Tummy Tuck Los Angeles, CA
If you have concerns about a flabby, loose stomach, please come visit Dr. Kenneth Benjamin Hughes, MD, Harvard-educated, Harvard-trained board certified plastic surgeon at Hughes Plastic Surgery in Los Angeles and Beverly Hills for a tummy tuck (abdominoplasty). Many women sacrifice a great deal in having a child or children and restoring a svelte abdomen is just something that everyone should entertain as an option. The tummy tuck is not just for women who have had children. Women who have lost weight or who have loose skin from yo-yo dieting or genetic factors may benefit from a tummy tuck as well. Furthermore, many men can benefit from a tummy tuck after weight loss procedure or massive weight loss as well.
Dr. Kenneth Benjamin Hughes, MD, A Harvard-Trained Tummy Tuck Expert in Los Angeles, Has Performed Hundreds of Tummy Tucks
Dr. Hughes, tummy tuck surgeon, has performed hundreds of tummy tucks in his Los Angeles surgery center, and he can perform these procedures in 1 to 2 hours, which means less time under general anesthesia, fewer complications, and a faster, better recovery. Dr. Hughes will remove the loose skin and fat, tighten your abdominal muscles, and give you a new, more attractive belly button and have you back to work, in many cases, in just one week. Some patients may need 2 weeks off from a sedentary job. Patients can usually return to exercise in 6 weeks.
In his fully accredited surgery center, Dr. Hughes can perform tummy tucks in combination with many other procedures such as liposuction or liposculpture or breast augmentation. When tummy tuck is combined with breast augmentation, this is referred to as mommy makeover. These represent only a few of the procedures that can be performed in addition to tummy tuck or in conjunction with tummy tuck at Hughes Plastic Surgery. Breast augmentation, breast lift, liposuction, Brazilian buttlift, arm lift, thigh lift, body lift, rhinoplasty, and other facial surgeries can all be performed at the same time as the tummy tuck with the expert skill set and knowledge base of Dr. Kenneth B. Hughes, Harvard-educated, Harvard-trained, board certified plastic surgeon in Los Angeles and Beverly Hills.
What is a Tummy Tuck?
Answer: The tummy tuck or abdominoplasty is a procedure to address loose skin and fat in the abdomen that has developed most commonly as a result of pregnancy or major weight loss. The abdominal wall can be tightened in this procedure as well through a process called plication (rectus muscle plication as well as oblique muscle plication). Though the incision in some may need to be longer to address more significant skin issues, Dr. Hughes specializes in short scar tummy tucks. These short scar tummy tucks offer all of the advantages of a tummy tuck with a shorter scar. In most cases, the short scar tummy tuck has the same length incision as a minitummy tuck but removes about twice as much skin and fat as the minitummy tuck and tightens the abdominal muscles as well.
Dr. Hughes, tummy tuck surgeon, tightens the muscles, removes skin and fat, and gives you a new belly button all through a smaller incision. The incision that is made is very low, below C-section scars, which can be removed at the time of the tummy tuck. The incision is so low that bikinis may be worn afterwards. In addition, Dr. Hughes creates the best possible scar which is flat all the way across and is not a smiley face. This way the ends of the scar never rise above low cut clothing. In addition, though healing is never entirely predictable, many patients have commented that the scar is not only low but the limbs are perfectly symmetric and straight. Dr. Hughes really endeavors to create the optimal and best result for the individual tummy tuck patient.
Dr. Hughes creates a belly button that eliminates the scar at the top of the belly button, because Dr. Hughes knows that the odd appearing belly button can make patients hesitant about undergoing the procedure in the first place. Dr. Hughes also anchors the belly button to the underlying fascia to give the belly button more depth to improve the appearance. These seemingly trivial details can mean the difference between an average and a superlative result.
Dr. Hughes is also very aware of the fact that many patients want to have the appearance of a smaller waist and not appear to be square or straight. Dr. Hughes creates the appearance of a smaller waist through very particular technical maneuvers during the tummy tuck. In addition, Dr. Hughes frequently performs liposuction of the sides, flanks, and back to reduce the waist by frequently many inches. The results can be absolutely unbelievable.
