The 411 on Tummy Tucks

Are exercise and weight loss not giving you the abdomen you desire?

The tummy-tuck (abdominoplasty) procedure helps to flatten your abdomen by removing excess skin and fatty tissue.  This procedure is suitable for men and women who are in good general health. Tummy tuck should not be confused with liposuction (the cosmetic surgery used to remove fat deposits), although your surgeon may also elect to perform liposuction to improve the overall results. Good candidates for tummy-tuck are women who have muscles and skin stretched by multiple pregnancies, and persons who were obese at one point and still have excessive fat deposits or loose skin in the abdominal area.

If you are a woman who is still planning to have children, you may want to wait to investigate the tummy tuck procedure until you are through bearing children. If you are planning to lose weight, you do not want to consider a tummy tuck until you have reached and are maintaining your goal weight.

How is a tummy tuck done? 

Depending on your desired result, this surgery can take from 1-2 hours.  The complexity is dependent upon the amount of excess tissue you have in the lower abdominal wall. Most patients will receive a general anesthetic. There are several options for tummy tuck.  Your surgeon will examine you and then discuss your desired results and anticipated outcome for each. 

Complete abdominoplasty.  The incision is made in the lower abdominal wall area, from hipbone to hipbone.  The excess tissues beneath the umbilicus (belly button) are subsequently removed and the scar is hidden beneath the panty line. 

Belt abdominoplasty. This procedure is for patients who have usually lost a considerable amount of weight, and the laxity of the skin and fatty tissues occurs not just on the front of the abdomen, but also around to the back.  This requires a circumferential excision of these tissues to get the overall best result. 

Partial or mini abdominoplasty. Partial or mini abdominoplasty is often performed on patients whose fat deposits are located in a very small area beneath the belly button.  This procedure can be done in the office with local IV sedation.

How to prepare for a tummy tuck

If you are a smoker, you will have to stop completely for a certain period, as determined by your doctor, because smoking can cause improper and poor wound healing. It is also important to eat a well balanced diet, as nutrition plays a key role in the healing process. Your physician will discuss with you the medications that you are currently taking and whether these can be taken during the time leading up to your surgery.   

What are the potential complications and side effects of tummy tuck surgery? 

In the approximately 1,000 procedures that I have performed, most patients rate the initial pain level at 3 to 5 on a scale of 1 to 10.  After surgery, all patients should expect some type of minor discomfort for at least one week; swelling may occur for 2-5 months. You may experience some numbness and bruising over the treated areas. The numbness will resolve between 2-6 months after your operation. With any surgery there are risks, the most common are infection, excessive scarring and skin loss. 

Does insurance cover this procedure? 

Insurance carriers generally do not cover elective cosmetic surgery, but your carrier may consider coverage of a certain percentage, if you have a hernia that can be corrected during this procedure. You should discuss this with your surgeon during your initial consultation.

Recovery 

The majority of my patients love their look after this procedure; however, you must realize that you might not feel like yourself for several weeks after this operation. Most patients can probably return to office work within two weeks and heavy lifting within 3-5 weeks. Your body has been under tremendous stress, both emotionally and physically. It is very important that you follow proper diet and exercise to maintain your new look.

For more information, please visit our website at www.ruckermd.com. Feel free to leave a comment and visit our Facebook page at www.facebook.com/ruckermd.

Moles on the Mind.

 
    Unless you are Cindy Crawford, having a mole is probably not your trademark. Moles are not only an aesthetic distraction but can get in the way of shaving, can rub against clothing or jewelry or be a source of suspicion.
     In the majority of cases, a mole is merely a benign growth in the skin. They come in various shapes and sizes and can appear literally anywhere on the body. Some are clustered in groups and some are singular. You can be born with a mole or discover them over time. On rare occasions they may be pre-cancerous--reason enough to have them checked, if not removed completely.
     Why hesitate?  Despite the obvious cosmetic reasons most people postpone mole removal because they fear it will be painful and/or cause scarring.  For years physicians removed moles through direct excision which meant minor surgery that required anesthetic and sutures. In reality, this technique did involve a higher risk of excessive scarring.
     Freezing moles was and is another popular method, but recurrence is common and scarring can still be an unwanted byproduct.  Chemical removal is discouraged as it is almost always accompanied by noticeable scarring.    
     The good news is that mole removal, with minimal or eliminated scarring is available and is our preferred method of addressing this concern. Radio surgical mole removal involves a laser-like pencil device to remove the lesions with thermal energy. A local anesthetic is applied. There is virtually no scarring because stitches are unnecessary. The mole can easily be sent away to check for harmful cells. Most procedures take less than 15 minutes depending on the number of moles. Over the course of a few days the skin heals, leaving little trace that the lesion was ever there.  Deeper or larger moles might leave a small pink spot that will fade or become lighter over time.
     In my 25 years of experience with over 10,000 cases I have found this method to be the most quick, painless and effective technique for removing moles without significant scarring. There is no excuse to wait for smoother, clearer skin.

For more information, please visit our website at www.ruckermd.com. Feel free to leave a comment and visit our Facebook page at www.facebook.com/ruckermd.

