Tummy tuck on large belly poses some unique challenges, which should be recognized prior to surgery to achieve the best results possible and to avoid or at least minimize the incidence of complication.
To shed light on the effects of tummy tuck on large belly, leading Beverly Hills plastic surgeon Dr. Tarick Smiley has recently posted videos and photos of a female patient who had this anatomy.
Aside from the apron-like abdominal skin, the patient also had “bra and back rolls” caused by excess superficial fat, which sits close to the skin. This is different from the deeper visceral or intra-abdominal fat that is linked to obesity and so the only way to eliminate it is through weight loss.
To eliminate the fat rolls along the flanks and upper and lower back, Dr. Smiley performed liposuction prior to the creation of tummy tuck incision.
“I always perform liposuction along the flanks first so I would know how much skin to pull and tighten during tummy tuck,” he said.
During liposuction, Dr. Smiley created several small puncture wounds where a hollowed tube called cannula was inserted and used to break up and remove the superficial fats responsible for the “unsightly rolls” that are more apparent in tight clothing.
Afterwards, the celebrity plastic surgeon created a flank-to-flank tummy tuck incision that was made very low, slightly below the pubic hairline, so “the resulting scar is hidden by the patient’s underwear.”
Dr. Smiley said bleeding is one of the issues in tummy tuck and so all efforts are made to minimize it.
“I pre-treat the abdominal area. Epinephrine is injected prior to the creation of tummy tuck incision; this is a drug that constricts the blood vessels to reduce bleeding,” he explained.
Keeping the patient’s blood pressure relatively low, which is possible because of general anesthesia (administered by board-certified anesthesiologist), also contributes to less bleeding and reduced risk of large fluid imbalance, Dr. Smiley added.
In his previous Snapchat posts, Dr. Smiley said he only works with board-certified anesthesiologist to ensure patient safety.
(Note: Anesthesiologists not just administer numbing medications and sedatives; they also monitor the patients’ vital signs such as blood pressure, oxygen level, and heart rate during surgery.)
Meanwhile, Dr. Smiley removed a chunk of excess skin and fat that almost reached the patient’s knee; it also had a thickness of about 2 inches.
After removing the excess skin and tightening the abdominal muscle, he closed the wound in several rows so the skin would receive no or very minimal tension, which is the key to “favorable” scar, he said.