What’s the Difference Between Panniculectomy & Abdominoplasty?

It’s not unusual for massive weight loss patients to develop loose, saggy abdominal skin. This excess skin can cause a variety of functional problems including chronic rashes, infection, and back pain. In addition, loose abdominal skin may cause aesthetic deformities which effect self-esteem and self-image.

For these reasons, patients frequently seek corrective surgery following massive weight loss. When this situation arises, a variety of treatment options exist that address the skin, fat, and underlying muscles. These procedures are tailored to the patient’s specific anatomic findings and unique aesthetic goals. 

In some cases, an abdominal panniculectomy can be performed. This procedure involves removal of excess lower abdominal skin. When this skin apron is removed, the umbilicus and underlying muscles are left alone. This procedure has a significant impact on function, but has aesthetic limitations. These include continued upper abdominal loose skin, pubic skin sag, and weak abdominal muscles. 

For these reasons, it’s not unusual for patients to request abdominoplasty surgery. This procedure not only removes excess lower abdominal skin, but also removes excess upper abdominal skin and tightens the abdominal muscles as well. This procedure requires detachment of the umbilicus and transposition to a higher level. It’s associated with improved functional results and dramatically improved abdominal aesthetics. Unfortunately, tightening the abdominal muscles does occasionally prolong the recovery period. 

It’s important to realize that each patient’s situation is unique. For this reason, it’s important to discuss your aesthetic goals with your plastic surgeon. Your plastic surgeon should be able to formulate a treatment plan that’s appropriate for your aesthetic goals and life style. In your case, it may not be appropriate to tighten your abdominal muscles. 

C-Sections & Tummy Tucks

Abdominoplasty isn’t recommended immediately following a C-section for a variety of reasons. These include the inability to make aesthetic judgments immediately following pregnancy, the mother’s overall health status, and the demands of a newborn child on the mother.

The timing of surgery following pregnancy is important and several issues should be considered before proceeding with surgery. It takes time for a new post-pregnancy body to reach its new baseline following pregnancy, and during this transition, it’s impossible to make aesthetic judgments. During this period, stretched skin may contract, a swollen uterus may shrink, and the weight gained during pregnancy may gradually disappear. This process takes 3 to 6 months and needs to occur before abdominoplasty is performed. 

Ideally, patients should be within 10% of their ideal body weight and in good health otherwise. The majority of women who have undergone C-sections aren’t in good physical shape and are therefore not optimal candidates for surgery for a variety of reasons. These may include severe fatigue, a depressed immune system, possible blood loss, an increased potential for infection and elevated estrogen levels which can increase the risk of blood clots.

Finally, the demands of a newborn would make the recovery from these combined procedures very difficult. For instance, the use of postoperative pain medications would prevent you from breast feeding. In other words, the abdominoplasty might impact your developing relationships with your newborn child. 

For all these reasons, it’s obvious that C-section and abdominoplasty shouldn’t be performed together. If you’re considering abdominoplasty it’s important to give yourself time to fully recover from your C-section. Once this has occurred it’s appropriate to consult a board-certified plastic surgeon.  

Is There An Age Limit for Breast Augmentation?

We frequently see women in their fifties and sixties who request breast augmentation. In the vast majority of these patients, breast augmentation can be performed without any difficulty.

It’s important to realize that as we get older, changes occur in our bodies.  These changes are often related to multiple pregnancies.  In many cases, they have developed loss of breast volume and associated breast sag.  For these reasons, many of these patients will need breast lifts at the time of their breast augmentation.

The Impact of Weight Gain Following Tummy Tuck

Significant weight gain can occasionally occur following tummy tuck surgery.  In the vast majority of abdominoplasty patients this is not a problem.  In abdominoplasty patients, life-style changes are often an important part of their recovery. They tend to watch their diet and exercise more frequently.

Unfortunately, when weight gain following abdominoplasty occurs, the impact upon the procedure can be significant. Many of the original problems such as loose, saggy skin, weakened muscles, and stretch marks can be recreated.

Can Skin Sag Result From Abdominal Liposuction?

Every patient has the potential to develop loose skin following liposuction surgery. It’s therefore important that this topic be a part of the preoperative discussion and informed consent process.

The potential to develop loose skin varies from patient to patient. This determination is based on physical examination alone. Some patients have excellent skin tone with minimal laxity and aren’t likely to have difficulty with skin sag. These patients are often younger and are close to their ideal body weight. In this group, liposuction is an excellent treatment option with high satisfaction rates.

There are also patients who are clearly at risk for developing skin sag. This group is often older and their skin has more laxity. They have experienced greater fluctuations in their weight and have had multiple pregnancies. In many cases, they are not within 10% of their ideal body weight. They may also have associated weakness of their underlying abdominal muscles.