While the tummy tuck is certainly effective in its removal of tissue and correcting issues of skin laxity and size, the scar produced is often objectionable to many patients. Dr. Kenneth Hughes, MD in Los Angeles has extensive experience and amazing successes with the Bodytite technology to avoid the longer scars associated with tummy tucks as well as other excisional procedures such as arm lifts, thigh lifts, butt lifts, etc. Bodytite can be used in conjunction with liposuction to tighten the tissues of the abdomen (tummy), arms or thighs or wherever by about 40%. These types of results will not be achievable by another technology or my another surgeon. Please look at the amazing Bodytite results in this link. Although Bodytite will never reproduce the excisional surgical results, optimal treatment by Dr. Hughes in Los Angeles can come pretty close.
Physical Exam Considerations of the Patient Interested in Tummy Tuck
Dr. Hughes will note skin laxity, striae, and scars. He will point out any irregularities or asymmetries such as an umbilicus that is not midline. Vertical midline scars will decrease the amount of flap advancement possible. Dr. Hughes will determine whether scars are mobile or fixed to the underlying fascia — fixed scars are more likely to reflect interrupted flap circulation. If the skin appears of good quality with minimal or no laxity and the defect appears to be excess adipose tissue or musculoaponeurotic laxity, a minimal scar procedure may be appropriate. Dr. Hughes performs many short scar tummy tucks or mini tummy tucks, and he will determine if these are appropriate for you during your consultation. He will also determine if liposuction or liposculpture will be appropriate or beneficial.
Upper and lower abdominal skin laxity with significant umbilical ptosis should be addressed with full abdominoplasty. The amount of lateral and back skin laxity should also be assessed to determine whether a high lateral tension abdominoplasty, abdominoplasty with thigh lift, or circumferential body lift would be appropriate.
Pinching the subcutaneous tissue between thumb and forefinger in various locations helps assess the differences in thickness of the subcutaneous layer.
Dr. Kenneth Benjamin Hughes, MD will distinguish between intra-abdominal and subcutaneous fat. The relative contribution of subcutaneous fat and intra-abdominal contents to the abdominal contour defect will be assessed and discussed with the patient. Only subcutaneous fat can be remedied surgically. Intra-abdominal fat is not amenable to removal during the tummy tuck procedure.
Dr. Hughes will assess for midline abdominal protuberance in the standing patient. He will ascertain whether the prominence is epigastric, infraumbilical, or both. Dr. Hughes will assess the strength of the abdominal wall musculature as well as diastasis recti and musculoaponeurotic laxity that may be amenable to plication and correction during the tummy tuck.
The abdomen will be palpated for masses and hernias. If a ventral or umbilical hernia is discovered, Dr. Hughes can usually repair most of these hernias during the tummy tuck procedure.
Different Types of Tummy Tucks
A minitummy tuck involves removal of a small amount of skin and fat below the belly button that addresses only the lower portion of the abdomen. No plication or muscle tightening is performed and belly button remains attached and unchanged. This procedure applies to very few patients and is appropriate only for patients who have loose skin at the inferior aspect, or bottom, of the abdomen. If patients have loose skin above the belly button or a muscle laxity, a full tummy tuck would be more appropriate. If a patient does not want a lot of down time but a small improvement without an optimal improvement, then a minitummy tuck can be considered as well.
Tummy Tuck Float Procedure or Umbilical Float Procedure
A tummy tuck float procedure involves removing skin from below the belly button and detaching the belly button to get additional skin removal without performing a full tummy tuck. Plication may be performed at the same time. This procedure is used very infrequently due to the fact that the belly button is moved to an inferior location. Thus, it is a more appropriate technique for a patient with a high belly button.
Extended Tummy Tuck
An extended tummy tuck represents a full tummy tuck and all of its components (muscle plication, umbilical transposition, etc.) with the addition of an extended incision to the sides or toward the back. This type of extended tummy tuck will treat patients who have tremendous skin laxity on the sides or near circumferential skin laxity, most frequently observed after massive weight loss. If the skin laxity is completely circumferential then a lower body lift or circumferential belt lipectomy may be appropriate. This surgery involves a scar that goes completely around the body at the level of the belt line.
Reverse Tummy Tuck
This is a very specialized type of tummy tuck procedure which situates the scar under the breasts and treats upper abdominal skin laxity only. Dr. Hughes does not perform the conventional procedure in which the scar crosses the midline. Dr. Hughes camouflages the entirety of the scar under the breasts. This type of tummy tuck requires immense skill to take out enough tissue to improve the appearance, to anchor the abdominal flap to minimize breast droop, and to perfectly reapproximate the tissues to avoid bunching and wrinkling.
