• Important Articles on Tummy Tuck
  • For some patients, there is sweating and discomfort around the loose skin. After childbirth, some women will say that sometimes they still feel pregnant, and a tummy tuck can reverse that. Additionally, some women experience a loose, empty, or full vulva.

    While diet and exercise will reduce fat and strengthen muscles, they cannot remove loose skin, stretch marks, or tighten separated muscles. Indeed many tummy tuck patients are very thin and fit. When the skin is loose and muscles are separated, there simply is no alternative to some type of a tummy tuck. Simply put, a tummy tuck does something that nothing else in the world can do.

    Tummy tuck patients are among the most thrilled plastic surgery patients. Once again they can wear a bikini. They no longer see skin and fat rolling over their underwear. They can bend over and not feel loose and wrinkled skin hanging down. After a tummy tuck, the most stylish clothing can fit well and patients regain a sexiness and beauty they may not have had for years.

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    The concepts behind this type of tummy tuck are abstract and in this paper Dr. Teitelbaum explains them to other surgeons.

    Tummy Tuck Procedure

    Tummy tuck surgery involves a continuous spectrum of options, ranging from a mini tummy tuck with a short scar, to a full tummy tuck that can remove a lot of skin and fat, tighten muscles, and fix hernias. Dr. Teitelbaum is a master at assessing the individual components of each patient's problems and will work together with you in a step-by-step manner to create a custom operation for you. In this way, he hopes to provide you with the best tummy tuck Los Angeles can offer.

    The primary objective of an abdominoplasty is to create a svelte and beautiful abdomen. Many patients also have laxity in their pubic area and groin, or even their upper thighs.

    Adjustments can be made to also improve these areas. Dr. Teitelbaum considers the "total picture" and adjusts the procedure to create the maximum benefit and restore the most ideal contours.

    Dr. Teitelbaum always keeps the scar as narrow as possible. Because a wider scar may provide more advantageous results in other ways, he will provide you with all information necessary to determine what size scar is most appropriate. Dr. Teitelbaum has had this discussion with hundreds of patients and he is sympathetic to patients trying to make this choice. He will take as much time as necessary to help you figure out whether you want a tummy tuck and the type of a tummy tuck that most appeals to you.

    As underwear and bikini styles have become lower on the hips in recent years, Dr. Teitelbaum has modified his approach to further lower his scars so that they can be concealed within most underwear and two-piece bathing suits. Interestingly, in 2017, swimsuits and underwear styles indicated a trend to start riding higher again. He will discuss with you the location of a scar that will be the most hidden for you.


    Tummy Tuck after Pregnancy

    Pregnancy can do two things to a woman's stomach that can only be fixed with surgery: it can stretch the skin and it can separate the stomach muscles that are normally fused in the center.

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    Diet and exercise do not tighten skin. There is, alas, no "skin machine" in the gym. We work out to strengthen our muscles, heart, and lungs, but we can't tighten skin through exercise.

    The enlarging uterus puts pressure on the abdominal wall, which can separate the paired rectus muscles that go all the way from the rib cage down to the pubic bone. When these muscles are separated, it is called a "rectus diastasis". Sit-ups can make the muscles stronger, but they won't fuse them back together. Once there is a gap, the pressure from inside the abdomen pushes out and can at times make even a thin woman look bloated or pregnant. Just like the skin, only a tummy tuck can connect those muscles together again.

    A swift and safe recovery is critical to enable mothers to return to being with their children. Dr. Teitelbaum is very conservative and careful with every aspect of his surgery. He has lectured about the complications of tummy tuck surgery and understands the findings of the latest publications. In 2016-2017, he was president of the ASERF, the national research organization of plastic surgery. So he is aware of all of the latest developments in tummy tucks. While safety is paramount for every surgical patient, Dr. Teitelbaum realizes that there is an extra something that needs to be considered by mothers contemplating surgery.


