Celebrity Plastic Surgery, News, Gossip

By Lois W. Stern, Editor-at-Large, Makemeheal.com

A little over a year ago I wrote an article about the tragic death of Donda West, mother of the celebrity rapper, Kanye West, following plastic surgery. In the aftermath of Kanye’s rude mishap with Taylor Swift at the VMA Awards , I thought I would revisit his mom’s tragic story.

Why tragic? After doing some research on her case, I concluded that a significant factor in her death was due to poor medical judgment. Well, here we go again, some more bad news following plastic surgery. But this time, due diligence may avert the supreme tragedy of another life lost.

While investigating the Donda West tragedy, I had called both the ABPS (American Board of Plastic Surgery) and the ABMS (American Board of Medical Specialties) to inquire about the board certification of Donda West’s surgeon, Dr. Jan Adams. I learned two alarming facts. Dr. Jan Adams was not listed as a board certified plastic surgeon. Furthermore the only physician on record with the ABMS bearing the name Dr. Jan Thatcher Adams was board certified in Family Medicine – not plastic surgery.

I concluded that if Donda West had only made those phone calls prior to selecting her surgeon, she might have selected differently. She might even be with us today.

Donda’s autopsy results yielded no physical findings (such as a heart attack or blood clot) to explain why she went into cardiac arrest. According to Barry L. Friedberg M.D., a board certified, globally recognized leader in the field of office-based anesthesia, it was unlikely that either the length or extent of West’s surgeries caused her death. “More likely, it was the manner in which the surgery was performed; i.e. under general anesthesia which does not reliably produce pre-emptive analgesia and, therefore, often necessitates postop narcotics to manage pain. If West had sleep apnea as a pre-existing condition, even average doses of narcotics could easily prove fatal,” claims Dr. Barry Friedberg.

We will never know for sure what killed Donda West. But we do know that sound medical judgment comes only with quality training followed by lots of experience putting that training to practice.

On June 13^th, 2009, the Hartford Courant ran a story about Dr. Efraim Gomez-Zapata, a name currently in the news for allegedly practicing plastic surgery without proper credentials. (According to the Hartford Courant, Dr. Efraim Gomez-Zapata is credentialed as a family practice physician, but because his name is not listed with the Connecticut State Medical Board, I was unable to verify this information.). His medical license has been suspended by this same board based on charges that he violated medical standards by performing plastic surgery without appropriate qualifications or standards to protect patient safety. The allegations of the Connecticut Department of Public Health against Dr. Efraim Gomez-Zapata include administering anesthesia and performing plastic surgery on patients without the proper license or qualifications and failing to keep proper records or have the appropriate staff, equipment, office setup and hospital privileges required in case of complications. In two patient cases cited where complications did occur, one woman had a seizure after Gomez-Zapata administered a combination of painkillers, anti-anxiety medication and a local anesthesia; while a second went into respiratory arrest after Gomez-Zapata gave her a spinal anesthesia.

What simple steps can the rest of us take to avoid fates similar to those of Donda West or the unfortunate patients treated by Dr. Gomez-Zapata? I like to think of the word TEE (short for Training, Experience and Expertise) as a handy acronym to help me remember how to investigate the credentials of any prospective surgeon.

TRAINING: Know that ANY board certified physician in any field of medicine can legally perform plastic surgery and call himself a cosmetic surgeon.
DO YOUR HOMEWORK. Be sure you have selected a surgeon board certified in the area that relates to your surgical needs or desires.

EXPERIENCE: You can check out the history of any prospective surgeon by calling the medical records department of the state where he practices. Visit http://www.floridamalpractice.com/linksotherstatebds.htm for the telephone number of the medical records department of the state where your surgery will take place.

I do not know how many cosmetic surgeries either Dr. Jan Adams or Dr. Efraim Gomez-Zapata has performed. But I do know that their surgical histories send up some immediate red flags. According to medical records from the state of California, in 2001 two malpractice lawsuits were filed against Adams, ending in payouts of close to half a million dollars. Prior to the Donda West tragedy, three new, unsettled medical malpractice lawsuits were pending against this same doctor. As for Dr. Gomez-Zapata’s record, we do know that one of his patients experienced seizures during surgery and a second went into respiratory arrest. These are enough red flags to alert us to quickly do an about face and walk away from either of these offices.

