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    Dr. Sam Jejurikar Answers Patients’ Top 10 Tummy Tuck Questions

    Tag Archives: Dallas Plastic Surgery Institute

    tummy tuck surgery 

    It’s part and parcel of mommy makeovers and is more in demand than ever, thanks to the pressures of social media and the washboard abs streaming on our TVs, but tummy tuck surgery, also known as abdominoplasty, is nothing new. The procedure — which is elective and aimed at improving the shape and appearance of the abdomen — was first performed in France in 1890. In 1899, Baltimore surgeon Dr. Kelly performed the first tummy tuck in the U.S. Since then, advances in medicine have transformed this surgery into a safe, streamlined procedure that, according to Dallas-based cosmetic surgeon Dr. Sam Jejurikar, has given the term “cutting edge” a whole new meaning. 

    What should I expect from tummy tuck surgery?

    According to the Mayo Clinic, people with excess fat and/or skin in the navel area, or those with a weakness in the lower abdominal wall, are common candidates for abdominoplasty. The surgery removes excess skin and fat from the abdomen. Using permanent sutures, the connective tissues in the abdomen are tightened as well. 

    Tummy tuck procedures generally take two to three hours and are performed in a hospital or outpatient surgical facility setting under general anesthesia. During the procedure, the plastic surgeon makes a horizontal, oval, or elliptical incision, depending on the amount of tissue to be removed, just above the pubic line. When the incision heals, the resulting scar runs along the natural skin crease of the bikini line. In addition to removing excess skin and fat and tightening the connective tissues, the surgeon pulls the belly button through a small incision, anchors it into its normal position with sutures, and then judiciously repositions the surrounding skin to achieve a firmer, more toned aesthetic.

    What are the benefits of tummy tuck surgery?

    The main reasons for undergoing a tummy tuck procedure are enhancing body image and boosting self-esteem. Feeling good about how we look has a definite correlation with our mental health.

    While body image concerns are relatively common and are not considered mental health issues per se, according to the U.K.’s Mental Health Foundation, such worries can signal risk factors for potential mental health problems. It reports: “Research has found that higher body dissatisfaction is associated with a poorer quality of life, psychological distress, and the risk of unhealthy eating behaviors and eating disorders.”

    In addition to improving self-esteem, tummy tucks also afford patients a host of other valuable health benefits.

    A tummy tuck can strengthen your abdominal muscles. Having a stronger core can improve flexibility, help alleviate lower back pain, improve posture, and ward off hernias.

    A tummy tuck may reduce the risk for certain medical conditions, including sleep apnea, diabetes, heart disease, and gallbladder disease.

    A tummy tuck can increase bodily function control and decrease urinary stress incontinence occurrences. Many factors lead to the loss of bowel or bladder control. Aging, multiple pregnancies, and significant weight loss can be all factors. These issues can be exacerbated by the presence of excess fat and skin in the abdomen. Removing extra skin and fat and tightening connective tissue in the abdomen can improve control over bodily functions and lessen involuntary urinary leaks.

    How long after a tummy tuck can I sleep on my stomach?

    The accepted rule of thumb is to avoid sleeping on your stomach for six weeks after undergoing tummy tuck surgery. This hiatus from stomach sleeping ensures the skin and muscles have adequate time to heal. However, each patient is different, and some may need to stay off their tummies longer than six weeks. It is highly recommended you discuss a postsurgical sleeping protocol with your doctor prior to the procedure. 

    What’s the best way to recuperate from a tummy tuck procedure?


    Recuperating from a tummy tuck takes time and proper care of the body. To facilitate a speedy recovery, I recommend the following: 

    Eat right and keep hydrated. High-protein foods benefit healing by boosting energy and promoting muscle growth. Conversely, foods with high sugar and sodium content can have a negative impact on the healing process and should be avoided. While patients who’ve undergone abdominoplasty experience swelling, drinking adequate amounts of water (eight glasses per day is recommended) reduces retention by flushing fluids from your system.