    Tummy Tuck after Weight Loss

    Many men and women are seeing plastic surgeons following enormous weight loss, either following new weight loss operations or committed diet and exercise programs. After devoting enormous effort to losing weight, people want to look as good as possible. Depending on the quality of the skin and the amount of weight lost, patients can vary from having a little skin laxity to being extremely deflated and suffering from a substantial amount of excess and hanging skin.

    A top Los Angeles abdominoplasty surgeon, Dr. Teitelbaum studied with the plastic surgeon that pioneered the modern techniques for body contouring following weight loss. He even attended the very first meeting ever devoted to discussing the plastic surgery treatments of massive weight loss. He has spoken to weight loss support groups to explain the potential of these procedures. His experience is vast and his understanding sophisticated.

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    Massive weight loss patients differ from post pregnancy tummy tuck patients in three important ways: First, the amount of laxity can be substantially greater, and the laxity more frequently extends all the way around the waist. Correcting this often requires more complicated procedures, better preoperative planning, and particularly meticulous surgical technique.

    The second difference is that there is generally a greater degree of damage to the quality of the skin in patients who have lost a lot of weight than patients who have simply had pregnancies. This requires a different degree of pull on the skin. Directions of pull, the amount of pull, and other technical issues are different with weight loss patients. Patients need to understand that the impaired skin elasticity frequently prevents the result from being quite as excellent as the patient and surgeon would desire because surgeons cannot improve the underlying quality of skin. It is important for a plastic surgeon to notice the quality of the patient's skin and incorporate that into the surgical plan as well as to help the patient understand before surgery the sort of result he or she is likely to achieve.

    Finally, some, but not all, massive weight loss patients have significant medical issues that need to be considered, such as diabetes, hypertension, skin rashes, nutritional deficiencies, and sleep apnea, among others. To be safe, such patients should consult with plastic surgeons experienced with helping plastic surgical patients with these problems. Dr. Teitelbaum and his nursing staff excel at managing these medical issues.


    Dr. Teitelbaum's expertise in Tummy Tuck Surgery

    Tummy Tuck Los Angeles

    Dr. Teitelbaum has performed hundreds of tummy tucks since the early 1990s and continues to do so on a regular basis. He has authored peer-reviewed journal articles, written two recent plastic surgery textbook chapters on abdominoplasty, and has made presentations on tummy tucks at meetings of plastic surgeons.

    Dr. Teitelbaum has been a leader in writing about the high lateral tension abdominoplasty. This technique, while being more difficult to understand, is known for achieving a more natural improvement to the entire trunk as well as the thighs. Years ago, Dr. Teitelbaum visited the surgeon who invented this technique to learn its nuances and master its execution.

    Tummy Tuck Los Angeles

    Dr. Teitelbaum openly discusses with patients both the amount of improvement they are likely to get as well as the extent of scars necessary to achieve their desired look. While the results are magnificent, he believes a patient should be given substantial opportunity to think about and then decide on what she wants.

    As a long-term member of a plastic society's task force on emerging trends, Dr. Teitelbaum is aware of every new innovation in plastic surgery. There has been a cavalcade of high tech devices that claim to tighten skin or remove fat without surgery, and patients are naturally interested in these procedures. However, until they offer the results that patients are expecting, Dr. Teitelbaum will protect his patients from dashed hopes, lost money, and potential health hazards.

    For these reasons, Dr. Teitelbaum is lauded as offering among the best tummy tucks Los Angeles patients can obtain. His stunning, personalized results draw patients from not just Santa Monica, but from all of California and beyond.


    What to expect from the surgery

    Your abdominoplasty treatment generally takes between 1 and 3 hours, and is most often performed under general anesthesia.

    A full tummy tuck usually entails a hip-to-hip incision that gives the doctor access to excise troublesome fat deposits and excess skin from the belly. Usually another incision is made at the belly button. Once the skin is lifted, the separated abdominal muscles are revealed. Dr. Teitelbaum can then tighten these so that your abdomen is flatter, tighter, and more attractively contoured.