Another way to assess the adequacy of a surgeon’s experience is to inquire about the number of procedures of a particular type he performs each year and how long he has been performing them. Ask to speak with some of his patients and try to meet with them in person to assess the surgeon’s work.

EXPERTISE: Ask your surgeon where he has hospital privileges and place a phone call to that hospital to inquire if he has privileges to perform the exact procedures you are considering. This step is essential, even if your surgery is to take place in an outside surgical facility. Why? The chief of plastic surgery assesses the experience and skill of the surgeon before granting him privileges for any surgical procedure. Surgeons are often granted privileges for some procedures while having privileges for others withheld, based on their experience and expertise. If a surgeon skirts this issue or tells you it isn’t necessary for him to have hospital privileges since surgery will take place in an outside facility, turn around and walk!

It is important to learn how to separate the sound from the noise. Donda West’s surgeon, Dr. Jan Adams had appeared on numerous national TV shows, including Oprah, CNN, Entertainment Tonight, and Discovery Health, to name a few, as a plastic surgery ‘expert’. I congratulate his PR agent for doing a phenomenal job. But great hype does not a great surgeon make. Surgical expertise does not come from making TV appearances.

Statistically, cosmetic surgery procedures have a strong safety record, but you need to heed some cautions. In a study evaluating the safety of accredited office based surgical facilities, only 1 death occurred in 58,810 surgical procedures, but there is one important caveat to that study that should not be overlooked: All of these procedures were performed in office surgery facilities accredited by the AAAASF.

While in the process of writing my first book, I had the privilege of interviewing Dr. Keyes, the lead surgeon of the above study. He explained that each surgical facility accredited by the AAAASF mandates that a) the doctor be board certified in the medical specialty recommended for that procedure and b) that the doctor has been granted privileges to perform those same procedures in the hospitals with which he is affiliated. Again, remember to do your homework.

Here are just a few of the life saving questions you should ask before engaging a surgeon

Do you have hospital privileges to perform the procedures I am considering? If so, where?

What you should do next: Call the hospital(s) to inquire.

What is your board certification?

What you should do next: Contact the American Board of Medical Specialties (Internet: www.abms.org/ Phone:1-847-9091) Consider surgeons with board certification in: plastic surgery, ophthalmology, otolaryngology, dermatology. Here is where Experience and Expertise come into play.

Is the facility where your surgery will take place an accredited facility?

What you should do next: Ask by whom? You are in good hands if accredited by the AAAASF or AAAHC for ambulatory facilities or the JCAHO for hospital facilities.

Who will administer my anesthesia?

What you should do next: Find out if this person is a board certified anesthesiologist? Understand that the training of a board certified anesthesiologist is far more comprehensive than that of a nurse anesthetist. In determining the extent of your anesthesia needs, consider the extent of your surgery, your physical condition and age.

You need to consider the risks and rewards to your surgery. Here are some additional questions to ask your surgeon:

What are the risks to my surgical procedures?

Do you consider me a good candidate for the surgeries I am requesting?

Do I have any medical condition, health habits, etc. that we need to consider?

I am ever mindful of the words of Dr. Rohrich, former president of the ASAPS and a member of their Innovative Procedures Committee: Most women spend more time selecting a pair of shoes than selecting a plastic surgeon. You can take back your shoes, but you can’t take your face or your life back.

Lois is the author of Sex, Lies and Cosmetic Surgery and Tick Tock, Stop the Clock. She also has developed a special Support Tool DVD for Professional office use – a practical communication tool to help surgeons personalize their services while communicating with their patients. Check out Lois’s website at: www.sexliesandcosmeticsurgery.com.

Lois and Patty Kovacs are the co-founders of Coast2Coast - Eye on Beauty Newsletter.

