Going Home after a Tummy Tuck

After a Louisville Tummy Tuck, the question of an overnight stay vs. going home frequently comes up.

Reasons to stay: A tummy tuck, aka Abdominoplasty, is a pretty big operation. They typically take 2 or 3 hours or longer. My take on staying is that it provides for good nursing care which translates into pain control and early mobility which helps keep complications at bay. The cost is minimal in the overall scheme of things and a lot of surgeons think it’s safer.

Reasons to go home: You won’t get woken up all night, you can be in your own bed, and you might simply hate hospitals. It does save a  little money. We give you narcotics and I use pain pumps so a lot of patients don’t feel like they need to stay for pain control reasons.

In the end, there are no set rules. I let some folks go home and ask others to stay. A recent study published in the Plastic and Reconstructive Journal looked at this question and found that complications were no higher for the patients who went home vs. the ones who stayed overnight.

Lee Corbett, MD

www.CorbettCosmeticSurgery.com

all posts on the blog are presented by Louisville Tummy Tuck surgeon, Dr. Lee Corbett

Drains and Plastic Surgery

If there is one constant in my Louisville Ky cosmetic surgery practice, it is the dislike of Drains.

Drains are round or flat tubes that are placed in surgery. They exit through the skin and empty into some form of reservoir. Patients don’t like them at all but they are necessary “evils” following procedures like Louisville Tummy Tucks and Louisville Facelifts.

During surgery if we elevate the skin, as in a facelift, breast lift, or tummy tuck from the underlying muscles, our body will leak serum into that new space. Serum is basically the watery part of our blood. If there is no method to evacuate that fluid, it will form a collection called a seroma. Seroma can cause a variety of problems and so we do our best to avoid them. Thus,  the drain. The drains are placed and serve as an exit route for the fluid. They stay in after surgery anywhere from 12 hours to a week or two depending  on the procedure. They are typically removed not based on time but on output.

So, while they are not the most popular part of cosmetic surgery, they do serve a valuable purpose in helping you achieve a great surgical result.

Lee Corbett, MD
www.CorbettCosmeticSurgery.com

Combining Cosmetic Procedures

Here in my Louisville Plastic Surgery office we are seeing our usual “Spring Rush”.  More than ever, it seems like patients are wanting to do more than one operation simultaneously. Common examples are a Louisville facelift with a blepharoplasty or a Louisville Breast Reduction with a Lousiville Tummy Tuck.

My opinion on combining procedures is based on many factors. First, I look at your overall health status. Secondly, I look at the scope of the procedures we are planning and their physiological impact, and finally we need to consider how much time it will take to get you in and out of the O.R.

My advice is to come in for a consultation, let me see your “wish list”, then we’ll take a look at your starting point. I can then map out a plan and we can then decide the feasability. Our consultations are complimentary.

Lee Corbett, MD

Louisville KY. Cosmetic Plastic Surgeon

www.CorbettCosmeticSurgery.com

Update: Insurance coverage for tummy tucks and panniculectomies

I see a lot of patients who have lost weight and want their insurance to pay for their Louisville Tummy Tuck or Louisville Panniculectomy.

What I am seeing is that all of these requests for insurance coverage are denied. A Tummy Tuck is and always has been considered a cosmetic procedure. Cosmetic translates into self pay. We have been asking insurance companies to pay for panniculectomies but what we get 100% of the time is a refusal. We have not had a panniculectomy be approved since sometime back in 2007. In ’08 and ’09 we had a zero % approval rate.

Lee Corbett, MD

www.CorbettCosmeticSurgery.com

Skin does not respond to exercise.

I see patients everyday who are frustrated becaue they are exercising and their skin won’t tighten. More often than not they are inquiring about a Louisville, KY Tummy Tuck or Louisville, KY Liposuction.

Skin is not an exercise sensitive tissue. If your skin is stretched there is no exercise you can do to change this fact. Muscle will tone, skin will not.

Lee Corbett, MD

www.CorbettCosmeticSurgery.com

Panniculectomy vs a Tummy Tuck

I often meet patients who schedule to be seen for a Louisville Panniculectomy when they really want a Louisville Tummy Tuck.

The difference between these two is substantial but there is a lot of confusion. First, insurance pays for a panniculectomy.  A tummy tuck is self pay, e.g. Cosmetic.

A panniculectomy only treats from the belly button down. A tummy tuck treats the whole abdomen.

So, while the thought of insurance paying is obviously attractive, make sure you choose the procedure that best suits your needs.

