FROM THE DOCTOR: Springtime heralds the travel season, spring - TopicsExpress

FROM THE DOCTOR: Springtime heralds the travel season, spring break and summer trips to the beach, evenings out to dinner, out-of-doors workouts and other activities that involve less clothing and more exposed skin. That spurs thinking about how one looks in a swim suit or evening dress and therefore thoughts about dieting, working out and plastic surgery. Typical procedures include breast augmentation and/or lift, abdominoplasty (“tummy tuck”), and liposuction-- or in the case of the “mommy makeover," all three! Combined procedures have the advantage of saving recovery time and money and have a dramatic transformative factor to a degree not otherwise experienced. Other than moms-who hate what pregnancies do to their bodies almost as much as they love their kids-patients who have undergone massive weight loss also frequently opt for such a metamorphosis. Recently, we had such a patient undergo abdominoplasty, breast lift, and arm/upper back lift with concomitant elimination of armpit hair and sweat glands! She wheeled into the OR then out again in 6 hours almost unrecognizable-- in a good way. She has experienced only moderate and short-lived postoperative discomfort and the life--changing thrill of seeing in the mirror the person she always thought herself to be. Seeing a patient through such an experience is what makes being a plastic surgeon such a blast. So it is with less ambitious efforts such as tummy tuck alone. This aesthetic procedure is #1 in customer satisfaction. One of my favorite things is to prove a patient wrong when I hear “I’m not ever going to wear a bikini again…” Although the procedure entails a long horizontal scar, it stays low and eliminates the vertical scar from some cesarean sections or hysterectomies. The scar around the belly button improves its appearance. One thing often not appreciated is that the bulge of the mid- abdomen, called diastasis recti, caused by the expansion of the baby or intraabdominal fat breaking down the midabdominal ligament, will not respond to even an infinite number of crunches. In fact, the crunches can actually make it worse by increasing pressure in the abdominal cavity which pushes the intestines outward through the defect. Only surgical repair can undo the change. This also accounts for why many women who present asking for liposuction are better candidates for abdominoplasty. Another point is that the repair helps to narrow the waist and get closer to the ideal 0.7 ratio between waist and hip diameter. In studies, people who are shown cartoon sketches of women always choose pictures with this proportion as the most attractive, regardless of the overall weight depicted. If the muscle tightening alone does not achieve the goal, liposuction can make the difference and does not add to the cost of the procedure. All-in-all, patients get the most bang for their buck with these contouring procedures and are uniformly glad they chose to do it. Give yourself 3 weeks to get back to normal and have some help around the house. Sadly, sweeping, vacuuming and similar activities are out during that time period. Tight waist bands are dangerous early in the recovery so wait for the doctors go-ahead before wearing those new jeans!