Tags: celebrity, cosmetic surgery, job, Lois Stern, plastic, plastic surgery, surgery

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February 6, 2009 - Los Angeles, CA

Make Me Heal (www.makemeheal.com), the world’s largest website for all things plastic surgery, cosmetic treatments, and anti-aging, has announced that over fifty top plastic surgeons have joined Makemeheal.com to answer questions live that are posted by consumers on the website’s Ask-An-Expert area. Launched in November of 2008, Ask-an-Expert is a free service that allows consumers to ask a question and get key answers from top doctors and experts about any procedure or topic within the fields of plastic surgery, dermatology, and skin care. Moreover, regular people from the Makemeheal.com community can also post responses to questions.

“Ask-an-Expert is rapidly becoming one of Makemeheal.com’s most popular areas of our portal, as it allows consumers to ask important questions and get answers from different leading doctors and experts at a click of a button — and for free,” says Ariel Perets, Founder & CEO of Makemeheal.com.

Aside from asking questions, users can simply use this incredible resource to do research numerous types of procedures, treatments, and products using sophisticated search functions on Ask-an-Expert.

Among the physicians answering questions on the Makemeheal.com site include Dr. Marcel Daniels, Dr. Brent Moelleken, Dr. Shervin Naderi, Dr. Alexander Rivkin, and other top plastic surgeons.

Check out Ask-An-Expert.

About Make Me Heal

Make Me Heal (www.makemeheal.com) is the world’s largest website for all things plastic surgery, beauty enhancement, and anti-aging.  With 1 million members and over 300,000 unique visitors per month, Make Me Heal is a one-stop portal for all the products, services, and information resources needed by the consumer.

Discover The Make Me Heal World…

• Find a great plastic surgeon on Makemeheal.com’s Plastic Surgeons Directory, check credentials, and read patient reviews of doctors.

• Chat, ask questions, and get advice from people on our Message Boards & Blogs.

• View or upload Before & After Plastic Surgery Pictures in the world’s largest photo library of women and men who’ve had plastic surgery.

• Ask top plastic surgeons questions & get answers live on Make Me Heal’s Ask-An-Expert area.
• Shop for Plastic Surgery Recovery & Preparation Products and Beauty & Skin Care Products.
  
• Read Plastic Surgery News & Gossip.

Visit the website: Make Me Heal

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By Andrew Wolfe, MD

Obesity and the constellation of diseases which result from obesity are among the most significant health problems in the United States today. In an effort to combat this epidemic, patients are increasingly turning to Bariatric Surgeons for massive weight loss surgery. Last year 200,000 Bariatric procedures were performed, representing a 10-fold increase over the previous decade. The benefits of the weight loss are profound and far-reaching. Physiologically, there are improvements in many weight-related conditions, such as diabetes, cardiovascular disease, and skeletal disorders. The psychological benefits include marked improvements in body image and social acceptance as well as decreases in depression and anxiety.

Although the weight loss is truly a life saving process, it is not without its negative side effects. Psychological challenges can include stressful changes in relationships with the patient’s spouse, friends, and the opposite sex. These changes can be so pronounced that patients may experience an identity crisis after weight loss, and psychological counseling and support groups are integral to the successful transition from obese to non-obese. Physically, the loss of fat results in disproportionately loose skin and underlying soft tissue, which can lead to both aesthetic and functional concerns.

For many massive weight loss (MWL) patients, Plastic Surgery is a vital step in their journey, and improves their physical and psychological well-being. More than 100,000 contouring procedures have been performed on MWL patients, and that number is growing exponentially. The goals of surgery are straightforward – improved function, hygiene and appearance, achieved through safe, predictable procedures. As straightforward as these goals may be, post-MWL Plastic Surgery is a rapidly-evolving specialty, and procedures are constantly evolving to offer patients better, safer results.

Prior to any elective surgery after MWL, preoperative considerations which must be taken into account include nutrition, weight stability, and smoking habits. Nutritional deficiencies are common after weight reduction surgery, although newer Bariatric procedures are less likely to affect patients adversely than were older techniques. Vitamin and protein levels are generally checked before surgery, and supplemented if necessary, in an effort to maximize the efficiency of wound healing. Weight stability prior to contouring procedures is beneficial, and most patients undergo Plastic Surgery 12 to 18 months after their Bariatric procedure. A minimum of 3 months at a stable weight is a typical benchmark, although 6 months of stability is preferred. Of note, some patients do find that contouring procedures lead to further weight reduction through increased activity levels postoperatively. All nicotine-containing products must be avoided around the time of surgery, as they significantly increase the risk of wound healing complications.

