Liposuction or Abdominoplasty: That is the Question
The female abdomen is a very special anatomical area; not only is it the focus of body contour in fashion photos, it is the place of procreation, reproduction and the continuation of the family tree. Women exercise, measure and evaluate their abdomen regularly upon dressing and shopping for new clothes. It is not surprising that the shape of the abdomen is addressed during almost half of all new patient consultations with the plastic surgeon. Changes may occur with pregnancy, with weight gain and loss, and with any abdominal surgery, which may disrupt the muscular balance and alignment.
Most women store fat in the abdominal wall, which is the space between the skin and the muscles. This fat is particularly unattractive because it effects the waist to hip ratio. Some of us, particularly men, store fat within the abdomen in a structure called the omentum or around the abdominal organs, themselves. The omentum is a fatty apron, which protects and encloses the bowels. Fat in the abdominal wall is amenable to liposuction or liposculpture, but the internal fat is not correctable with plastic surgery. The plastic surgeon must make the distinction between the two fatty placements as a very important diagnostic requirement prior to body contouring surgery. In that regard, post-operative expectations can more realistically be determined and achieved.
When liposuction or liposculpture alone is being considered, the skin of the abdomen must be healthy, with good elasticity. When stretch marks are prevalent, there is indication that the skin has been badly damaged. It will not contract and respond favorably to liposuction alone. However, when the proper indications are met, and the skin is relatively healthy, the results can be very satisfying, sparing the extensive surgery of a tummy tuck or abdominoplasty.
After the female abdominal wall has been stretched through pregnancy or opened during surgery, very often, the musculature does not adequately support the internal structures, or the back, and a protuberance (pooch) is noted. In the time following the child-bearing years, often the patient can benefit from muscle repair by permanently attaching the two, central, rectus muscle bellies together. Thereby a flattening of the abdomen is achieved and the waist is reduced in circumference. After these muscles are surgically repaired, the excess skin is removed, resulting in a scar around the umbilicus and in the lower abdomen, often from right hip bone to left hip bone. This surgical process is termed an abdominoplasty and results in a permanent repair of the floppy belly. Most patients will benefit from a good diet and exercise program before and six weeks after abdominal surgery. The better toned, the muscle, the more favorable the repair.
Of course, diet and exercise alone, can greatly improve the abdominal contour, but in those patients whose muscles are severely stretched or have been detached, exercise will not fix the problem. In fact, sometimes, the muscle connections can tear, resulting in a hernia, or weakness, which allows the bowel to protrude through the abdominal wall. Once this defect forms, a surgical repair is necessary to correct the problem. If the repair is performed by a general surgeon, often an abdominoplasty can be offered in conjunction. Regardless of the approach, the best results are found in the person who is fit and properly nourished prior to surgery. The results should last a life time!
MARCIA V. ORMSBY, MD
Posted on September 2, 2011 in Articles, Patient Stories
It is very curious, that the young would come to the plastic surgeon, who is known to perform rejuvenation surgery. Appearing youthful is indeed important, but really, it is quite clear that we all do wish to appear healthy, fit, toned and most importantly more attractive – handsome or beautiful. The very particular way that applies to those in their 20’s and even younger, is to consider facial balance and symmetry. A child with a large nose, protruding ears or acne skin eruptions, may be teased mercilessly, and may be building a negative self-concept leaving this child socially marred. Most of the corrections for these problems are relatively simply; they are safe and predictable. In so many instances, a small change produces a major improvement in appearance and self-confidence.
Below a 19 year old patient is seen before and 6 months after rhinoplasty for correction of her large, deviated nose.
In my practice, I see many patients in their 20’s who are terribly affected by their appearance. They are very often accompanied by a parent who renders compassion and support for their child’s concerns. A large nose, most often is the focus of the appointment. It may, however be that their protruding ears have prevented them from a sporting activity or wearing their hair short or pulled back. One very important aspect of this consultation is the establishment of a relationship with the plastic surgeon. The motivation to proceed with surgery needs exploration to ensure good intentions of self-improvement, not desires to please a parent or a friend, or to impress others with the ability to have surgery.
Once completed, this surgery is often no less than life changing. The confidence and poise with which I see my patients enter the next phase of their lives, is truly remarkable. One patient dreamed of becoming a ballerina, but her ears prevented her from tying her hair back. Once fixed, this young lady proceeded to secure a successful career in dance.
Other benefits include:
- Introducing an excellent daily skin care regime preventing early aging changes
- Preventing sun damage and potentially skin cancer
- Ensuring a healthy diet in recovery from surgery and throughout life
- Establishing an exercise routine to maintain good circulation and excellent form
The tangible benefit to plastic surgery is the removal of a visible barrier to your ability to see yourself as beautiful and talented, with valuable gifts to develop and offer the world. It brings me great joy to keep in touch with my patients, as they move into adulthood, shinning like stars with their brilliant contributions.