Umbilicoplasty or alteration of the belly button is done as a component of the tummy tuck but can be done as an individual procedure. Dr. Hughes in Los Angeles is frequently tasked with belly button correction following tummy tuck performed somewhere else or as a separate procedure to improve the belly button shape. This procedure can be performed under local anesthesia and can be done in combination with umbilical hernia repair in certain cases.
Your Tummy Tuck Day of Surgery with Dr. Hughes in Los Angeles
On the day of surgery, the patient will arrive to the surgery center approximately one hour prior to the beginning of the surgery. The patient will be checked in and paperwork and consents will be finalized as well as additional questions answered. Vital signs will be obtained as well as additional history and physical information obtained by the nurse and anesthesiologist. The anesthesiologist will meet with the patient to explain the anesthesia process and answer any concerns about anesthesia. The patient will meet with Dr. Hughes again to reiterate the surgical plan and to answer any additional questions or concerns.
The patient will be taken into the operating room and administered relaxing medication and be ushered off to sleep. The tummy tuck surgery itself will take about 2 hours on average, and the patient will be transferred to the recovery room upon completion. The patient will remain in recovery for 1 to 2 hours before departing from the surgery center with a responsible adult.
Recovery In Tummy Tuck
The tummy tuck typically requires 1 to 2 weeks before a patient can return to a sedentary job. The patient should avoid exercise, strenuous activity, and lifting more than 5 lbs for at least 6 weeks. Patients should consume at least 100 grams of protein during the recovery period to ensure adequate wound healing. Patients should not strain the area around the incision. Poor nutrition and stressing an incision have ruined many of Dr. Hughes’s best tummy tuck results on the table and these complications are almost completely preventable by following Dr. Hughes’s postoperative instructions.
Dr. Kenneth Benjamin Hughes, MD typically uses 1 drain in tummy tucks to avoid the most common complication, which is seroma or fluid collection. Drainless tummy tucks will not help avoid fluid collections, but rather will result in a higher percentage of fluid collections. It is simply not worth the risk of developing a fluid collection, which can sabotage the contours, result in infection, and cause the incision to open.
Dr. Hughes can typically remove the drain in 2 weeks or so. An abdominal compression garment will be given to the patient to be worn for the first 6 weeks or so after surgery to help reduce the risk of fluid collection.
Most Common Complications in Tummy Tuck
- The most frequently described postoperative complications are seroma, wound separation, and infection. Generally, one or two drains are placed after a standard tummy tuck. A standard operative abdominal binder provides compression to decrease seroma formation and maximize contouring results.
- These are usually relatively minor in nature and can be addressed nonoperatively
- Postoperative skin necrosis, scar dehiscence, dog-ears, and above-scar fat folds frequently require revision procedures
- Injuries to the lateral cutaneous nerve of the thigh occur in as many as 10% of patients. Dr. Hughes has never encountered this problem in his cohort of patients.
- It is imperative that the patient ambulate early and often after surgery to reduce complications including deep venous thrombosis (blood clots in legs) and pulmonary embolus (blood clot that travels to the lungs). Fatal pulmonary embolism is uncommon (1/1000), but prophylaxis is prudent
- Low-molecular-weight heparin can be administered to patients who are at higher risk for deep venous thrombosis and pulmonary embolism.
- In addition, fat embolism has been reported when liposuction is added to abdominoplasty procedures. Dr. Hughes has never encountered this problem in his cohort of patients.
- Large quantities of tumescent fluid can lead to lidocaine toxicity and pulmonary edema. Dr. Hughes has never encountered this problem in his cohort of patients.
Achieving Your Best Tummy Tuck Result
If you want to have surgery, you should seek out the board certified plastic surgeon who you feel has the highest likelihood of success and then dedicate yourself to recovery process for the best result. It simply does not make any sense to go through a surgery with its attendant risks and long recovery period and its expense and then not get the best result due to not following postoperative instructions. Dr. Kenneth Hughes will get you the best tummy tuck result possible, but you will have to do your part in the recovery process. Visit Dr. Kenneth Hughes, MD at his new offices and surgery in Los Angeles (Beverly Hills).
