Case Number: 327
- Before After
Richard D. Fisher, M.D.
This is an unusual case of tummy tuck performed along with liposuction. These procedures are not generally performed together, because of the fear that some skin will die in the middle of the abdomen. However, a clever surgeon has published a paper about this combination, and in order to make it safer, the surgeon did not make an opening in the whole abdomen area, just the middle of the abdomen. How it works is a little complicated (see below), but now these procedures can be done much more safely.
Compare these photographs to Dr. Yoho's No Scalpel Tummy Tuck. The results are similar but with no scar. A bit more saggy skin is seen, however, with the No Scalpel Tummy Tuck. The key to both procedures is the skin shrinking to fit on the new form without the fat.
Both the No Scalpel Tummy Tuck and this procedure were done under anesthesia that was NOT general anesthesia. The patient was comfortable in each case and did not remember the process. See anesthesia chapter of Dr. Yoho's book for more information about the anesthesia Dr. Yoho uses for his surgical procedures.
Traditional tummy tucks have a high death rate of approximately 1 in 2000 and a high bleeding and blood clot rate on the legs and the lungs. These last two problems have been thought by many observers (dermatologists in particular) to be related to the use of general anesthetic together with a tummy tuck.
With this new tummy tuck procedure, the surgeon liposuctions the involved areas and then goes ahead and cuts the skin out. In order to have a better chance of an excellent recovery and a safe result, the blood vessels from the lower abdomen are not cut. Instead, only the skin is taken out after the liposuction is performed. A new bellybutton is still constructed. Also, a traditional tummy tuck undermines or cuts a big hole in the whole area of the abdomen underneath the skin right next to the layer above the muscle. The new kind of tummy tuck, of which this photograph is representative, undermines or creates a hole in the midline 2 inches or so of the front of the abdomen (belly). After this, the muscles are sewn together using the usual method of a traditional tummy tuck.
This patient is seen here on the right a month post-procedure. The area of the scar is still red. Although this scar will not go away completely, it will lighten up and at least turn brown at a minimum and probably fade significantly over a period of months.
Patients like this need careful instructions in weight and exercise management and possible hormone therapy in order to maintain their new weight. If this individual goes back to the same diet and exercise habits as before, the weight will be regained and will likely go on arms and legs and inside the abdominal wall. However, there are some studies that show improvement in diabetes for large-volume liposuction patients such as this. We are hopeful that long-term positive medical effects result from these procedures.