9101 N. Central Expwy.
Suite 600, Dallas, TX 75231
Tel: 214.827.2814

What’s the Point of Muscle Plication (Tightening) During Abdominoplasty? Tummy Tuck Specialist Dr. Sam Jejurikar

Tag Archives: board certified plastic surgeon

Many patients ask if their muscles truly need to be tightened during a tummy tuck. For most patients, the answer is yes. After pregnancy or massive weight loss, many women develop a condition known as rectus diastasis. With this condition, the midline vertical muscles that extend from the sternum and rib cage to the pubic bone, known as the rectus abdominis muscle, separate in the midline. This leaves a gap that was not present before pregnancy or weight loss. The gap is not indicative of muscle weakness, but it does lead to an abnormal bulge in the upper abdomen. As well, it can contribute to an overhanging skin apron in the lower abdomen.

Because this is not indicative of muscle weakness, performing abdominal wall exercises to strengthen the rectus muscles do not considerably improve this. The only true way to fix the abdominal bulging is to tighten these muscles by bringing them back together in the midline. As of now, this can only be accomplished with surgery, with the placement of multiple sutures to restore the overall integrity of the abdominal wall.

Obviously, removal of skin and reshaping the belly button are also integral portions of an abdominoplasty (tummy tuck). For most patients, however, failure to tighten the muscles of the midline abdominal wall would lead to less than optimal results.

For additional questions, please do not hesitate to contact Dr. Jejurikar via the web or via telephone at 214-827-2814.

The terms “closed rhinoplasty” and “open rhinoplasty” are thrown around frequently by plastic surgeons. The difference between these two operations is actually quite small. In an open rhinoplasty, an incision is made across the columella (base of the nose) and extended into the nostrils. In a closed rhinoplasty, incisions are made just within the nostrils. This is sometimes also called an endonasal rhinoplasty. Thus, the only real difference between these operations is the presence of a very small scar across the base of the nose.

So, what are the implications for patients? First, with an open rhinoplasty, visibility of the cartilaginous and bony portions of the nose is much improved. This oftentimes allows surgeons to perform substantially more intricate work to the tip and base of the nose. Because there is such greater visualization, and the skin is lifted much more during this procedure, swelling tends to be worse after this procedure and it can take longer to achieve the final result

The scar at the base of the nose tends to be forgiving and, in most patients, tends to fade considerably over time, to the point of being virtually unnoticeable.

Should you have any other questions regarding rhinoplasty, please do not hesitate to contact Dr. Jejurikar at 214-827-2814.

Many patients have asked me about precautions I take to prevent infection in my cosmetic surgery patients. As everyone knows, cosmetic surgery is completely elective; infections after any surgical procedure can cause significant complications. It is therefore imperative to minimize the risks of infection.

Methicillin resistant Staphylococcus aureus, commonly referred to as MRSA, is becoming more prevalent in the community. Several years ago, this antibiotic resistant bacterium was present only in hospitals. Many healthy people are now colonized with MRSA. It can cause significant problems with delayed postoperative wound complications and infection. For that reason, I routinely screen my patients for bacterial colonization with MRSA before any type of cosmetic surgery procedure. Screening is done by performing a simple nasal swab and determining whether any resistant Staphylococcus aureus grows.

If patients have positive cultures, there is a simple decolonization protocol that is performed to reduce their risks of postoperative infection with MRSA. For five days, patients are asked to cleanse their body with 4% chlorhexidine solution. It is applied in the shower every day, with care taken to focus on the underarms, groin, and into any folds of skin. The antiseptic soap needs to remain on the skin for at least 5 minutes before it is washed off. In addition, patients are asked to apply 2% Mupirocin (Bactroban) antibiotic nasal ointment inside the nostrils 3 times a day.

After this protocol, most patients have been effectively decolonized and can safely proceed with cosmetic surgery.

Should you have more questions regarding this or other cosmetic surgery procedure, contact Dr. Jejurikar’s office at 214-827-2814.