Profiles Winter 2012

The new Profiles is out! Pick up your free copy at any participating business or in one of these newspapers: 

2/11: Eau Claire Leader Telegram
         LaCrosse Tribune
2/12: Chippewa Herald
2/15: New Richmond News
         River Falls Journal
         Hudson Star Observer

Click to view Profiles Winter 2012!

Q & A with Dr. Rucker: i-Lipo and Non-Invasive Fat Removal

Q: Do you or will you be offering the i-Lipo procedures? Also, please explain the technology behind non-invasive fat removal. - RP

A: Fat removal without surgery 

Treatments that work through the skin to reduce the fatty layers are considered non-invasive. Over the next 2 to 3 years we should expect to see several technological breakthroughs for this type of fat removal.. These treatments utilize energies to reduce the fatty layer without damaging the skin layer. These devices currently utilize ultrasound, radiofrequency energy or a combination of them. All of these devices are designed to deliver energy to fat and collagen cells within the skin to reduce the fatty layer and secondarily reduce body circumference.

Multiple treatments needed
Approximately 4 to 6 treatments may be required, depending on the patient. Each treatment may take anywhere from 20 to 60 minutes. In those individuals maintaining a healthy lifestyle including regular exercise and proper diet, the results may last for up to 6-12 months. Maintenance treatments are generally required for most patients to retain their results.

Various treatments available 
Here is a brief review of some of the devices non-invasive fat removal. This is just a brief list and may not include every device out there. It is merely meant to give you an overview of what’s available and how some of these technologies work

Thermage® 
Thermage is a non-invasive treatment that uses radiofrequency energy to tighten and contract collagen fibers that lie deep in the skin, reducing the appearance of fat in the process.. The draw back with this technique is that many patients feel it is too painful.

Cryolipolysis™
Cryolipolysis is a developing, non-invasive fat removal technology.   It claims to use cold to kill fat.  The claims are that, this fat-freezing process not only destroys unwanted fat cells, but also leaves surrounding tissue and skin unharmed. While Cryolipolysis has not yet received FDA approval for fat reduction, results from animal studies have been positive to date. Further clinical trials are currently underway. Sit tight.

LipoSonix®
LipoSonix is a technology which uses high-intensity ultrasound to warm, "melt," and remove pockets of unwanted fat. As with several other non-invasive techniques, dissolved or melted fat is naturally filtered out of the body via the lymphatic system and eventually excreted through urination. LipoSonix is still in development and has not received FDA-approval for use in the United States. 

VelaShape™
VelaShape is a procedure that uses radiofrequency and light energy to re-contour the body and "shrink" fatty tissue.

i-Lipo 
i-Lipo is a non-invasive fat reduction device that utilizes low energy lasers to reduce the fatty deposits.  It is FDA approved. However, I have concerns about the safety of laser technology for this purpose.  

UItraShape®
UltraShape is a new, non-surgical technique that uses ultrasound pulses claiming to "blast away" targeted fat cells, meanwhile keeping surrounding tissue safe and whole. The manufacturer claims it may remove unwanted fat and provide effective body contouring, claiming to reduce the circumference of treatment areas by 1 ½ inches (4 centimeters). Some patients have seen reductions as great as 4 inches (10 centimeters). UltraShape has not yet received approval from the Food and Drug Administration for use in the U.S. This is the technology that I am awaiting FDA approval of.  I have researched the device and I feel that better results with less discomfort can be attained. 

I will continue to post on my blog and keep you informed of any new developments in this field.  
JR

Q & A with Dr. Rucker: Rhinoplasty Imaging

Q: I have been in for a rhinoplasty consultation and you do not do imaging to show what the nose may look like after surgery. Would you consider doing this? If not, why not? I am going to have it done but would like see something like this.

A: In regard to your question regarding computer imaging in an attempt to better visualize the result of a rhinoplasty.  I have researched this technology extensively and have used the software required for computer imaging.  I have come to the conclusion that this is not a viable option for my practice for the following reasons. 

1. I feel the imaging process does not give an accurate picture of the result in many cases. This has been a concern with this technology throughout the plastic surgery community.  This discrepancy in anticipated results has lead to a significant amount of displeasure with patients seeing one result and in reality not receiving that result.  

2. I feel that those users of the technology tend to over estimate the anticipated result on the computer image, which can also lead to a strain on the patient to physician relationship. This technology I feel is better suited for showing possible results following body contouring but is significantly lacking with trying to show the anticipated results on the face.  I try to present a mental pictures to the patient of the anticipated result.  I emphasize shape, tip reduction, nostril changes and alterations of the bridge of the nose.  In this way I feel that each patient can better understand the anatomy and how we anticipate the changes that we propose for it.  The most common concern that my patients tell me is that I don’t want my nose to be overdone.  We strive to give a result that looks natural and compliments the overall appearance of the face.    

JR

Welcome to the Rucker MD Plastic Surgery Clinic blog. Through this blog, we hope to provide and educate you with information on the ever-evolving field of plastic surgery as well as post announcements and specials for our Medispa on here. Feel free to leave any questions, ideas or comments and we will be sure to read them. We hope you enjoy your visit.