    The mini tummy tuck, which is discussed in depth on an additional page, results in less downtime and less discomfort, but only targets the area of the torso that lies between the navel and the pubic zone. If this region is where you tend to accumulate unwanted and stubborn fat deposits, the mini tummy tuck may be just the solution you've been seeking. Dr. Teitelbaum approaches the mini and full tummy tucks as procedures at opposite ends of a spectrum with an infinite array of options in between. So rather than just offering patients one of two tummy tuck procedures, he suggests various customized options to suit their anatomic needs and the results they want.

    There is also a third option called the reverse tummy tuck. This procedure can help to eradicate sagging skin and fat that lies above the belly button. The incision is made beneath the breast crease, which often means that the same incision can be reused to perform breast surgery, cutting down on recovery time and lessening scarring.


    Recuperation

    Tummy tuck recovery is not insignificant, and you should be able to set aside two to three weeks before expecting to really be back to usual activities. For the first night or two, patients typically stay in a recovery center. That way they can have the comfort of a hospital bed, their meals and medication brought to them, and the option of getting a pain shot rather than just a pill.

    Your good recovery is a major priority for Dr. Teitelbaum and he spares no expense, effort, or technology to give you the easiest experience possible. This begins with the anesthesiologist and the outstanding medications and techniques they use. It includes injections of special medicines while you are asleep that can block nerves for a few days. In most situations, patients do not need to have a drain that leads to additional scars, discomfort and inconvenience during the healing. Rest assured that everything to increase your comfort will be done.

    Ready for a Tummy Tuck Consultation?

    For more information about tummy tuck surgery in Los Angeles, call board certified plastic surgeon Dr. Steven Teitelbaum at 310.315.1121 or click here to contact us.

    Who is a candidate for a tummy tuck?

    Most tummy tuck patients have had a child and have some combination of extra skin on the abdomen, excess fat, and separation of the muscles in the center of the abdomen. Some people have just one issue and some have all issues. Patients who have lost a lot of weight can have any of those same issues and are frequently candidates for tummy tucks. It is a procedure that both men and women benefit from.

    What are the most important factors to consider when deciding whether or not to have a tummy tuck?

    A tummy tuck is a big procedure; it is relatively painful, expensive, has a long recovery, and a significant scar. But the results are dramatic. Each patient has to weigh these risks versus the benefits.

    How will you determine what is the best tummy tuck for my body?

    Dr. Teitelbuam will examine you standing, sitting, and bending over. Some tummies look nearly perfect standing, but demonstrate significant laxity when the patient sits. When examining before and after photos of tummy tuck, it is critical to look at the patients in all three positions: standing, bending over, and sitting down.

    How will you determine if I need a tummy tuck or abdominal liposuction?

    A tummy tuck is necessary if there is loose or redundant skin, if there are significant rolls of loose skin noted when sitting, or if there is a separation of your muscles. It is very uncommon for someone who has had a baby to be a candidate for liposuction. Liposuction of the tummy is reserve for cases in which the skin is very thick and tight and the fat itself feels firm. Abdominal liposuction is one of the most over-performed procedures, in part due to the fact that many women do not want the scares of a tummy tuck and think that the tummy tuck may adequately satisfy their wishes.

    Will I still have stretch marks after my tummy tuck?

    With a full tummy tuck all of the stretch marks beneath the belly button will be removed. Depending upon how loose the skin is, some of the stretch marks above the belly button will be removed. Even if the upper stretch marks are not removed, they are at least shifted strongly downward. Though a stretch mark is actually a scar, which means that it is an indelible mark in the skin, by tightening the skin with an abdominoplasty the stretch mark becomes taught and thereby is typically much less visible.

    Should I have a tummy tuck if I plan on getting pregnant in the future?

    The short answer is that it is okay to get pregnant again after having a tummy tuck; the skin will and muscles are able to accommodate the baby. Dr. Teitelbaum has performed many tummy tucks on women who have already had children, may have gotten divorced and would like to have more children, but have no idea when that might happen. But it is unusual for a woman in a marriage to have a tummy tuck between children; they usually wait until they know that they are done making babies.