    Don’t overdo it. People are eager to dive back into their everyday routines after surgery, but this can be a mistake. Instead, ease gradually into daily activities, and if your body is giving you the warning to stop doing something, listen to it. In general, tummy tuck patients should refrain from pulling, pushing, bending, and lifting heavy objects for a minimum of six weeks after surgery.

    Look into lymphatic drainage massage. As the name implies, lymphatic drainage massage stimulates the body’s lymphatic system. This enhances its efficiency, speeding the removal of toxins, boosting immune response, and aiding in the overall healing process.

    What’s the difference between a tummy tuck and liposuction?

    As mentioned above, a tummy tuck is a surgical procedure performed under general anesthesia in a hospital or outpatient surgical setting. Liposuction is a much less invasive procedure that does not require a surgical incision and can be performed under a local anesthetic (although general is preferred). Abdominoplasty is strictly abdominal surgery, while liposuction can be performed on any area of the body where stubborn fatty deposits that resist traditional weight loss protocols occur, including the neck, thighs, back, and arms.

    During liposuction, no skin is removed, nor is fat surgically excised. Instead, a saline, water, and anesthesia solution is injected into the target area. A cannula is then inserted, and the fat is sucked out. Those considering either procedure should consult with a reputable cosmetic surgeon before proceeding to better understand which one best meets their needs.

    How soon is it safe to get a tummy tuck after pregnancy?

    Due to significant changes in the body, one of the most prevalent times women choose to get a tummy tuck is after pregnancy. It’s only natural to want to get back to your pre-baby body as soon as you can. However, some guidelines must be adhered to in order to safeguard a woman’s health and achieve the maximum benefits from the procedure. 

    Six months after giving birth is the earliest patients should schedule a tummy tuck. Moms who’ve undergone a C-section may have to wait longer (up to a year) and should discuss any potential surgery with their doctor. There are other factors that may make postponing a tummy tuck a good idea as well:

    Are you still breastfeeding? Breastfeeding influences hormonal changes in the body that can impact the healing process and influence weight fluctuations. It’s recommended to wait until three months after you finish breastfeeding before getting a tummy tuck.

    Has your weight stabilized? Weight gain during pregnancy is normal. Getting back or close to pre-baby weight can take time, and many moms experience postpartum weight fluctuations. While a tummy tuck will improve physical appearance, it’s not strictly intended to be a weight loss procedure. Tummy tucks are most effective when patients are at or near their ideal weight. 

    Do you plan to get pregnant again? The logic of this is pretty simple: Every pregnancy can result in additional stretching of tissues and added fat to the midsection, all of which can undo the good your tummy tuck has done. If you think there might be more kids in your future, putting off tummy tuck surgery is best until after welcoming your last blessed event.

    Can men get a tummy tuck?

    The simple answer to this question is, yes. Men can and do get tummy tucks — and are doing so in increasing numbers. That said, when it comes to tummy tucks, not all men are created equal. Some men make better candidates for this surgery than others. Dr. Jejurikar advises men interested in the procedure to discuss their expectations with a certified cosmetic surgeon to ensure their desired outcome is realistic.

    Can a tummy tuck be combined with other surgery?

    Yes. One of the most popular cosmetic procedures currently performed is what’s known as the “mommy makeover,” which can combine a tummy tuck with breast enhancement and/or liposuction. The upside of combined surgeries is that they require only one recovery period. However, that recovery period will likely be longer than that of a single procedure. Your overall health is the biggest factor in determining whether multiple procedures are viable and must be determined by a doctor on a case-by-case basis.

    Who should not get a tummy tuck?

    Tummy tucks work wonders for some — but they’re not for everyone. The Mayo Clinic cautions that prior to embarking on the procedure, potential patients should thoroughly discuss any of the following conditions or concerns they have with their surgeon:

    You plan to lose a significant amount of weight. A major weight loss can result in excess skin on the abdomen. It’s better to wait until weight goals are met before undertaking tummy tuck surgery.

