La Jolla Tummy Tucks (Abdominoplasties) are one of the most common procedures among La Jolla plastic surgeons. This procedure can accomplish results that are truly dramatic. Abdomens that have lost their muscle tone, that are no longer flat but instead have a prominent bulge, skin that may have multiple stretch marks, and a loss of one’s waistline are all things that can be improved to a remarkable extent with a tummy tuck. Women who would benefit from Abdominoplasties usually have had one of two preceding causes that make this procedure so exceptional.
The first and most common reason for these problems is pregnancy. Women who’ve had multiple pregnancies, small women who have had large babies, or women in whom the skin develops extensive stretch marks make up the vast majority of the patients that I see requesting a Tummy Tuck. The second group of patients, who will benefit from this procedure have usually lost a large amount of weight and the skin has become stretched out. This may result in a panniculus, which is an apron of skin in the lower abdomen.
In the patients that are good candidates for a Tummy Tuck; there are no diets, exercises, skin creams, or other treatments that will be able to accomplish any significant improvement. Sometimes these patients maybe incorrectly treated with liposuction; but this does not work well, because the real problem involves abdominal wall laxity and excess skin. Tummy Tucks are very effective after C-sections. The entire C-section scar can be removed in the process.
One of the most common problems in this group of patients is abdominal wall laxity and a separation of the abdominal muscles, which is called diastasis recti. This refers to a separation of the paired abdominal muscles that are close together in the midline prior to pregnancies. With pregnancy these muscles are frequently separated with the fibrous layer between them stretched. After the pregnancy, the muscles can be strengthened by exercise, but it will not have any effect on the fibrous tissue which still remains stretched allowing the muscles to remain widely separated. This separation results in abdominal wall laxity and significant loss of the desired waist line.
This procedure is done in the office under general anesthesia, in which a very low abdominal incision is made. The skin and fat are then elevated from the abdominal wall. The umbilicus (belly button) is carefully trimmed so that the belly button is not moved or injured.
In order to achieve a truly worthwhile result, it is crucial to do the muscle repair. Special sutures are used to bring the separated muscles back together and significantly tighten up the abdominal wall. This will also give a much smaller and better contoured waistline.
Following this, the operating room table is partially flexed at the waist so the proper amount of skin can be fully excised and the skin carefully sutured in order to obtain the best possible scar. The excess skin and fat are carefully marked out and trimmed away. The amount of skin and fat removed is frequently much greater than a patient might imagine. At the same time excess fat is trimmed from the abdominal flap. This fat should be contoured so that there is a midline linear depression that is present in most well contoured and fit abdomens.
Even the belly button is important. Most belly buttons in young fit women are vertical ellipses (keel shaped), not round or triangular. Therefore in order to get the very best looking abdomen the umbilicus should be contoured so that it is not only vertical and narrow, but it has the proper inward contouring which is always present in a fit, attractive abdomen.
Another important development involves the use of the ON-Q pump. The ON-Q pump utilizes tiny catheters that are placed on top of the muscle. These catheters release a small amount of long lasting numbing medication around the muscle. This makes a huge difference in the amount of discomfort the patient may experience afterwards and helps determine how quickly the patient can return to roughly normal activity.
In conclusion, La Jolla Tummy Tucks are a wonderful operation for the right patients’. The surgical results can make a dramatic difference in both the patients’ appearance and also allows them to be able to regain their confidence and contentment with their physical appearance.
Dr. David Wolf (article author) received his board certification in plastic surgery in 1983. He is a Diplomat of the American Board of Plastic Surgery, a Fellow of the American College of Surgeons and a Member of the California Society of Plastic Surgeons. He has been a Senior Staff Surgeon at Scripps Memorial Hospital in La Jolla which is the campus where he operates today.
You may contact the helpful and caring staff of Dr. David Wolf at (858) 450-1776 | www.drdavidwolf.com | 9850 Genesee Avenue, Suite 500 La Jolla, CA 92037.