The Management of Breast Asymmetry

Breast asymmetry is an extremely common problem amongst women. In most cases, this is relatively minor and women aren’t bothered by it. Occasionally, it can be severe and treatment is necessary.

A multitude of options can be used to treat this problem. These may include breast reduction, breast lift, breast augmentation, or various combinations of these procedures.

It’s important to realize every patient is unique. They have specific aesthetic goals and unique anatomic findings. The specific treatment for any individual patient will depend entirely upon these issues.

Choosing a Plastic Surgeon

It’s important for patients to be comfortable with their choice of plastic surgeon before proceeding with cosmetic surgery. When choosing a surgeon, several issues should be considered. These include the surgeon’s training, certification, and experience.

Completion of a plastic surgery residency is an essential requirement when picking a surgeon. Although it seems obvious that cosmetic surgery is a procedure that should be performed by someone trained in plastic surgery, this is not always the case. There are many physicians who perform cosmetic surgery who haven’t completed plastic surgery training. They frequently refer to themselves as cosmetic surgeons and have trained in a variety of other areas.

Board-certification is also extremely important. This means that your surgeon has undergone testing and peer review. He or she has satisfied certain criteria that are associated with surgical excellence.

One of the most important factors is your surgeon’s level of experience. Surgeons who have extensive experience with aesthetic surgery tend to have higher success rates.

Keep Calm & Fight On!

Aesthetic Surgical Images’ Staff Members Attend Race for the Cure

This past Sunday, October 6th 2013, Aesthetic Surgical Images’ staff members participated in the Susan G. Komen Race for the Cure. The annual event helps raise funds to support breast cancer research. The event honors those who have lost their battle with breast cancer while celebrating those who have survived breast cancer. In addition to supporting research, the event also promotes breast cancer awareness, education, and early breast cancer detection.

We Have A "BOO"-Tox Special, Now Through October 31st!

 We Have A "BOO"-Tox Special, Now Through October 31st!

Mini Tummy Tuck vs. Full Tummy Tuck

Pregnancy has a significant impact on a woman’s body, and nowhere is this more noticeable then the abdomen. This area develops excess, saggy skin, weakened muscles, and stretch marks. Despite diet and exercise, most women are unable to reverse these changes and this ultimately affects their self-image and self-esteem. Treatment options are limited and in most cases involve either abdominoplasty or mini abdominoplasty.

Abdominoplasty is performed by making a lower abdominal skin incision and then lifting the skin and subcutaneous tissue to the level of the rib cage. This typically requires detaching the belly button, which allows more skin to be removed. The muscles are then tightened, excess skin removed, and the belly button re-attached in proper position.

Recovery Following Facelifts

Facelift recovery varies from patient to patient and depends on a large number of variables. Just as every patient is unique, the chosen procedure for he or she is unique as well. The differences in wound-healing characteristics and the type of procedure performed account for variations in facelift recovery.

Most patients feel pretty good in about four to five days, but their primary concerns are when they will look good enough to go out in public. Recovery following facelift surgery may last for months, but most patients feel they can go out in public in about two weeks. At this point, most of the bruising and swelling have resolved. Many patients adjust their hairstyle to hide their incisions and use make-up as well.

Breast Augmentation & Under Wire Bras

We generally avoid using under wire bras for six to eight weeks following breast augmentation. There are two reasons for this approach. First, when patients undergo sub muscular placement of breast implants, the pectoral major muscle may undergo spasm in the early post-operative period. This may force the implant in an upward direction and lead to malposition. When this situation arises, we utilize compression to force the implant in a downward direction. An under wire bra would have the opposite effect.

Another reason for avoiding under wire bras in the immediate post-operative period is the potential for the bra to irritate a fresh surgical incision.  An infamammary incision would be directly beneath the under wire bra and this might lead to irritation of the incision.

Signs of Breast Implant Leakage

In the majority of patients undergoing breast augmentation, implants last a lifetime. Occasionally, implants deflate and need to be replaced.

Current data suggests that implants deflate at a rate of 1% at one year and 3% at three years. Over time, this number can be expected to grow. Implants may deflate with no apparent cause or may deflate secondary to trauma.

When saline implants deflate, the diagnosis is relatively easy to make. These implants lose volume and flatten quickly. Silicone implants present a much more difficult problem when they deflate. Rupture of silicone implants may not be apparent for years.

Signs of deflation include soreness, redness, loss of volume, change in shape, and sometimes, capsular contracture. These signs may be subtle and a history of trauma may be the only early indicator.

