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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