    Are the results of a tummy tuck permanent?

    Tummy tuck is one of the few operations in all of plastic surgery that almost never needs a revision. Even women who get pregnant again tend not to loosen up as much as they did with their earlier pregnancies, however their muscles still may separate. Patients who have lost large amounts of weight and have terrible thin skin that has lost its elasticity is more predisposed to stretch again in the future.

    If I gain weight after surgery will my stomach look abnormal?

    The point of the tummy tuck is not so much to remove fat – though it does – but to tighten muscle and/or remove extra skin. So if someone gains weight after a tummy tuck, they simply look like they have gained weight; there is no specific damage to the procedure and there is no deformity.

    What is Dr. Teitelbaum's expertise in tummy tucks?

    Dr. Teitelbaum has performed hundreds of tummy tucks. Moreover, he has written two book chapters and an article about tummy tucks. He has also lectured to other plastic surgeons about tummy tucks.

    What form of anesthesia does Dr. Teitelbaum suggest for a tummy tuck?

    Most plastic surgeons use general anesthesia for a tummy tuck. Dr. Teitelbaum works with a fantastic anesthesiologist. Together they have performed many tummy tucks which allows them to coordinate anesthesia with surgery to optimize the balance of anesthetic medicines to be sure a patient has enough anesthesia but not too much.

    Where is the incision made for the tummy tuck?

    The incision is in a gentle arc just within the panty line. Dr. Teitelbaum asks patients to bring in underwear or a two-piece bathing suit bottom for him to use to plan the incision at the level the patient wants. The width is determined by where the laxity is. Patients pressure plastic surgeons to limit the width of the scars. But if you sit straight up and look down, it becomes apparent that skin will only be tightened for as wide as the scar is. An incision is typically made around the belly button with a full tummy tuck, but it is usually not done with a mini-tummy tucks.

    Will there be scars?

    Anywhere there is an incision there will be a scar. It amazes Dr. Teitelbaum how he can use the same techniques on two consecutive patients and one will end up with scars that are barely visible and the other will have scars that are thick and red. Much remains to be known about scarring. Despite the best techniques, some patients will have prominent scars. That is why Dr. Teitelbaum puts so much effort into concealing the scars within the lines of a woman's preferred underwear or bikini bottom style.

    Can I have other procedures done at the same time as a tummy tuck?

    One of the current controversies among plastic surgeons is identifying when it is prudent to perform another procedure along with a tummy tuck. For years this was a routine practice, but studies in recent years have shown that adding significant procedures to a tummy tuck substantially increases the risk of catastrophic complications, though such complications are extremely rare. The risk may have to do with the size of the tummy tuck, whether the muscle is being tightened, how mobile the patient will be early after surgery, etc. Dr. Teitelbaum is extremely conservative when it comes to making these decisions. He is on plastic surgery society task force examining these issues and has lectured about them to other plastic surgeons. He will be able to discuss the latest data on this topic when he meets you for a consultation.

    Does insurance cover tummy tucks?

    Insurance does not cover tummy tucks. But if there is a bonafide hernia then insurance should cover a portion of the hernia repair.

    Do I need to go to an aftercare facility after my surgery?

    An abdominoplasty is one of the few procedures for which Dr. Teitelbaum requires a stay at the recovery center. Two nights is a minimum, and most patients will stay just two nights. Many patients will stay for a third and a fourth night, depending upon expenses and the amount of peace and quiet they will be able to get at home. The recovery center is great because it has hospital beds that can be bent to make you comfortable, you can get pain shots if necessary, and simply the nurses know exactly what to do to make you comfortable as well as looking out for any possible problems. And since the recovery center is across the street form Dr. Teitelbaum's office, he and his nurse can pop by if there is ever an issue during the day. And since Dr. Teitelbaum lives nearby, he can always be reached to see you if you have an issue.