The types of procedures performed on MWL patients are different than those on non-weight-loss patients. Given the profound laxity that most patients exhibit, extensive excisional procedures are usually necessary, resulting in larger scars, longer recovery times, and greater risks. In addition to the increased amount of skin, the quality of the skin that remains after contouring procedures tends to be of poor quality – stretch marks, loss of elasticity, and atrophy of the skin are all to be expected. Because of this, secondary touch-ups and revisions are not unusual in this population, and should not be seen as failures of the original surgery. Fortunately, MWL patients tend to be very tolerant of scars, very motivated, and extremely satisfied with the dramatic improvements that these procedures can produce.

Procedure types are generally broken up into the lower body (abdomen, buttocks, and thighs), and the upper body (breast, back, and arms). MWL patients present with a wide variety of deformities, priorities, and expectations, and individualization of treatment is crucial to success. Many patients require more surgery than can safely be performed in one session, and a staged approach is usually necessary. The lower body is generally addressed first, as the abdomen is almost universally a priority for MWL patients. Second stage procedures address the upper body, while a third stage may be useful for thigh tightening and/or touch-ups. Facial procedures may also be performed.

Laxity of the skin and soft tissues of the abdomen can be pronounced after MWL, and virtually all patients require some type of abdominal tightening. An abdominoplasty, or “tummy tuck” corrects this laxity with a multi-layered approach that tightens skin and muscle while removing excess fat in the lower abdomen.

This diagrams illustrates the key steps of an abdominoplasty. The initial incisions are made around the umbilicus and in the lower abdomen, and the skin is lifted off of the underlying muscles up to the rib cage. The rectus muscles are then tightened. As shown, this tightening is generally done in a vertical fashion, although additional vectors of tightening may be added if significant laxity exists. The patient is flexed on the table, and excess skin is advanced down towards the pubis and excised. Finally, the umbilicus is brought up through the abdominoplasty flap and sculpted into position.

Photos of a 35-year-old woman who had lost 90 lbs, before and after an abdominoplasty.

Photos of a 44-year-old woman who lost 120 lbs after an open gastric bypass before and after an abdominoplasty. (She previously underwent an augmentation/mastopexy.)

Photos of 38-year-old woman who lost 180 lbs after a laparoscopic gastric bypass, before and after lower body lift with augmentation/mastopexy.

Surgical correction of the upper body includes the female breast, male chest, arms, and back. Female breast surgery is commonly performed after MWL with the goals of improving the breast shape, volume, and skin envelope. Given the loss of soft tissue integrity of the breast that comes with MWL, most patients will need some type of skin tightening, be it with a mastopexy, augmentation/mastopexy, or reduction. In some patients, this can be achieved with a vertical scar pattern, while others with more profound ptosis may need a Wise-pattern or “anchor” scar.

The preoperative breast volume may be ideal, in which case a mastopexy alone can be performed. In this operation, the breast gland is reshaped, and excess skin is removed. Although no volume is removed, the breast tends to appear smaller due to its more compact shape. Many patients present with breasts that remain too large even after weight loss, and a breast reduction is performed. Finally, patients may desire a breast that is larger and perkier than their current breast. A breast augmentation in conjunction with a mastopexy is then performed.

Photo of a 45-year-old patient before and after an augmentation/vertical mastopexy.

Arm laxity is an issue for many patients after MWL, and is corrected with an arm lift, or brachioplasty. A brachioplasty tightens loose arm skin, improves the contour of the axilla, and can be combined with liposuction of the arm if residual fullness exists. The degree of laxity often seen after MWL often requires a full brachioplasty as opposed to a more limited technique, and results in scars which extend to the inner elbow. These scars often heal very well but take years to fully mature, and are visible in a short-sleeved shirt.