Lee Corbett, MD

www.corbettcosmeticsurgery.com

Recurrent Skin Laxity in Massive Weight Loss patients

Massive weight loss patients are those who have had gastric bypass or lap band surgery. Most lose over 100 pounds and this leaves them with a lot of loose skin. As a result they seek a number of Plastic Surgery procedures like facelifts, brachioplasty, mastopexy, tummy tucks, thigh lifts and body lifts.

What we as a specialty have noticed is that after these surgeries, recurrent skin laxity is a problem. This brings revisions into consideration which entails additional surgery, fees, and recovery. MWL patients as a group tend to recur much more quickly and severely than ‘typical’ patients undergoing these surgeries. This doesn’t mean you should avoid these procedures, only that you should choose an experienced surgeon and have a good, candid conversation before you decide to proceed.

Lee Corbett, MD

http://www.corbettcosmeticsurgery.com/

After surgery, will I have stitches or do they dissolve?

Surprisingly, I find that a lot of my patients are more scared about having their stitches removed than having surgery!

Be it a facelift, breast augmentation or tummy tuck, there are usually a few sutures that need to be removed. Sorry. Here’s why.

There are absorbable and non-absorbable sutures. Both can be used to re-approximate deep tissues under the skin or the skin itself. More often than not though, we use the non-absorbable kind to close the skin. The reason is that they tend to be a mono-filament, like fishing line. This type of suture elicits less of a scar reaction than a braided suture. Most absorbable ones are braided. So non-absorbable ones make for nicer scars, the goal of every Louisville plastic surgeon.

What I like to do is use a long lasting absorbable mono-filament suture for skin closure. I put one stitch outside the skin, tie a knot to anchor it, and then run it under the skin surface and when I get to the other end of the incision I tie another knot to secure the stitch. That way, all I have to do is clip the knot on either end the rest will dissolve. Plus, because the suture lasts several months, it continues to add strength to the stitch line to keep the scar from widening. So yes, most of the time I do have to remove sutures but I try to make it as user friendly as possible!

Lee Corbett, MD

www.CorbettCosmeticSurgery.com

502.721.0330

All posts on this blog are presented by Louisville Cosmetic Surgery expert, Dr. Lee Corbett.

What happens to my belly button if I have a Tummy Tuck

Nothing actually.

I am writing this blog because a lot of people think that if they have a tummy tuck they get a ‘new’ belly button. You don’t. You get to keep the one you’ve always had.

When we do a tummy tuck we make an incision that sits low like a C-section and goes from hip to hip. We go down thru the fatty layer until we hit your muscles. That’s all the deeper we go. We then work up to the belly button and lift the skin/fat layer off of the muscle.

When we get to the belly button we come back to the skin surface and make a circular incision around it. We core straight down around it, like an apple corer would do. All that your belly button is, is a stalk of scar tissue. So, we isolate it and continue to undermine the skin/fat layer. Then we remove the skin from belly button down and the remaining skin pulls down like a window shade.

At this point your tummy tuck incision is closed but your belly button is buried. So, we make a new circular incision, remove a plug of skin/fat and Voila, your belly button pops thru like that button on your turkey when it’s done!

So in the end your belly button is the same one you’ve always had, but the skin around it is new.

Lee Corbett, MD

www.CorbettCosmeticSurgery.com

All posts on this blog are presented by Louisville Tummy Tuck surgeon, Dr. Lee Corbett.

I had a Lap Band, can I have my tummy done without hurting my fill port?

Absolutely. A panniculectomy or any version of a tummy tuck is possible.

This is a pretty good question that my post Lap Band patients pose when we are talking about doing their skin tightening procedures. The ports are safe for a couple of reasons.

Most of the patients that I see have ports that are fairly high up on the left upper quadrant of the abdominal wall. This puts them well out of the way of most tummy procedures. Now if we need to make a lower side to side incision and remove a vertical segment of skin, the port does come more into play but it typically still stays out of the way.

In the event it does come into play, and it has on several occasions in my experience, it’s not a big deal. First, as you know, the thing is pretty easy to feel so we know where it is. As I get close to it I just slow down and pay close attention not to hurt it. In fact the port itself is pretty indestructible. It’s the fill tube that can be injured and that is what I am really on the look out for. The body also does something that helps us, it surronds the port with a layer of scar tissue called a capsule. The capsule is dense, tough scar tissue that envelopes the port and adds yet another layer of protection.

All of this being said, as careful as your surgeon is, the port can be broken or may need to be moved and this possiblity needs to be part of your discussion with your Plastic Surgeon. Sometimes, your Plastic Surgeon may ask your Lap Band surgeon to help out.

Lee Corbett, MD

www.CorbettCosmeticSurgery.com

All posts on this blog are presented by Louisville Abdominoplasty surgeon, Dr. Lee Corbett.