Tummy Tuck–Mini Vs. Full

A lot of women have questions about the difference between a full abdominoplasty (or tummy tuck) and a mini-abdominoplasty.

Although the terms sometimes mean slightly different things to different practitioners, in my practice a mini-adominoplasty involves a smaller incision and less dissection, and no scar around the bully button.  Unfortunately, this also usually means less result.  The reason is that I cannot get as much skin removed, and I certainly cannot achieve as much fascial plication.  a full abdominoplasty involves more dissection, more plication, and a scar around the belly button, but also a typically more dramatic result.

So who gets a mini?  Although most women I see are better candidates for a full tummy tuck, occasionally I see a lady who has just the right combination of tightness above the belly button and looseness bleow that I think they will get a reasonable result from a mini.  And, as always, my job is to present them with options and let thaem decide. 

And while some women are really concerned about the scar around the belly button in a full tummy tuck, most of these women are not revealing their tummies to the world anyway, so if they are able to get a good enough scar that they feel comfortable with a bare midriff-great.  Otherwise they still usually derive benefit from clothes fitting better and having the abdomen be tighter.

The lower scar from either a full or a mini I try to keep very low, so as to hide under underwear or a bathing suit (perhaps not all styles!).  Usually this is an acceptable tradeoff to people for a better shape.

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Tummy Tuck vs. Liposuction

A lot of women I see want their abdomen rejuvenated. 

A common question is if liposuction will work.  For most women who have had kids, they probably need an abdominoplasty (tummy tuck) to get the result they are after.  remember, liposuction only removes fat.  A Tummy Tuck removes both fat AND SKIN, and also it tightens the abdominal wall.  So if there is loose hanging skin, although you COULD suction it, I would hate for a woman to undergo the trouble of doing the procedure unless she is going to get what she wants out of it, and for many women this involves removing the extra skin. And the tightening of the body wall is the “secret weapon” that I find does a lot of good, but that women don’t understand on the front end. This tightening does not occur with lipo. (When I do this, I physically pull together the “six-pack” muscles that have splayed out either from pregnancy, or weight loss, or whatever reason.)

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Mommy Makeover–What’s in a name?

Many great-sounding procedures in Plastic Surgery are a slight twist on established procedures that come with fantastic-sounding marketing names.  Even catchy names that are not associated with a company gain traction.  As an example, when I first got into plastic surgery, I thought “tummy tuck” sounded completely hokey and couldn’t believe, serious, educated, capable doctors used that term instead of “abdominoplasty”.  (Now I am in that category–it seems totally normal!)

The term “mommy makeover” falls in the same category, in my opinion.  I see a lot of women who never thought they would be seeking the services of a plastic surgeon, but have had pregnancy wreak havoc on their bodies. 

What is a “mommy makeover”?  Well, it could mean a lot of things.  But typically it refers to rejuvenation of a woman’s breasts and abdomen after childbirth.  For breasts, this could include breast implants, breast lift (mastopexy), breast reduction, or a breast lift in conjuction with implants (an “aug/-pexy”). 

Usually the abdomen needs a tummy tuck, but occasionally we can do liposuction alone on the abdomen, or sometime a mini-abdominoplasty.  (Most women who have had kids do better with a full abdominoplasty, in my experience).

And a lot of women are happy to consider a little liposuction on the outer or inner thighs.

So usually a mommy makeover is some combination of breast surgery and body contouring.  These operations are not new, but the TERM “mommy makeover” seems to be pretty new.  As always, my job is to give women education and provide options.  The final choice is up to the patient!

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San Antonio Silicone Breast Implants

A lot of women have questions about the use of silicone breast implants.

All breast implants have a shell on the outside and a filler on the inside. Saline implants use salt-water as a filler, but the shell of saline implants is SILICONE.

Let me back up and tell you a little about silicone. Silicone can be classified as an oil, gel, or elastomer. Just like there are different metals or different plastics, there are different silicones. Silicone elastomer is solid and is what is used for the shell of breast implants. If you are wondering what this is like, imagine a thicker ziploc bag–this is similar to the shell of a breast implant (although I do not know what ziploc bags are made of!).

In the first generation of breast implants, the filler was silicone oil. This was a liquid, and while not as runny as water, could flow more easily than the silicone gel. Currently the fillers used in silicone breast implants is silicone GEL. This is thicker, and if you cut a breast implant in two in my office, it does not run out. Imagine Jello on a dish. It doesn’t run off. And although being in someone’s body is a different, dynamic situation than being on a dish, the newer gels are hopefully less runny than the older implants. Sometimes people call these GUMMY BEAR implants.

Why do we care? Well, in 1992 the FDA took silicone breast implants off the market because they were concerned that ruptured implants were making women sick. When they did the science to check on it, they found that there was no evidence that ruptured silicone breast implants caused any systemic disease (although the implant may not seem right). So in the fall of 2006, silicone implants were put back on the market in the US. They were never off the market in South America and Europe (as far as I know). Breast augmentation remains the #1 plastic surgery procedure for women.

Of course, saline implants remain a good option as well! At least women have the choice now.

For more information on Silicone Breast Implants visit breastimplantsafety.

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