MWL patients often experience premature aging of the facial soft issues in addition to those changes seen in other parts of the body. Loss of volume and elasticity in the face can be corrected with procedures that resuspend soft tissues and tighten the skin while maintaining or augmenting facial volume. Newer facelift techniques may afford patients shorter scars, a quicker recovery, and fewer complications. A popular technique is the “Short-scar Lateral SMAS-ectomy” facelift, developed by Dr. Daniel Baker. Also known as a “Mini-facelift”, this procedure offers significant improvement in facial shape with a surgery less aggressive than that commonly performed. Many patients choose to add other procedures such as eyelid surgery (”blepharoplasty”) or brow lift at the same time for a more complete facial rejuvenation.

The risks associated with these procedures vary widely. For many body contouring procedures, the scars are long and heal to varying degrees of fineness. Wound healing complications are more likely in smokers and those with poor nutrition. Secondary relaxation of tissues is certainly possible, even after an aggressive procedure, and revisions are common in this patient population. As previously stated, a revision should be seen as a fine-tuning or enhancement of a previous operation. Deep venous thrombosis, or DVT, is one of the most dreaded complications seen with this type of surgery. During surgery, or in the postoperative period, these clots can form in the deep veins of the legs and have the potential to migrate to the lungs as a pulmonary embolism, a potentially fatal complication. A key intraoperative step to prevent DVT’s is the use of pneumatic compression devices that are applied to the legs. Early ambulation after surgery is also important. The risk of DVT is increased in the obese, older patients, smokers, and patients taking birth control pills. If multiple risk factors are present, short-term treatment with an injectable anticoagulant such as Fragmin or Lovenox may be used.

The postoperative recovery after surgery can range from less than a week for some breast procedures to three weeks for a lower body lift. Most breast procedures require a week off from work, and result in postoperative discomfort that requires prescription pain medication for three or four days. Lighter exercise may be resumed in two weeks, while more vigorous activities such as yoga or Pilates should be avoided for three or four weeks. In contrast, abdominoplasties and body lifts often require two tow three weeks off of work, with lighter exercise resuming at three weeks. Strenuous activities should be avoided for six weeks to allow adequate healing of the lifted tissues. Facial procedures tend to result in relatively mild discomfort, but patient appearance may dictate a two-week avoidance of social activities.

In summary, the field of Plastic Surgery after MWL is rapidly advancing. For these patients, safety is first and foremost, and a systematic approach to presurgical, intraoperative, and postoperative care can reduce complications. Communication, patient education, and informed consent are crucial, and patients must have realistic expectations. Finally, individualization and timing of procedures should be based on patient anatomy and patient priorities. Despite the challenges MWL patients present, the rewards for both surgeon and patient can be great.

About the Author

Born and raised in New York, Dr. Andrew Wolfe operates his practice, “The Center for Cosmetic Surgery,” in Denver, Colorado. Dr. Wolfe is passionate about his work, and thoroughly enjoys both the personal and technical aspects of the specialty. He believes that the physician-patient relationship is truly a partnership. “I have to understand a patient’s history, desires, and physical status before I can recommend a course of action. At the same time,” Dr. Wolfe says, “the patient has to learn about the various options available for any given procedure before they can make an informed decision.” Patient education is a high priority at the Center for Cosmetic Surgery, and Dr. Wolfe spends a great deal of time with his patients, both before and after surgery, making sure that they understand their surgical options. At the Center for Cosmetic Surgery, Dr. Wolfe has created a blend of state-of-the-art techniques and more traditional approaches. “I’m not shy about adopting new techniques or procedures”, he says, “but I need to be sure that they are safe and effective first.” Above all, Dr. Wolfe feels privileged to be able to be able to perform the work he does. “Virtually everything I do is elective, and I consider it an honor to be chosen by a patient to perform their surgery.” Learn more about Dr. Wolfe.

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See Julie’s Before & After Plastic Surgery Photo Album.