    You have a severe chronic condition, such as heart disease or diabetes. While abdominoplasty may lessen these conditions, if you already have them, they can put you at greater risk during surgery, especially when a general anesthetic is involved. 

    You have a body mass index greater than 30. Again, while tummy tucks do result in weight loss, it is not considered weight loss surgery. Patients who fare best are at or close to their ideal body weight.

    You smoke. In general, smoking increases surgical risks. It’s not a hard-and-fast rule, but nonsmokers generally enjoy better surgical outcomes.

    You’ve had previous abdominal surgery that resulted in significant scar tissue. Excessive scar tissue can be a side effect of any abdominal surgical procedure. Some patients are more prone to it than others. If prior surgery indicates that’s the case, further procedures might not be in your best interest.

    How do I find a good tummy tuck surgeon in Dallas or elsewhere?

     The qualities that make a good tummy tuck surgeon in Dallas are the same no matter where the procedure is being performed. A good tummy tuck surgeon combines thorough medical knowledge with technical artistry. A good tummy tuck surgeon truly cares about their patients, listens to their concerns, and helps them arrive at realistic goals and expectations. A good tummy tuck surgeon always makes the health of their patients their highest priority — even if that sometimes means saying no to a procedure.

    First and foremost, those considering cosmetic surgery should seek out a doctor who, like me, is board-certified in plastic surgery by the American Society of Plastic Surgeons (ASPS). Only board-certified plastic surgeons have the education, training, and certification to perform cosmetic surgeries on the face, breasts, and body. Always verify your surgeon’s credentials and make sure they have experience in the procedure you’re interested in.

    Recently published statistics from the American Society of Plastic Surgeons says the number of women undergoing “augmentation mammaplasty” rose 39 percent between 2000 and 2010, when more than 296,000 American women underwent the procedure. Not only does the number of women seeking the procedure seem to have increased, but also it seems as though many more patients are seeking bigger implants. A big reason for this is the increasing acceptance of the safety of silicone gel implants; with these implants, large cup sizes are achievable while still maintaining a natural looking result.

    Obviously, there’s an upper limit to what appears natural and what the breast ligaments can support. Still, in most patients, a 2 or 3-cup size increase, if desired, if possible.

    To learn more about breast augmentation or silicone breast implants, don’t hesitate to contact Dr. Jejurikar’s offices in Dallas or Plano at 214-827-2814.

    In most cases, when I perform breast augmentation, I place the breast implant, whether it is a saline breast implant or a silicone breast implant, behind the chest wall muscle.  There are many reasons for this.  The first is that the chest wall muscle (pectoralis major), actually serves as camouflage for the breast implant.  Some of the visible rippling that can be seen, particularly with saline breast implants, tends to be obscured to some degree with coverage by the pectoralis major muscle.  The second reason to put the implant behind the muscle is that it interferes with screening mammography much less.  There is good data from the radiology medical literature that demonstrates that placement of breast implants in front of the chest wall muscle can obscure a substantial amount of the breast field on mammogram.  The third reason is that traditional data with silicone and saline implants shows that the rate of capsular contracture, or pathologic scar tissue formation, is much higher when the implants are put in front the chest wall muscle as compared to behind it.

    There are a few anatomic conditions in which aesthetic outcomes are improved when the implant is placed in front of the chest wall muscle.  Careful examination and discussion with my patients are important in these situations to determine what will be best.

    If you have any other questions regarding this or breast augmentation in Dallas and Plano, please do not hesitate to contact my office at 214-827-2814.

    One of the most commonly sought out procedures in Dallas and Plano is the Brazilian butt lift.  This procedure involves performing extensive liposuction elsewhere on the body and using the removed fat to augment and lift the patient’s buttocks.  It is a well-tolerated procedure that generally takes about 3-4 hours.  Areas that undergo liposuction traditionally involve the inner and outer thighs, abdomen, love handles, and lower back.