Posted on November 30, 2010 in Facial Aging, Patient Stories
This patient is a 59 year old, healthy, but overweight female, who was very unhappy with her facial appearance. She thought that, perhaps, her weight would eliminate the possibility for facial surgery, but actually, if in good health, most people heal very well. A few requirements need to be met and the most important relate to your overall health. Diabetes, if present, must be well controlled, and no smokers are permitted in this special group of patients. Facial skin is usually well vascularized, but in the smoker, the blood supply is compromised. This patient is seen six months following her facelift, and even though she was very pleased with her results, went on to gain some twenty pounds. As you can see in her photos, her result is very good, but I must add that without the weight gain, would have been even better.
Facelift Surgery Patient Results – 6 Months Post Op
Face lifting is a safe, predictable procedure
Given expert technique and meticulous attention to detail, the face lifting surgery is an artful restructuring of the facial form, beneath the skin. Following support of the underlying structures, and filling of the defects, the skin is draped without tension or distortion. This application of very individual correction of facial aging renders a longevity and naturalness to the final result. My patients appreciate some 15 to 20 years of superb results before touch-ups may be needed.
It takes careful evaluation to set goals
During your evaluation, we will consider options for a realistic attainment of your goals, taking note of your time and lifestyle. Your surgery is performed in my fully-accredited surgery center. Since your life is busy and your time especially sacred, many times, combined surgeries are offered to reduce healing time and costs. You will enjoy a ‘house call’ following your surgery, so that I can determine your optimal healing conditions and correct any problems that may be interfering with a smooth, safe, pain free recovery.
Options for Face lifting surgery include:
Posted on November 23, 2010 in Liposuction, Patient Stories
Liposuction Corrections
This patient is a 49 year old, healthy female, who came to me three years following liposuction of her thighs, performed by a nearby plastic surgeon. Despite a long wait and reassurance by the operating surgeon, she was left with these scarred, irregularly surfaced thighs. The dimpling of the skin was so severe that she could not wear skirts or shorts, comfortably. After a complete workup in the office, I was able to perform Laser correction of the scarring and a thigh lift, removing the excess skin and smoothing the surface. The surgery was challenging, because of the scars that I encountered during the surgery, but careful Laser release resulted in a near perfect correction of her problem, as you can see in her photos.
Before Front
After Front
Before Side
After Side
Liposuction is a safe, predictable procedure
In nearly 25 years of practice, I have not ever seen this patient’s scarring resultant to liposuction. The correction was very successful, but the problem is completely avoidable with careful, primary attention to technique and appropriate selection of instrumentation. All surgery is meticulously planned to prevent untoward outcomes with strict attention to detail and post-operative care. However, if any results are unsatisfactory, there are modalities to correct these problems.
It takes careful evaluation to set goals
During your evaluation, we will consider options for a realistic attainment of your goals, taking note of your time and lifestyle. Your surgery is performed in our fully-accredited surgery center. Since your life is busy and your time especially sacred, many times, combined surgeries are offered to reduce healing time and costs. You will enjoy a ‘house call’ following your surgery, so that I can determine your optimal healing conditions and correct any problems that may be interfering with a smooth, safe, pain free recovery.
Options for Liposuction surgery include:
- liposuction alone, always using the tumescent technique and small cannulaes
- lifting of the surrounding skin
- liposuction with ‘Smart Lipo’ or Laser Liposuction
Posted on October 27, 2010 in Patient Stories
This patient is a 42 year old who came to me with concerns about her breast and abdominal contours, following her pregnancies. She had a saline filled breast augmentation some 15 years ago, with capsular contracture and unnatural elevation of the implants. She also suffered a separation of her abdominal muscles with stretched, badly damaged skin. Dr. Ormsby performed her corrective surgery with an exchange of implants to silicone gel, a breast lift (mastopexy) and abdominoplasty (tummy tuck). She is pleased with her outcomes, here at 6 months post op.
Your body changes after pregnancy
Becoming a mother is the accomplishment of my lifetime that I am most proud, I am certain that your journey has been one of joy and exuberating. However, your pregnancy does change your body that, without the benefit of surgery, remains throughout your entire lifetime. I take great pride in restoring the female form to one of beauty and balance, which approaches our pre-pregnancy shape. As our children take first place in our hearts and mind, often we allow our bodies to take a back seat in our life’s priorities. We deserve the attention required to restore our healthy selves; it is one of the most gratifying procedures that I offer.
Pregnancy effects both the breasts and the abdomen
The female breast may loose volume and shape or may gain excess skin with the subsequent loss of support. In the surgical repair of these effects, the skin is re-draped and the breast volume, restored with either an augmentation or a lift and support of the existing breast tissue. The female abdomen is often rendered with a lack of support, following pregnancy, in that the major muscle pair that supports your contour is divided in the middle. This division is an absolute during a C-section, whereby the muscle is not repaired, following delivery. Your post-pregnancy abdominal surgery provides a permanent repair of this muscle separation, so that you will never return to the un-supported state, throughout your lifetime.
It takes careful evaluation to set goals
During your evaluation, we will consider options for a realistic attainment of your goals, taking note of your time and lifestyle. Your surgery is performed in our fully-accredited surgery center. Since your life is busy and your time especially sacred, many times, combined surgeries are offered to reduce healing time and costs. You will enjoy a ‘house call’ following your surgery, so that I can determine your optimal healing conditions and correct any problems that may be interfering with a smooth, safe, pain free recovery.
Options for Mommy makeover surgery include:
