treatment. If the abdominal laxity is confined to the area below the belly button, a mini tummy tuck may provide a good fix with a shorter recovery.

I will add the final video from Living Well about liposuction shortly, so be sure to bookmark and check back. If you would like more information on Tummy Tuck San Francisco, click here to visit the Abdominoplasty page on DrMele.com.

Yesterday I was on NBC Bay Area, KNTV, Living Well with host Peggy Pico. We discussed the Mommy Makeover San Francisco, focussing on breast augmentation, tummy tuck, mini tummy tuck and liposuction. I will be posting several excerpts of the show on the San Francisco Plastic Surgery Blog. This video discusses breast enhancement and the future postings will discuss the belly enhancement, tummy tucks and liposuction. The full episode is also available on line. To view the entire segment, just click on the NBC Bay Area logo above.

Breast augmentation is one component of the Mommy Makeover. It has become the most frequently performed cosmetic plastic surgery procedure in the United States with 400,000 breast enlargement surgeries performed last year. That’s 800,000 breast implants.

This segment discusses the types of breast implants available: saline breast implants, silicone breast implants and even the soon to be available gummy bear solid gel implants. Comparisons area made between smooth round breast implants and textured shaped breast implants. The importance of body proportions is stressed, and before and after pictures are reviewed.

I will add additional video from the show about tummy tucks, mini tummy tucks and liposuction in the near future so stay tuned. If you would like more information on Breast Augmentation San Francisco, click here to visit the Breast Augmentation page on DrMele.com.