BLOODLESS EXTENDED TUMMY TUCK BY DR GABRIEL PATINO 06 25 2021

An Abdominoplasty or a tummy tuck Is done under general anesthesia and tumescent anesthesia at our fully accredited Cosmetic Surgical Center of El Cerrito. The procedure involves the removal of all the excess fat and excess skin below the level of the bellybutton. The entire abdominal wall is usually detached from the underlying fascia which covers the rectus abdominal muscles (Six pack). The remaining abdomen is called the flap because it is usually detached from its vascular supply. The blood supply to the flap is derived from the thoracic and lumbar adjacent blood vessels and any remaining perforator blood vessels ( Arteries that perforate through the fascia to nourish the flap). The umbilicus is usually pulled through an opening in the flap. A rectus muscle plication Is usually done for those patients who are not planning to become pregnant again. The rectus plication consists of bringing these twin muscles together in the midline with permanent sutures. The rectus muscles usually separate during pregnancy in order to allow more space for the baby to grow. This normal separation of the rectus muscles during pregnancy is called a rectus diastases. Sometimes a hernia may be present and it can be repaired at the same time. Simultaneous repair of an umbilical hernia has an increased risk of necrosis (umbilicus skin death) and subsequent infection. Dr. Gabriel Patino usually recommends that any known hernia be repaired before the tummy tuck but if a hernia is incidentally found during the surgery a hernia repair can be done at the same time provided that it can be safely done. Many surgeons do liposuction to the love handles (flanks) at the same time in order to limit the extent of the abdominoplasty scar. I believe that limitation of the length of the scar compromises the results. I prefer to do an extended abdominoplasty and then do an extended Liposuction not just to the love handles but to the entire abdomen and back if indicated. I usually wait six months after the abdominoplasty to do an extended liposuction because by that time the blood supply to the flap has regrown and the risk of necrosis of the abdominal wall ( death of the flap) is nil. The tumescent Anesthesia decreases the post operative pain, Intraoperative and postoperative bleeding, bruising and blood clots. I t also provides a much faster recovery. With this operative technique the Jackson-Pratt drains are usually removed much faster in the order of 3 to 5 days. A post operative compression garment is usually worn for the first six weeks. Walking is strongly encouraged immediately after the operation in order to minimize the risk of blood clots. The scar can be usually hidden in a bikini. Before and after photographs are taken at six weeks postoperatively. A breast augmentation ( mommy makeover) can be done simultaneously using silicone or Saline implants which can be placed through the abdominoplasty incision without any scars on the breasts, nipples or armpits. A Torsoplasty is when the ABDOMINOPLASTY incision is extended to also cover the entire lower back in a 360 degree circumferential belt like fashion. A torsoplasty is also known as a belt Lipectomy or a lower body lift because in addition to addressing the abdomen it also removes excess fat and excess skin in the lower back so the incision is located just above the buttocks.

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