Articles

Tummy Tucks part of trend in beauty-related surgeries

Women weighing options for enhancing beauty, especially after pregnancy

By Dr. Amy M. Ortega, Patrice Dickey

With the recent surge in popularity of beauty-related procedures, cosmetic plastic surgeon Amy M. Ortega, M.D. is often asked, "When should I start having plastic surgery?"

With the vast range of procedures now available, offering everything from subtle improvements to major changes, it seems there is always something for everyone.

The consideration comes down to two major categories—age and life situation . Certain age ranges naturally dictate the need for age-related procedures, while certain life events will create a need for certain procedures at any age.

All ages should get in the sunscreen habit—it's the best way to protect your skin from premature aging due to sun exposure. Dr. Ortega recommends an SPF 15 or above with a physical sun block such as zinc oxide.

By your 30s and older you may consider body contouring, especially after pregnancy. This may include breast augmentation, mastopexy (breast lift), abdominoplasty (tummy tuck) and/or liposuction. It's also time to consider slightly more aggressive skin maintenance procedures such as light peels or exfoliating products to help prevent fine lines.

The dreaded 'pooch'

Abdominoplasty, or "tummy tuck," is a frequently requested procedure designed to improve the appearance of the abdomen. While everyone's goal of a flatter tummy is the same, the cause of the often cited "beer belly" or "pooch" may be different from person to person.

"When I was younger I had a perfectly flat tummy," said metro area resident Mary Orr. "Then toward my late 30s or eady 40s, even though I exercised frequently, did endless crunches, and had never been pregnant, my tummy got all poufy. Even when I was underweight it wouldn't go away!" she confessed.

Some people simply gain weight in the abdominal area more than in other areas, and find this area to be problematic even with diligent weight loss efforts. With age, the muscles of the abdomen weaken, and the abdomen therefore may appear more prominent than before, especially in the lower abdomen. Weight changes can also weaken the abdominal muscles.

Although men and women both endure aging and weight changes, women have the added physical changes secondary to pregnancy. Many women don't realize that during pregnancy, the supporting muscles of the abdomen, called rectus muscles, are stretched and even separated.

After the baby is born, the size of the abdomen decreases, but the separation of the rectus muscles remains. This is called rectus diastasis. This is the reason that so many women are frustrated with exercise when trying to reclaim their pre-pregnancy figures. No matter how many stomach crunches one does, those rectus muscles will remain separated, and the lower abdomen will therefore remain weak, manifesting as the very unpopular "pooch."

In addition to that, the stretched abdominal skin resulting from pregnancy almost never returns to its previous appearance, often hanging empty. Another aspect is the weight gain during pregnancy that plagues so many and is so difficult to completely overcome, especially in the abdomen.

The result of all of these things is poor abdominal contour, which affects one's overall figure, how clothing fits, etc.

Countering gravity's effects

The single procedure best suited to address all of these issues is an abdominoplasty. This procedure combines the removal of lower abdominal skin and fatty tissue with the added advantage of an internal tightening of the rectus muscles for better support.

Through a lower abdominal incision, the surgeon can raise all tissues on the abdomen, all the way up to the rib cage. She can then visualize and repair the rectus muscles. The skin and soft tissue is then re-draped and excess is removed.

Marketing executive Mary Orr decided to go for the full spectrum of treatments after meeting Dr. Ortega at a networking event. On a Friday in October 2004, she had the full "lower body lift" which includes gluteal lift ("butt lift"), tummy tuck and liposuction.

The following Tuesday she had her face done with upper and lower blepharoplasty (eyelids), rhinoplasty (nose job) and eyebrow lift. She is delighted with the results. Some people combine the abdominoplasty with a gluteal lift for total lower body contouring, which adds another week of recovery time. There is no heavy lifting or heavy exercise routine permitted for six weeks to allow for healing.

After surgery, the abdomen feels very tight. During recovery, Mary wore the required support garment around her abdomen. Like most patients, Mary took about a week to recover well enough to return to her desk job, working from her home.

"Absolutely I'd endure the recuperation again," said Mary; age 50. "The pain wasn't as bad as when I had sinus surgery." However, she did advise that patients allot themselves two full weeks for recuperation rather than trying to rush back into their daily activities. "I was constantly exhausted, and took a lot of naps," she explained. "Dr. Ortega told me to expect that. Even people who have had only liposuction are constantly exhausted."

Advice from former patient

"Although my husband had told me that I didn't need lipo, when I showed him the before and after photos, he said, 'Wow!' There's no way I could wear some of the clothes I can wear now--not with my poufy tummy before. Dr. Ortega and her staff were fantastic."

They didn't need any professional home care post-surgery, but her husband moved them into the first floor bedroom so she wouldn't have to deal with stairs.

Mary advises those who are considering any plastic surgery procedures to make sure you're comfortable with the surgeon; that you know their credentials and that you've seen a lot of before and after photos of their own patients.

"Also, be realistic about what it's going to do for you," she said. "A lot of women treat a tummy tuck as a diet--it's not a weight loss thing. Your body needs to be at a stable weight, especially if you're having body sculpting as I did. Wait until you are at your desired weight," she advised.

One thing is certain--people are no longer waiting until they are in dire need; there is more of a trend toward "maintenance." Having one's procedures over several years can maintain a more youthful look and helps avoid a dramatic change in appearance.

Subtle improvements are often not recognized as plastic surgery, but rather as "looking more rested and refreshed," "looking like you've lost weight," etc. On the other hand, when there is room for dramatic improvement, there is usually a procedure or combination of procedures that can produce a significant change.

Amy M. Ortega M.D. is a Board Certified double-fellowship trained cosmetic plastic surgeon with special interest in cosmetic surgery of the face, breast and body. She can be reached for surgical consultation at A New You Skin & Body Clinic in Woodstock at (678) 739-0040 or her Buckhead office at (404) 751-2500. For more information visit www.ASAbeautiful.com.