Which Tummy Tuck is Right For Me?

(00:03): You're listening to Behind the Double Doors with Houston plastic surgeon, Dr. Bob Basu.

(00:09): On today's show, we're talking about abdominoplasty, or tummy tuck surgery. Our question is from Theresa who lives in Katy, Texas. "Hi, Dr. Basu. Thank you for taking my question. I'm 35. I had twins two years ago. They were big, they were full term, so my stomach really stretched out and never went back. I'm not overweight. I lost all the baby weight a while ago, so I'm not sure if a tummy tuck is the right procedure or if there's something else. I'm not really sure where to start with my research and would like help knowing which direction to go."

(00:38): So Theresa, thank you for your question. Such a common concern for moms, particularly those that have twins. Your loved ones have really damaged your tummy from stretching everything out. We can help. We've got some solutions. It sounds like based on what you've described, you'd be a perfect candidate for a tummy tuck. Obviously, I don't know your medical history, and that would require formal consultation, but based on what you're describing, it sounds like you would do very, very well with the tummy tuck.

(01:01): And the basic aspects of a tummy tuck is that we have to accept some degree of scar to achieve that much, much better form. So scar for transformative form. Now, we work really hard to get that scar as low as possible, ideally hidden in your bikini line or your undergarment line. Typically, the incision is hip to hip. But when you have more severe loose skin, I may need to consider you for an extended tummy tuck, which simply extends a scar a little bit longer beyond the hips, along your bikini line. And I work really hard to get that scar as low as possible, because look, we get it. Jeans are cut lower, bikinis are cut lower. So I want you to feel comfortable wearing what you want to wear after you're all healed.

(01:40): There's also an incision inside your belly button, which we can use to reduce your belly button size. I often do what's called a reduction umbilical plasty with all my tummy tucks, because that helps me to give my patients a very cute little innie. The belly button is such a hallmark. It's an important landmark, and a great looking belly button achieves a very natural looking washboard tummy. So belly button is really important to me for my patients.

(02:04): In addition to removing excess skin and fat from your lower belly, we're also tightening up those ab wall muscles, or your rectus muscle. So Theresa, you had twins, you had big babies. Those muscles are likely stretched out, and those stretched out muscles are likely creating a lot of bulging. A lot of moms come in and say they feel they look pregnant still because they're bulging out. They're not overweight. It's because their muscles are stretched out, and no amount of diet exercise can help bring those muscles back into play. So what we do with every tummy tuck is we tighten the muscles. The muscle tightening is really the internal power of the tummy tuck. It's what allows me to give you that flat washboard belly. It's very common that we also look at the waist, because what I don't want to do is give you a flat washboard belly and you still have the muffin top on the side. So it's really common. About 80% of the tummy tucks that I do, we do simultaneous liposuctioning of your waist to help give you a really nice hourglass shape.

(02:55): Oftentimes also we're looking at the mons, or pubic area, particularly for women who've had C-sections. The mons can fall, so we do a mons or pubical lift to tighten up that area. Oftentimes we will also do a mons or a pubic reduction. What you don't want is to have a tummy tuck and you've got a nice flat tummy, but then your pubic area is bulging out. It looks very awkward if you're wearing form-fitting clothing or exercise clothing or yoga pants. So in some cases, we'll also do a mons lift or reduction. So tummy tuck really is a very powerful procedure to really transform your abdominal wall. And I think, Theresa, for you, having had twins, it's likely a tummy tuck is what I'd recommend.

(03:30): So a mini tummy tuck, I mean, who doesn't want a mini procedure? But the problem with the mini tummy tuck, and in my extensive experience seeing six to eight mommy makeover consultations every single office hours to date, less than 3% of patients, moms that I see are actually candidates for mini tummy tuck. And what a mini tummy tuck is it simply makes a C-section type incision, a little bit longer than a C-section scar, and you're just removing excess skin and fat in the lower tummy area. Now you can do some liposuction at the same time.

(04:03): So who's actually a good candidate for a mini tummy tuck? Well, it's the patient who looks amazing above their belly button. They've got no muscle separation, so their tummy is pretty flat. But all they have is loose skin in their lower belly. Their belly button looks great, upper tummy looks great. They have no muscle separation or bulging. All they have is loose skin hanging in their lower tummy. A patient who might be a good candidate for that is someone who's had a C-section, who looked great in their upper tummy, their belly button looks great, and they just have loose skin hanging over their C-section scar. That's a pretty rare patient that I see in my practice.

(04:39): Most moms need more than just a mini tummy tuck. I do a lot of revisional work, and unfortunately, I do see patients who went elsewhere and had a mini tummy tuck when they needed a full tummy tuck. The result is not good. What happens is the lower belly may look flat, but now they have excess skin hanging over their belly button that was never treated, the muscle separation was never treated, and they have loose skin in their upper tummy. And that's a challenging problem to fix. So it's important to do your homework, visit with a board certified plastic surgeon, look at before/after pictures, and create a treatment plan that you and your surgeon on the same page about.

(05:15): On the other spectrum of tummy tucks, there is an extended tummy tuck. And extended tummy tuck simply means I'm extending the tummy tuck scar along the bikini line further back. The reason why I would need to do that is if you have loose skin in your waist, well, we don't want to leave that loose skin hanging in your way, so I extend the scar to remove that skin so I can pull in your waist and give you a much nicer waist contour. Sometimes when I do liposuction of the waist, remove the love handles, or the muffin top of the sides, there's loose skin left behind when you hollow it out. So I have to extend the scar laterally, so I can remove that skin to give you a much nicer result.

(05:56): It's important to remember that a tummy tuck, like most body contouring procedures, the basic principle that applies is that we have to accept some degree of scar to achieve that much, much better form. And I know it can get potentially confusing in a podcast to talk about the differences between a mini tummy tuck, a full tummy tuck, and an extended tummy tuck. I encourage you to visit our website @basuplasticsurgery.com. And on our website on our procedure page, we actually have a diagram that will show you, and it illustrates exactly the differences between these three procedures, so you have a better understanding of what each procedure entails.

(06:28): To learn more about tummy tucks, visit our website at basuplasticsurgery.com. We have hundreds of tummy tuck before/after photos of my patients. So I encourage you to visit the galleries, visit our procedure page, and I encourage you to follow us on Instagram @basuplasticsurgery.

(06:48): Take a screenshot of this or any podcast episode with your phone and show it at your consultation or appointment to receive $50 off any service at Basu Plastic Surgery. Basu Plastic Surgery is located in Northwest Houston in the Towne Lake area of Cypress. To learn more about the practice or ask a question, go to basuplasticsurgery.com/podcast. On Instagram, follow Dr. Basu and the team @basuplasticsurgery. That's B-A-S-U Plastic Surgery. Behind the Double Doors is a production of The Axis, T-H-E A-X-I-S.io.