Dr. Kenneth Hughes – Best Tummy Tuck in Los Angeles, Beverly Hills, and Worldwide
Common Questions about the Tummy Tuck Procedure:
No. Dr. Hughes performs short scar tummy tuck variants for patients who are good candidates. He also performs minitummy tucks, tummy tuck float procedures, and reverse tummy tucks as well for appropriate candidates.
2) Where Will the Incision for the Tummy Tuck Be?
Low. Dr. Hughes will place the scar as low as possible. This will be below the level of a C-section scar and almost to the level of the leg crease. With the low scar, the scar can be concealed by virtually any piece of clothing. Dr. Hughes will produce the best possible scar and contours for tummy tuck.
3) I Have Had Multiple C-sections and Other Surgeries. Can I Still Have a Tummy Tuck?
Yes. In most cases, Dr. Hughes performs tummy tucks after previous surgeries including gastric bypass, lap band, C-section, hysterectomy, appendectomy, gall bladder removal, etc.
4) I Have a Hernia. Can I Still Have a Tummy Tuck?
Yes. In most instances, Dr. Hughes can repair your hernia at the time of the tummy tuck.
5) Who is a Good Candidate?
If you have reached a safe, stable weight and are otherwise healthy, you can be considered for tummy tuck surgery with Dr. Hughes in Los Angeles.
Best Tummy Tuck Los Angeles Beverly Hills
BEFORE & AFTER GALLERY
The tummy tuck or abdominoplasty is a procedure to address loose skin and fat of the abdomen as well as abdominal wall laxity that has developed most commonly as a result of pregnancy or major weight loss.
Browse Beverly Hills and Los Angeles Tummy Tuck Articles at Hughes Plastic Surgery:
Article 1: Goals, History, and Anatomy of the Tummy Tuck
Article 2: Abdominal Wall Anatomy and Physical Exam in the Tummy Tuck Patient
Article 3: Physical Exam in the Tummy Tuck Patient
Article 4: Risks, Limitations, Good and Bad Candidates for Tummy Tuck
Article 5: Subgroups of Tummy Tuck Patients
Article 6: Operative Details and Safety in the Tummy Tuck
Article 7: Mini Tummy Tuck, Short Scar, and Standard Tummy Tucks
Article 8: Postoperative Management and Complications in Tummy Tuck
Dr. Hughes, Published Author on Scar Revision Has the Answers to Your Scar Concerns:
Dr. Hughes’s Tummy Tuck Videos in Los Angeles and Beverly Hills
PREPARING FOR SURGERY
- STOP SMOKING: Smoking reduces circulation to the skin and impedes healing. It is best to avoid smoking, second hand smoke and cigarette replacements, such as nicotine patches or gum, in the perioperative period. While you should ideally stop smoking for 4 weeks before and after your surgical procedure, Dr. Hughes will determine what may be appropriate for an individual scenario.
- TAKE MULTIVITAMINS: Start taking multivitamins twice daily to improve your general health once you have scheduled your surgery.
- TAKE VITAMIN C: Start taking 500 mg of Vitamin C twice daily to promote healing.
- START TAKING AN IRON SUPPLEMENT: A good iron supplement, such as Feosol Spansules, is required starting one week before surgery and four weeks following surgery. Bowel movements may appear darker than usual as a result. Feosol is available without prescription.
- DO NOT TAKE ASPIRIN OR IBUPROFEN: Stop taking medications containing aspirin or ibuprofen. Review the list of drugs containing aspirin and ibuprofen carefully. Such drugs can cause bleeding problems during and after surgery. Instead, use medications containing acetaminophen (such as Tylenol).
- LIMIT VITAMIN E: Limit your intake of Vitamin E to less than 400 mg per day.
- FILL YOUR PRESCRIPTIONS: You will be given prescriptions for medications. Please have them filled BEFORE the day of surgery and bring them with you.
- CONFIRM SURGERY TIME: We will call you to confirm the time of your surgery. If you are not going to be at home or at your office, please call us to confirm at (310) 275-4170.
- PRESCRIPTIONS: Make sure that you have filled the prescriptions you were given and set the medications out to bring with you tomorrow. Make sure to have the number for your pharmacy ready so that if Dr. Hughes and associates need to call in any special medications for you on your day of surgery they will have that information readily available.
- CLEANSING: The night before surgery, shower and wash the surgical areas with an antibacterial soap such as Dial, Safeguard, or pHisoHex.