After the birth of her youngest son, Julie (friendname: Morgandy) began to lose all of her baby weight but could not get rid of her “tummy pouch”. After getting down to her ideal weight, she decided she might need some liposuction on her trouble spots, so she called up Dr. Linda Huang, who had performed Julie’s breast reduction previously. Since she was so happy with the results of her breast reduction, she trusted Dr. Huang’s opinion. Dr. Huang explained that her “tummy pouch” was loose skin from her pregnancies, and a tummy tuck would be necessary to get rid of that skin. After spending time lurking, and finally posting, on the Make Me Heal Message Boards and buying a stage one compression garment to help with her recovery, she finally had her abdominoplasty procedure on June 10, 2008. Though it took a few weeks of dealing with back and abdominal pain, with the help of her husband and kids she recovered with amazing results.

Julie’s words of advice to anyone considering a tummy tuck are:

“Be sure to do research. Ask questions and don’t be afraid to visit more than one doctor before making your decision.”

Please join us for an interview with Julie:

Make Me Heal: When did you first have the idea to have your procedure(s)?

Julie: I have been thinking about having a tummy tuck for several years - ever since my youngest son was born. I had lost a lot of weight and my stomach was really stretched out and no matter how much I worked out that area, it didn’t budge.

Make Me Heal: What were your motivations (physical, emotional, social, etc.) behind your decision to have the procedure(s)?

Julie: My motivation for having this done was emotional for the most part. I did not like the way my stomach looked after I lost the baby weight.

Make Me Heal: How long did it take you to make a decision and was it an easy or difficult one to make?

Julie: It was a very easy decision to make. I knew I wanted a tummy tuck after I had lost the baby weight, but still had the tummy pouch. I went with the surgeon that did my breast reduction.

Make Me Heal: Did your family, friends, and any other people in your close circle give you support, opposition, or did you make this decision without considering them?

Julie: The only person who knows about this is my husband. I made the decision myself and he supported it. I feel it’s a very personal thing and did not want a lot of people to know. We told our kids that I was having surgery to take care of stomach scar tissue due to my c-section.

Make Me Heal: How did you research the procedure and come to decide on this particular procedure?

Julie: For research I looked online at various websites and came across Make Me Heal. I lurked for quite a bit - viewing other people’s photo albums and reading their stories. I had a consult with my surgeon and viewed before/after pictures in her office as well as checked out her website.

Make Me Heal: Please discuss if you used any of Make Me Heal’s resources such as the message boards, pictures library, doctor directory and doctor reviews, and any recovery and preparation products that you used.

Julie: I bought a stage 1 garment from MMH and then started posting on the message boards. There’s a wealth of information on the MMH website and the people on the boards are always very helpful and willing to offer advice and suggestions.

Make Me Heal: How did you come to choose your doctor?

Julie: I chose my doctor based on the fact that she did my breast reduction and I am beyond thrilled with the results from that. I know how the scars will look after a few years and knowing that helped me see how the tummy tuck scar will turn out. She has amazing bedside manner and is very nice.

Make Me Heal: Please discuss if you have any role in deciding the type of technique used for your surgery by the doctor, incision placements, implant brand, anesthesia type, etc.

Julie: I first went in for just some liposuction on the tummy, but she suggested the tummy tuck and explained why - extra skin etc. I didn’t really have a role in determining things, but she explained everything so well and clearly and answered my questions fully.

Make Me Heal: How did you prepare for the surgery?

Julie: For surgery prep I started taking Arnica Montana pills and Bromelain 2 weeks before. I also was sure to take a multi-vitamin. My husband took a week off work and we arranged for our kids to stay at Grandma’s for a vacation.

Make Me Heal: How were you feeling the night before the surgery and on the moments before the surgery itself?

Julie: I was pretty nervous before the surgery, but even more excited. I got to sleep late and we had to be up at 4:00 to leave by 4:30 to be at the hospital by 6:00 am. I think being a bit tired helped me not be as nervous. I prayed that things would go well and felt comforted by that.

Make Me Heal: How was the recovery process? Please discuss what side effects you experienced. What were the worse parts of the recovery? Did anyone help you during the recovery?

Julie: I stayed overnight at the hospital and went home the next day. Recovery was longer than I thought it would be. The worse parts of recovery was when I had to do anything that involved moving my torso. Sneezing and coughing were the worst, followed by trying to get up out of bed. My husband was there to help me with getting things I needed.

Make Me Heal: Please discuss the pain or discomfort you experienced during the recovery?