Many patients ask me if their breast implants have any type of warranty. The answer is yes. Here are the details of Allergan’s ConfidencePlus® breast implant warranty program:

Lifetime Product Replacement – regardless of the age of the implant, Allergan provides product replacement in the event of a deflation or rupture
10 years of guaranteed financial assistance
Up to $1200 in out-of-pocket expenses for surgical fees, operating room and anesthesia expenses not covered by insurance
Silicone filled and saline filled breast implants covered

If you’d like more information on breast augmentation in Dallas or Plano, or would like to schedule a consultation, please contact Dr. Jejurikar’s office at 214-827-2814.

Buttock augmentation with fat, or the Brazilian Butt Lift, is being performed with increased frequency. The concept is quite simple; patients undergo liposuction in various locations and the fat that is removed is then re-injected to create a fuller, shapelier buttock.

The most common sites for liposuction include the love handles, inner and outer thighs, abdomen and lower back. The fat that is removed is processed prior to reinjection to remove natural oils and serum. Even with this, the body reabsorbs some of the fat that is injected in the first few weeks after surgery. To compensate for that, if possible, Dr. Jejurikar overinflates the buttocks initially after surgery. To try to minimize the amount of fat reabsorbed, patients are asked to avoid placing any pressure on the buttocks for 10-14 days postoperatively. They are also asked to minimize sitting as much as possible and to pad the buttock while sitting for six weeks thereafter.

For more information, check out the photo gallery or contact Dr. Jejurikar’s office at 214-827-2814 to set up an appointment.

I’m struck by the number of patients who come in seeking liposuction, but really need abdominoplasty surgery (tummy tuck). There are important differences between tummy tuck and liposuction, which help determine which procedure is right for you.

During liposuction, a blunt cannula is used to suction fat through multiple tiny incisions. Although many types of liposuction are available, including standard tumescent liposuction, ultrasound liposuction (VASER), power-assisted liposuction, tickle liposuction (vibroliposuction), etc., no skin is removed with any type of liposuction. The best liposuction candidates maintain a healthy lifestyle and have focal fat deposits not responsive to diet and exercise.. Liposuction is not effective as a means for major weight loss. Liposuction is not effective in treating skin with stretch marks, which are signs of irreversible skin injury, or muscle looseness, all of which is common after pregnancy or massive weight loss. In fact, in a patient who really needs a tummy tuck, liposuction may worsen the patient’s appearance. However, in patients close to their ideal body weight, without significant stretch marks, liposuction can be highly effective in treating extra fat of the love handles, thighs, back, arms, neck, calves and ankles.

Abdominoplasty (tummy tuck) is usually a far better option for patients who have experienced massive weight loss or multiple pregnancies. Most of these women have extra abdominal skin with stretch marks, and separation of the abdominal wall muscles (rectus diastasis). The muscle looseness gives the impression of an upper abdominal bulge and a lower abdominal skin apron. These women are great candidates for a tummy tuck, particularly if they are close to their ideal body weight. With removal of the extra abdominal skin, tightening of the abdominal muscles, and reshaping of the belly button, achieving a youthful appearance to the abdomen is often possible!

Questions? Feel free to call 214-827-2814 to schedule an appointment today!

A commonly asked question during Dallas breast augmentation consultations is whether breast-feeding is affected by the placement of breast implants. The most definitive answer is…maybe….but probably not! The official position of the American Society of Plastic Surgeons is that breast-feeding is not affected by placing silicone breast implants or saline breast implants. There are countless women in the world who have successfully breast fed their babies after breast augmentation.

There are some important facts to know, though. First, it’s well accepted that certain incisions are more prone to causing nipple and areola (the pigmented skin surrounding the nipple) numbness. The periareolar incision is the most likely to do this. It is reasonable to assume that nipple numbness, although not preventing breast-feeding can impede the mother’s ability to do so. Second, there is debate about whether silicone from implants can leak into breast milk, and if it does, whether it’s harmful to a baby. Despite repeated attempts to prove so, no large studies conclusively demonstrate higher levels of silicone in breast milk of mothers with silicone breast implants, nor do they show a higher incidence of autism, autoimmune disorders, swallowing dysfunction, or other disease.