- EATING AND DRINKING: Do not eat or drink anything after 12:00 midnight except for a small amount of water to rinse your mouth while brushing your teeth.
- SPECIAL INFORMATION: Do not eat or drink anything! If you take a daily medication, you may take it with a sip of water in the early morning.
- ORAL HYGIENE: You may brush your teeth but do not swallow the water.
- MAKE-UP: Please do not wear moisturizers, creams, lotions, or makeup.
- CLOTHING: Wear only comfortable, loose-fining clothing that does not go over your head. NO TIGHT PANTS. Remove hairpins, wigs, and jewelry. Please do not bring valuables with you. Remove all piercings and artificial nails.
- CHECK IN/PREPARATION:
- Scheduled Surgery Time:
- You should plan to arrive earlier than your scheduled surgery time. Please do not be late. This will delay the surgery and delay other patients from having surgery and may result in having to reschedule your surgery.
- CARETAKER: Someone must spend the first night after surgery with you and accompany you from the surgery center if you have any anesthesia other than local anesthesia.
TUMMY TUCK / ABDOMINOPLASTY POST-OP INSTRUCTIONS
- The first week you will need to rest frequently. You need to walk around the house as tolerated. Avoid stairs if possible.
- You may not be able to stand up straight for the first week or longer. It may be normal to walk at a 45 degree angle bent at the hips. Your back may become sore in this position. You may try to stand up straight after the first week as tolerated.
- For the first week post-op sleep on your back with your head elevated and knees bent with a pillow underneath them. This will keep the tension off your abdomen. In cases of combination procedures, Dr. Hughes will help formulate a very specific sleeping and resting position based upon the procedures performed.
- Every 2-3 hours take deep breaths to expand your lungs. Hold your incision while coughing.
- Avoid picking anything up greater than 5 lbs for the first 6 weeks.
- No exercise or strenuous activity for 6 weeks.
- You may not drive the first week or while you are taking pain medication. After that it will depend on your ability to handle a car without causing any discomfort.
- Do not engage in sexual activity at least 4-6 weeks after your surgery.
- No smoking. This will interfere with your healing and can potentially cause tissue necrosis and loss of skin and tissue.
- Eat light to start, advancing to a regular diet as tolerated.
- If you have persistent nausea stick to a bland diet until it subsides.
- Avoid foods that can cause a lot of gas. This can cause abdominal distention and undue discomfort. Small frequent meals are best.
- Please consume at least 100 grams of protein each day for optimal recovery. If there is any doubt that this amount is being met, please supplement with protein shakes. Premier Protein shakes contain 30 grams of protein per shake and only 160 calories.
- The pain medicine may cause constipation. Drink plenty of fluids. You may take any over the counter laxatives or stool softeners as needed.
- You will have abdominal binder over your abdominal dressings. You may change the dressings if they become saturated. You should wear the binder most of the time for 4 weeks and while the drains are present.
- It is normal to have numbness over the surgical sites for several weeks or months.
- Do not use a heating pad or ice around the surgical sites. It could cause a burn.
- You may not shower the first week – sponge bathe only, until dressings are removed at your first post-op visit.
- It is normal to see dried bloody drainage on the abdominal binder.
- You will have 1 drain in your abdomen, which may stay in for 1 to 2 weeks. Record the output of each drain for every 24 hour period and bring to followup appointments. Please make sure to strip the drains every 2 hours or as instructed by the nurse or Dr. Hughes after surgery.
- Take your antibiotic until it is completed. You may take your first dose about 4 hours or so after your surgery is completed.
- If the pain medication is a narcotic it should be taken as prescribed. Do not take any Tylenol while on pain medication. The medication we prescribe may already have Tylenol in it.
- Do not drink alcohol or drive a car while taking pain medication.
- The pain medication may cause nausea and should be taken with food at each dose.
- You may resume your regular medication after your surgery except for Vitamin E, Fish oil and Ibuprofen (wait at least 7 days post-op).
- If you take aspirin or coumadin check with the doctor to see when you may resume them.
CALL THE OFFICE IF YOU HAVE:
- A temperature greater than 101.5 degrees.
- Excessive bleeding from the incision.
- A sudden increase in drainage, pain, or swelling around the incision site or the surrounding area.
- If you have persistent vomiting.