Julie: I had enough pain for the first 2 days to take the prescription pain medicine that I was given, but was able to switch to Advil after that. My stomach was very sore and tight and my back was sore as well from being hunched over due to the fact that I couldn’t stand up straight.

Make Me Heal: How well prepared were you for the recovery from physical, emotional, and mental respects? Did you do any research (i.e. online, books, message boards, etc.) to make your recovery smoother?

Julie: I believe I was very well prepared for the recovery from reading threads on the MMH message boards. I knew it would be tough from reading about others experiences and that helped me know that what I was experiencing was normal.

Make Me Heal: What are your top recovery tips to other patients?

Julie: Recovery tips to others - make sure you have plenty of help so you can sit or lay around and do NOTHING! If you feel better, don’t get up and start cleaning. Be sure to take a good 2 weeks or so to just lay around and recover. Make sure you have help to get medicines, cook meals and take care of kids (if you have any).

Make Me Heal: How long did you take off from work? What did you tell your co-workers about taking this time off? Did anyone notice your cosmetic procedures at work and what did you tell them if they asked about it?

Julie: Fortunately I don’t work, so that wasn’t an issue and so my husband took off a week. After that, I was better able to move around and by that time, my kids were home from Grandma’s and they were able to help me out.

Make Me Heal: How happy are you with the results?

Julie: I’m extremely happy with results. I thank God everyday for the wonderful results I have and how great a doctor Dr. Huang is.

Make Me Heal: How has your makeover impacted your life from personal, social, career, and other respects?

Julie: I think I am a bit more confident. I can wear better fitting clothes which in turn make me feel more pretty and confident.

Make Me Heal: Would you have done anything differently if you had the chance?

Julie: I’m not sure I’d have anything different done. Maybe some more lipo around the flank area, but everything is looking so well now.

Make Me Heal: Was Make Me Heal beneficial to you along your journey?

Julie: It was very helpful! The people on the message boards are extremely helpful and the wealth of information on the website is amazing. Everything is explained so well. Highly recommend this site!

See Julie’s Before & After Plastic Surgery Pictures Album.

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Even though most people understand what a Tummy Tuck is, not all know the different procedures available to make it happen and what connection the Tummy Tuck has with the conditions of the skin. Dr. Brent Moelleken, a board certified plastic surgeon part of the ABC’S hit show “Extreme Makeover,” and Discovery Health Channel shares his knowledge on this procedure and warns us that even though the effects of the Tummy Tuck should be permanent, this is no excuse to abuse from our eating or exercising habits.

MMH: What are the main techniques available to perform a tummy tuck and which one do you favor? Why?

Dr. Moelleken: There are a confusing number of procedures available for tummy tucks: micro tummy tucks, mini tummy tucks, full tummy tucks, and now the hybrid abdominoplasty. The technique that is best for the patient depends on how loose the skin is, and how loose the underlying layer, or fascia is, and whether or not there is extra fat that can be reduced. Of course, every patient would like to have the micro tummy tuck version, but only patients with a small amount of excess skin qualify for this procedure. When there is looseness of the fascia, or hanging skin, or excess fat, a more traditional tummy tuck may serve the patient better.

MMH: What are the new innovations/improvements in tummy tuck techniques over the last few years that you employ in your procedures?

Dr. Moelleken: The biggest innovation in our practice is the hybrid abdominoplasty (hybrid tummy tuck), a procedure that combines a short incision with full tightening of the deep layer, or fascia.

MMH: What is a full tummy tuck and how does it differ from a mini/partial tummy tuck? How long does it take to perform each type of procedure?

Dr. Moelleken: Full tummy tuck: large removal of extra skin and fat; full tightening of the deep layer. Incision from hip to hip. 3 hours in surgery

Mini tuck: removal of lower abdominal fat only. Tightening only of the lower abdomen. Short incision. 1 1/2 hours in surgery

Micro tummy tuck: removal of extra skin only, from the lower abdomen, through a short incision. 1 hour in surgery

Hybrid abdominoplasty: short incision, full tightening of the deep layer. Suitable for patients in great shape who have the “mommy gap” between the stomach muscles (rectus muscles), especially noticeable when they do a sit-up. 3 hours in surgery.