    Will I get a phone call from the doctor the night of my surgery?

    Dr. Teitelbaum checks regularly with his abdominoplasty patients' nurses at Serenity. He and his nurse will stop in to visit you the evening of your surgery and again the next day. On the second day after surgery patients will be driven across the street to Dr. Teitelbaum's office.

    How painful is the recovery?

    A tummy tuck is one of the more uncomfortable operations routinely performed by a plastic surgeon. Some patients who have also had C-sections will say it is about as bad as a C-section, but some will say it is worse. But Dr. Teitelbaum will give you plenty of pain medications so patients never suffer after the procedure. Pain builds gradually and responds promptly to medicine, so there should not be anxiety about pain going in to the surgery. Patients who do not have their muscles tightened have a much easier recovery.

    How soon can I go to work?

    When you feel ready to do your job is highly individualized. After a tummy tuck, most patients wouldn't go to work for twelve to fourteen days.

    When can I drive?

    Most patients will drive about ten days after a tummy tuck. But this is highly variable based upon your body type and what was done.

    When can I resume exercise?

    Exercise can begin about one month after a tummy tuck. Sit-ups should be delayed for about three months (no one has ever complained about that!)

    How long does the swelling last?

    Swelling increases after surgery, usually peaking about 5-6 days after surgery. After that, the swelling will subside, rapidly at first, and then gradually. After one month, you'll think the swelling is gone, but it will still go down more at three months, and even more at six months and even a year, though at that point changes are subtle.

    Will I have a special garment to wear after surgery? How long will I have to wear it?

    Most patients are given a garment to wear after surgery. Many patients will soon switch to wearing spanx. There is no specific time for which it has to be worn; in general, the more it is worn the less the swelling builds up and the faster the swelling resolve.

    What do I have to do to care for the incision?

    There will be steri-strip tapes on your abdominoplasty incision after surgery. These will start to peel off after about a week. You are then ready to put on scar treatment formulas. Dr. Teitelbaum will discuss options for scar treatment with you.

    Do I need to take shots to prevent blood clots?

    An area of controversy in plastic surgery is when to give tummy tuck patients blood thinners to prevent blood clots after surgery. When this needs to be done, patients will commonly start these once a day shots the day after surgery. When they leave the recovery center, they will continue at home for a week. Dr. Teitelbaum has lectured on this subject and will discuss the latest information on this subject and suggest what he thinks is most appropriate for you to do.

    When do the stitches need to be removed?

    There are stitches around the belly button that are removed 5 days after surgery, but the stitches along the panty line incision are all dissolvable. There are usually two drains to remove fluid that come out of the groin area on each side. These are removed from five to eight days after surgery, just depending upon the quantity of fluid coming through the drains.

    What should I do to prevent scarring?

    Usually the liposuction scars are small and heal very well. The bottom line is that the fate of your scar is mostly determined by your own genetics and by the surgery itself. It is not clear the extent to which putting things on scars will influence their final appearance. However, most patients want to do something. There has never been a direct comparison between the various products. Patient feedback has been the most positive from three sorts of things: Scar Guard, which is a liquid containing steroid, Vitamin E, and silicone that you brush on like nail polish; Silicone gel strips (such as Neosporin scar strips); and silicone ointment (such as Scar Fade.) You can get these from the office or the pharmacy, and you can start putting them on once the glue or the steri strip is off, following the instructions on the packaging.

    What do I need to watch out for?

    You will be given detailed post op instructions by Dr. Teitelbaum and his staff both before and after surgery. There are two points that deserve emphasis. Sudden and painful swelling can be a sign of bleeding and the doctor should be alerted right away. Patients have drains after surgery, and one of the signs if this may be that the drains get filled with clots and stop draining. Another important thing to look out for is any sign of a blood clot. Calf pain, swelling of one leg, and shortness of breath are all extremely serious signs and you should be seen immediately if any of these occur. Shortness of breath mandates an immediate call to 911.

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