Dr. Moelleken Clarifies the Differences in Tummy Tuck Procedures
Even
thought 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