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Dr. Levens' Parkland Life Magazine Articles
Beating Belly Fat:
Tummy Tuck, Mini-Tuck and/or Liposuction
By
David J. Levens, MD, PA, FACS
When
dieting, aerobics and sit-ups fail, there are three surgical
options which can successfully address the issue of a bulging belly. Evaluation
by a Board-certified plastic surgeon is the only way to determine
which approach is best for each individual, but here are some guidelines.
Women with “stretch
marks”, sagging, excess skin and weakened abdominal muscles due to childbirth
are ideal candidates for the traditional tummy tuck (abdominoplasty).
Pregnancy causes enlargement of the uterus with significant stretching of the
tissues of the abdomen. After delivery, exercise can help recover the tone
in the muscles themselves, but the fascial tissues (which interconnect the
muscles) do not respond to exercise. Stretching or looseness of these lower
abdominal tissues creates bulging, which no amount of abdominal crunches can
correct.
Other good
candidates for abdominoplasty are men and women who have excess skin, bulging,
and/or stretched muscle tissue as a result of rapid weight loss, poor posture
or the aging process.
Incisions
for abdominoplasty are placed low on the abdomen for concealment purposes.
The length of the incision depends on the degree of looseness in the skin and
how much will need to be removed. An 8-10” incision is typical. Skin
and fat are first lifted off the underlying musculature of the abdomen. If
the fascia tissue is stretched, it is tightened by placing multiple rows of
sutures. In essence, the underlying framework of the abdomen is reshaped.
The skin
and fat are then pulled downward; excess skin and fat are removed. Due to the
amount of skin that generally must be removed, it is usually necessary to make
an incision around the umbilicus (belly button), leaving a barely perceptible
scar inside the umbilicus.
Incisions
are closed with sutures placed beneath the skin. Patients can usually
shower or bathe 3-5 days after surgery but are asked to wear an elastic garment
for two weeks or more after surgery to support the tightened abdominal muscles,
minimize fluid collection and swelling, and increase comfort. Often,
small plastic drainage tubes are used to prevent accumulation of fluid under
the skin; they are removed in the surgeon’s office several days after
surgery. In most cases, patients return to work and social activities within
10-14 days.
If the patient’s
abdominal bulge is mostly beneath the belly button and is being caused by weak
muscles and excess fat—but very little excess skin—a “mini
tuck” can be performed. It typically involves a shorter
incision at the “bikini line” and may include a small incision
at the belly button. Rarely, when there is truly minimal excess
skin and only the separation of muscles to repair, an endoscope may be used
for the tightening procedure, using even smaller incisions. If liposuction
is also performed to remove excess fat, additional small incisions may be made.
While the “mini
tuck” is much less invasive than a traditional abdominoplasty, the majority
of patients with significantly protruding abdomens need the full tummy tuck. Recovery
time for a “mini tuck” is somewhat shorter than for a full abdominoplasty.
If a patient
has a modest belly bulge, strong abdominal muscles, minimal separation of the
muscles and very minimal excess skin, liposuction alone can
produce some improvement. A small incision is made and excess fat is
removed. Once an area has undergone liposuction, fat is highly unlikely
to accumulate there in the future. Though clearly the least invasive
option, liposuction alone cannot achieve the “flat belly” look
produced by the muscle and skin tightening procedures.
#
David Levens, MD, PA, FACS has been
practicing cosmetic surgery in Coral Springs since 1989. In addition to his private practice
at 1725 University Drive, Dr. Levens has served as Vice
Chief of Staff and Chief of Surgery at the Coral Springs
Medical Center. He is Certified by the American Board of Plastic Surgery
and is a member of the American Society for Aesthetic Plastic Surgery
and the American Society of Plastic Surgeons. Dr. Levens has
been cited repeatedly in Miami Metro Magazine’s annual lists
of “Best Doctors in South Florida”. He
earned his medical degree at Columbia University, New
York, and served residencies in general surgery and
plastic surgery at Montefiore Hospital & Medical
Center, New York. He
lives in Coral Springs with his wife,
Linda, and their two children, Danielle and Ben. He can be
reached at 954-752-1020 or www.DrLevens.com
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