    One of most important thing a patient needs to know before the procedure is the expected recovery time.  Patients are asked to refrain from lying on their back, so as to avoid pressure on their buttock, for 2 months after the procedure.  Patients are also asked to avoid directly sitting on their buttock for 2 weeks after the procedure.  After 2 weeks, patients are asked to place a rolled towel or a pillow under the back portion of the thighs, specifically where the hamstrings lie.  With this, the pressure on the buttock is off-loaded, and this is thought to help fat heal quicker after the operation.

    If you would like to learn more about one of the most popular procedures in Dallas, please do not hesitate to contact Dr. Jejurikar’s office at 214-827-2814.

    How much swelling and bruising you have after Dallas laser resurfacing depends entirely on how much time you have to recover from the procedure. Laser resurfacing in Dallas and Plano must always be individualized to the needs of the patient.  If you have a few weeks, I can be very aggressive with the procedure. This will lead to dramatic improvement in facial wrinkles and pigmentation; redness may last 3-6 months after the procedure. If you only have 3 or 4 days, there are still excellent laser treatments I can perform, with much less redness thereafter. Ultimately, the specific laser treatment must be tailored to the amount of time you have to recover after the procedure.

    So, what are the different options for laser resurfacing in Dallas?  One of the ways we classify different laser resurfacing procedures is by whether or not they are fractional or full field resurfacing.  Full field laser resurfacing includes some traditional types of laser treatments, including carbon dioxide and erbium lasers.  With these types of procedures, all of the skin on the face is treated. Although the results can be beautiful, if the treatment is done at a deep depth, it will take longer to heal.  A full field laser can be done at a more superficial depth to speed up the recovery.  Fractional lasers treat some of the skins but leaves tiny islands of skin cells untreated.  Two of the most commonly used fractional lasers used in my practice is Fraxel re:pair and Fraxel re:store.  While all the differences between these lasers are too much for this blog entry, the re:store is non-ablative, which means it is not destructive, and the re:pair is ablative, which means that it destroys columns of skin. Re:pair usually is performed in the operating room and re:store is usually performed with the patient awake in a treatment room.

    Regardless of the amount of time you have to heal, there are great treatments available to you.  Benefits of all of these laser treatments include elimination irregular pigmentation, treatment of fine or deep wrinkles, and a healthier glow to the skin.

    If you would like to learn more, please do not hesitate to contact Dr. Jejurikar at 214-827-2814.

    It is common for patients to negotiate an appropriate level of activity after undergoing tummy tuck, breast augmentation, liposuction, or any other combination of surgeries that make up a Dallas mommy makeover.  The thought is, if they can convince me that they need less time to recover than other patients, somehow the surgery will be lessened in magnitude, or that they will be able to recover more quickly after the procedure.

    Childbirth takes a dramatic toll on the female body.  To reverse those changes with a mommy makeover, significant surgery is involved.  With a Dallas tummy tuck (abdominoplasty), in addition to removing skin, extensive sculpting of the waist and upper abdomen is performed with liposuction, and the muscles of the abdominal wall are significantly tightened.  Undue straining for a period of time after surgery can disrupt the sutures, and lead to a less then desirable postoperative result.  In addition, straining after surgery can cause problems with wound disruption and bleeding, not to mention prolonged swelling in the abdomen, breasts, and lower extremities.

    I usually recommend that my patients take 1-2 weeks off of work after surgery.  Some patients will take less time and others more, depending on the level of physical exertion required at their work place.  I also strongly advise my patients to refrain from any vigorous exercise for 6-8 weeks after surgery.  Although it is important to walk almost immediately after surgery to prevent blood clots and respiratory problems, too much activity can lead to infection, bleeding, and wound healing problems.

    Ultimately, to get the best result after mommy makeover, a patient has to allow herself the appropriate amount of time to recover.  Should you have any questions, please do not hesitate to contact Dr. Jejurikar’s office at 214-827-2814.