Aesthetic Surgical Images Sees 100,000th Patient

When you’re considering cosmetic surgery, the experience of your surgeon is extremely important. In 1970, Aesthetic Surgical Images saw its first patient. We are proud to say that after 43 years, we have seen over 100,000 patients. This is not only a testimony to our longevity, but the support of the community as well.

One of the driving forces behind the achievement of our practice is the strength of our surgical team. Comprised of four, board-certified plastic surgeons, our team members were selected not only for their credentials, but also for how their skills would complement one another for the benefit of our patients. For these reasons, you can count on our surgeons to provide integrity, trust, and excellence from the consultation and surgery to each postoperative visit.

Drs. Heieck, Edney, Bruneteau, and Montag want to thank the community for your continued support and look forward to serving you well into the future. As always, our cosmetic consultations are complimentary. To schedule a day or evening appointment, please call 402.390.0100.

When is the Best Time to Get a Mommy Makeover?

Pregnancy causes significant changes in a woman’s body.  These changes vary from patient to patient and are permanent in most cases unless surgery is undertaken to reverse them. These changes can affect the breast, abdomen, and lead to fat accumulation in the hips and thighs. Many patients attempt diet and exercise, but this isn’t always helpful.  This problem can ultimately affect self-confidence, self-esteem, self-image, and the quality of day-to-day life. For these reasons, many patients request breast augmentation, tummy tuck, and liposuction.

The timing of surgery following pregnancy is important and several issues should be considered before proceeding with surgery. It takes time for a new post-pregnancy body to reach its new baseline following pregnancy. During this period, stretched skin may contract, a swollen uterus may shrink, and the weight gained during pregnancy may gradually disappear.

The breasts also undergo significant changes with pregnancy and breast-feeding. This results in breast enlargement, which continues with nursing. After nursing is stopped, it takes time for the breasts to return to their new baseline. At this point, the breasts may be smaller and have sag. This process takes three to six months to occur. All of these changes need to occur before a mommy makeover is considered.

What is an Endoscopic Browlift?

Brow descent occurs with normal aging and is typically treated with a browlift. The traditional open transcoronal approach and the endoscopic approach are the two most commonly used techniques. 
 
A transcoronal browlift is performed by making an incision across the top of the head from ear to ear. The forehead skin is lifted off the bone to the level of the orbital rims. The forehead muscles that are responsible for frown lines are then treated under direct vision. The brow is elevated by removing a strip of skin along the incision. 
 
In contrast, endoscopic browlift is performed through several small incisions placed behind the hairline. The operation is performed with a scope, ultimately accomplishing the same basic maneuvers as the open approach. 

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At Aesthetic Surgical Images, we are now offering special pricing for all CoolSculpting treatments. Let this be our gift to you and our way of saying thanks for another year of continued support.

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Call 402.390.0100 for more information
or to schedule your FREE consultation today!

Tummy Tuck Scars

It’s safe to say that it’s impossible to perform a tummy tuck without scarring. This operation trades stretch marks, loose skin, and weakened muscles for a scar that is hopefully well positioned.  The patient’s particular anatomy will have a profound impact on scar placement. Factors such as the transverse width of the abdomen, the distance from the pubis to the rib cage, the position of the umbilicus, and the patient’s stretch marks are all extremely important variables.

Each patient is unique and it’s important to have good communication between the patient and surgeon. We find that it’s very helpful to perform pre-operative markings with the patient wearing her swimsuit. By utilizing this maneuver, confusion regarding incision placement is minimized.

How Long Do Breast Implants Last?

This is a commonly asked question and a frequent source of confusion amongst patients. There is a common misperception that breast implants should be replaced every ten years. The origin of this belief is unclear, but is probably secondary to misinterpretation of implant warranty terminology.

The manufacturers of breast implants clearly state that these devices are not intended to last a lifetime, despite this many patients can expect to have implants last their entire lifetime. Current studies suggest that implants deflate at a rate of 1% at one year and 3% at three years. Over time this number can be expected to grow.

Implants may deflate with no apparent cause or may deflate secondary to some type of trauma. Under these, the decision to replace implants is easy.

Father’s Day Botox Special!

Not sure what to get that special Dad for Father’s Day? How about some Bro-tox? Bro-tox is Botox for men! Bro-tox makes a great gift for all those hard working Dads! 

Does Dad always look stressed or angry? Does he have lines between his eyes? Are the lines on his forehead getting deeper? 

At Aesthetic Surgical Images, we can help get rid of those angry frown lines by performing a simple Botox injection. For the months of June & July, men will receive a 10% discount on Botox injections. Let this be our gift to you and our way of saying thank you for another year of continued support!

Call today and say you were referred by the Father’s Day Botox Special!

402.316.5739