MMH: Are there differences in technique or the recovery process when performing tummy tucks on female versus male patients?

Dr. Moelleken: Yes, although when men have lost a great deal of weight, the procedures are similar. Men typically require mini or micro tucks since they do not have the damage to the fascial layer that childbirth causes.

MMH: What can a patient realistically expect from a tummy tuck in terms of losing weight and dropping actual waist sizes?

Dr. Moelleken: The differences, especially with full tummy tucks, can be profound. A typical weight loss would be around 6-7 pounds, with an immediate reduction in waist size of several inches.

MMH: What other procedures do you typically suggest to combine with a tummy tuck to improve the result in the abdomen?

Dr. Moelleken: Liposculpture can usually be conservatively done at the same time as a tummy tuck.

MMH: Is a tummy tuck recommended for a patient who wants to get pregnant after the procedure? Do you see any potential health risks such less available fat/tissue that might help the baby’s natural growth in the future, or less fat and skin needed to expand?

Dr. Moelleken: We do not tighten the fascia in patients who are anticipating childbirth. However, we do tighten the skin, especially if patients have had massive weight loss and have a lot of excess skin.

MMH: If someone is considerably overweight, how close to their goal weight (please specify number of pounds) should they be before they should consider a tummy tuck?

Dr. Moelleken: Goal weight is often a pipe dream, something we would like to have but can’t afford. A stable weight is usually the best we can get, and more realistic for the patient to shoot for.

MMH: What is a normal recovery time period? When can a patient resume regular activities?

Dr. Moelleken: After 2 weeks, patients can walk long distances. Workouts must wait from 4 to 6 weeks.

MMH: How soon after the procedure can a patient expect to begin seeing results?

Dr. Moelleken: Immediately.

MMH: How long do the results of a tummy tuck last? What can a patient expect after 4-5 years, and after 10 years?

Dr. Moelleken: The results are permanent. This is, of course, not an excuse to overeat, since the patient has no protections against gaining excess weight if they overeat. However, the fascial looseness and hernias, particularly from pregnancy, cannot be fixed by any other method than tightening the fascia.

MMH: Can the effects of a tummy tuck disappear without proper fitness and proper eating habits? What activity or habit should a patient pursue to prolong the results of the procedure?

Dr. Moelleken: It is a lifelong battle: exercise and a good diet.

MMH: What are the most common side effects (i.e. swelling, bruising, etc.) that a patient can expect after undertaking the procedure? How can a patient prepare for these side effects and mitigate them?

Dr. Moelleken: Swelling, pain, fluid collections are common, and usually greatly subside by 2 weeks.

MMH: For how long should a patient expect to have swelling, bruising, soreness, and numbness?

Dr. Moelleken: Numbness lasts typically for many months; significant soreness and bruising usually less than 2 weeks.

MMH: How long after a tummy tuck can a patient resume sexual relations?

Dr. Moelleken: After 2 weeks—like porcupines—carefully!

MMH: Which compression garments and scar healing products do you recommend for a faster recovery?

Dr. Moelleken: Many good postsurgical garments and abdominal binders exist. The real gem is the body shaper, inexpensive and offering great support, which patients start wearing after one week.

 

Brent Moelleken, M.D. is a Beverly Hills plastic and reconstructive surgeon certified by the American Board of Plastic Surgery. He is an attending physician at UCLA Medical Center and Cedars-Sinai Hospitals. He has studied at Harvard and has his MD from Yale University. He has been practicing in Beverly Hills since 1995. He has numerous studies and papers on his American Society Aesthetic Plastic Surgery (ASAPS) award winning superficial cheek lift and over 100 published articles, presentations and abstracts, including many in the Journal of Plastic & Reconstructive Surgery. He is a surgeon on ABC’S hit show “Extreme Makeover,” and Discovery Health Channel, and has over 75 television appearances including Dateline, ABC, CBS, NBC, Extra, and numerous national and international shows. He does extensive charity and volunteer work through UCLA and his “About Face” surgical foundation.

Visit Dr. Brent Moelleken’s Website at: www.drbrent.com.

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