So, in a nutshell, it’s more than reasonable for mothers with breast implants to attempt breastfeeding and to feel comfortable that they are not negatively impacting the health of their babies. For more information, or to schedule a consultation, don’t hesitate to contact our office at 214-827-2814.

Breast augmentation is an intensely gratifying procedure for patients, as they see immediate results after the procedure. Like any surgical procedure, though, patients need to allow some time for recovery.

Recovery is variable from patient to patient. Most patients feel tired and sore after breast augmentation surgery, but this usually passes in a day or two. Many patients return to work within the week. After a week, most patients have mild fatigue and soreness, but no other significant symptoms.

Surgeons vary in the amount of time they restrict their patients from exercising postoperatively. I ask my patients to refrain from all vigorous exercise for 2 weeks postoperatively and from all upper body exercises for 4 weeks. Patients don’t always want to comply with this, as they feel relatively normal well before their postoperative restrictions are lifted.

Scars from breast augmentation incisions will begin to fade in a few weeks and will continue to fade for months or years.

This story is taken from the Wall Street Journal

A Johnson & Johnson (JNJ) unit has decided to stop making and selling a product called Evolence, used to fill facial lines in cosmetic procedures.

Ortho Dermatologics, a division of J&J’s Ortho-McNeil-Janssen Pharmaceuticals, has a note on its Web site regarding the withdrawal, which it said was announced on Tuesday. The company confirmed the move in a statement.

The Evolence halt is part of an effort “to refine strategic priorities and focus investment on other growth opportunities,” Ortho Dermatologics said.

Many options for future management were explored before this decision was made, the company said. It added that patients and medical professionals can be assured that Evolence “remains effective for the correction of moderate to deep wrinkles and folds with a favorable safety profile.”

The facial filler gained approval from the U.S. Food and Drug Administration in June 2008, but it has been available in certain international markets since 2004. The U.S. arrival coincided with a rough time in the market for cosmetic medical products, which usually are not covered by insurers and came under pressure due to the recession.

J&J announced on Tuesday that it plans to lay off as many as 8,200 workers worldwide as part of a plan to save up to $1.7 billion in 2011.

-By Jon Kamp, Dow Jones Newswires

Awake Liposuction

Wide-awake liposuction is one of the newest trends in body sculpting surgery. Dr. Jejurikar can perform liposuction on selected areas of the body without his patients needing general anesthesia. Not only does this lower the costs, but it avoids some of the side effects traditionally associated with general anesthetic agents. The procedure is performed at EpiCentre Park Lane (Dallas) as well as at EpiCentre Legacy (Plano).

Technique

Dr. Jejurikar utilizes vibroliposuction for wide awake liposuction. In this system, which was invented in Beligum and is now used extensively in Europe, Asia and South America, the liposuction cannula is activated by air pressure, producing a complex movement of the tip. The complex cannula movement allows local anesthetic to infiltrate more evenly in the patient’s fatty tissue, creating less patient discomfort. In addition, the cannula movement causes emulsification of the patient’s fat, allowing for quicker and more uniform fat removal. In addition, this technique promotes much less post-procedure swelling and bruising.

Recovery and Results

After wide-awake liposuction, patients may experience mild swelling, bruising and discomfort in the treated area. Compression garments or elastic bandages may be used to help reduce these symptoms while the area heals. Patients usually can return to work in one or two days. Exercise and other strenuous activities should be avoided for two weeks.

Call 214-827-2814 to arrange a comprehensive consultation for body contouring surgery

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Our Location Dallas Plastic Surgery Institute

9101 N. Central Expwy.
Suite 600, Dallas, TX 75231
Tel: 214.827.2814

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