    Rhinoplasty, or nose reshaping surgery, can be performed for many reasons, but most commonly is done to improve appearance, improve breathing, or after an accident or trauma.  Although specific medical insurance policies vary, many medical insurance plans will cover some of the costs of nasal surgery if it can be documented that it is being done for functional reasons (i.e. to improve breathing). Any aspect of the procedure done to improve appearance, however, including reshaping of the tip, removal of a hump, narrowing of the nose, etc., generally is not covered by these same insurance policies.

    To learn more about rhinoplasty, including its risks and recovery, don’t hesitate to contact Dr. Jejurikar’s office at the Dallas Plastic Surgery Institute or at Legacy Medical Village in Plano at 214-827-2814.

    It is not uncommon to have patients come in seeking liposuction for major weight loss.  It is important to clarify with these patients, and to the general public, that liposuction is not a great option for weight loss.  Liposuction gives much better and more predictable results for patients close to their ideal body weight who are looking to sculpt their body. 

     

    If a considerable amount of weight loss is required, other surgical options are better.  Specifically, bariatric procedures, including LAP-BAND, gastric bypass, gastric switch, etc.  These procedures allow for much greater and predictable amounts of weight loss, which then can be followed by body contouring surgery to help sculpt the body. 

     

    If you have any questions about body sculpting or body contouring surgery, please contact Dr. Jejurikar at the Dallas Plastic Surgery Institute at 214-827-2814. 

    Women with large, droopy breasts causing pain, discomfort or social embarrassment usually are great candidates for breast reduction (reduction mammaplasty). Patients oftentimes complain that they have difficulty finding appropriate-fitting bras and have difficulty exercising due to their large breast size. Although breast reduction is generally recommended for women with fully developed breasts, surgery may be performed on teenagers if their breasts are causing serious pain and physical discomfort.

    Breast reduction involves making incisions to remove breast tissue and to perform a breast lift. The incisions vary for each patient, but commonly involve an incision around the areola (pigmented skin around the nipple) and a vertical incision below this. In some cases, an incision in the crease below the breast is also needed.

    In exchange for these scars, which tend to fade considerably over 1-2 years, patients can achieve smaller, perkier breasts with relief of their back, neck and shoulder pain. Patients usually report an easier time shopping for bras after surgery and a greater ability to exercise.

    To learn more about breast reduction surgery, including its risks and recovery, don’t hesitate to contact Dr. Jejurikar’s office at the Dallas Plastic Surgery Institute or at Legacy Medical Village in Plano at 214-827-2814.

    Capsular contracture can be a relatively common complication after placement of silicone breast implants or saline breast implants. Scar tissue normally forms around breast implants in all circumstances. In some cases, over time, it can tighten and compress the implant, making it feel firm and painful, causing what is called a capsular contracture. Capsular contracture is more common following infection, hematoma, or seroma, and the chance of it happening may increase over time. It occurs more commonly in revision breast augmentation than in primary breast augmentation.

    Capsular contracture is also a risk factor for implant rupture, and is the most common reason for re-operation after breast implant placement. Symptoms of capsular contracture can range from just mild firmness and discomfort, to severe pain, distorted appearance of the breast, and the ability to feel the implant. It is classified into 4 levels, depending on its severity:

    Baker Grade I: The breast is soft, and looks natural.

    Baker Grade II: The breast is a little bit more firm, but looks normal.

    Baker Grade III: The breast is firm and looks abnormal.

    Baker Grade IV: The breast is hard, painful, and looks abnormal.

    The data for both silicone and saline breast implants says that about 1 in 6 women will develop a severe capsular contracture, either grade III or IV, through 7 years after breast implant placement. For women receiving revision breast augmentation, this risk increased to about 1 in 5. When pain and firmness or abnormal appearance is particularly severe, additional surgery may be required. This usually requires removal of the breast implant capsule and replacement of the breast implant.

    Should you be developing firmness, hardness, or distorted appearance after your breast implant placement, you may have a capsular contracture. To learn more about this condition, please contact Dr. Jejurikar at 214-827-2814, at the Dallas Plastic Surgery Institute.

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