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TUMMY TUCK (Abdominoplasty, Abdominal dermolipectomy)

Removal of excess skin and fat tissue from the abdomen.

The so-called ’’bikini” incision goes horizontally in the lower abdomen above the genital region, and in depth up to the front abdominal muscles. The excess skin and fat tissue is removed, and the belly-button may be moved to another, higher position. If necessary, the liposuction from the hips or thighs, as well as strengthening of the muscles of the front abdominal wall may be performed in the same act. Most frequently, positioning of the aspiration drainage is required.

The surgery is performed in total anaesthesia and lasts 3–4 hours depending on the volume of the intervention. In the easier variant, only the lifting of the sagging lower abdomen may be performed.

The drains are most frequently removed after 3 days, and the sutures gradually 14 days. After the surgery, wearing of the firm elastic band for 40 days is required, as well as abstaining from major physical efforts in that period.

Selling of the abdominal wall with the prolonged oozing of the transparent serous liquid.

A Tummy tuck, also known as abdominoplasty, is a surgical procedure that removes excess skin and fat from the middle and lower abdomen. The procedure also tightens the loose abdominal muscles, giving the appearance of a flat and tight abdomen. An abdominoplasty can create a dramatic difference in the appearance of the abdomen, but the surgery does leave a horizontal scar extending from hip to hip just above the pubic area. However, this scar can usually be hidden under the bikini line. Both men and women are candidates for this surgery.

While this surgery is particularly helpful in women with previous pregnancies and stretched out abdominal skin and muscles, an abdominoplasty also dramatically improves the appearance of those who have undergone successful weight loss surgery. An abdominoplasty takes approximately 3-5 hours depending on the size of the patient. It is performed under general anesthesia and usually requires an overnight stay in the hospital. Recovery time after surgery is usually between 10 days to 2 weeks. Most people are back to work by 2 weeks and back to full activity including exercise by 4 weeks.

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Dr. Baros postoperative instructions for tummy tuck:

  • 1. Your abdomen is bandaged with abdominal gauze-pads, and the abdominal binder. Leave them on for 48 hours after your go home. Then, you can take the abdominal binder and all other dressings off and get in the shower. You can take the yellow gauze out from the belly button. Leave your Steri-strips (surgical tape along the incision line) on for the shower. You can take the drains into the shower as well. After showering, pat dry all of your incisions and wrap your abdomen with the abdominal binder. If there is drainage on the abdominal binder, place clean pieces of gauze on the incision line and wrap the abdominal binder over the gauze. Absolutely no baths or swimming for 2-3 weeks. Showering is OK.
  • 2. Empty and record your drain output daily. The markings are on the side of the drain bulb in increments of 25cc. The drains will be pulled out in the office when the total daily output is less than 30cc.
  • 3. Call and make a follow-up appointment for 7 days following surgery.
  • 4. Keep your abdominal binder on at all time for 4 weeks. Do not pick up objects greater than 5 pounds (i.e. phone book = 5 pounds).
  • 5. If the abdominal binder is too tight, you can rewrap it to a comfortable level, but the binder has to be situated over the lower abdomen and your hip area.
  • 6. Do not apply a heating pad over your abdomen. Portions of your abdomen will be numb and you may get a burn from the heating pad.
  • 7. Scar therapy for your incisions will start at 2 weeks following surgery. Dr. Baros will instruct you regarding scar creams.
  • 8. Stay out of the sun. Sun exposure will make your scars red, raised, and persistently irritated for a long period of time. Make every effort to avoid the sun for up to 1 year following surgery. You can cover up the incision with sun screen (SPF 15 or above) or clothing.
  • 9. Make every effort to walk around the house and sit in a chair starting on the day that you are home from surgery. Staying in bed for long periods of time can lead to blood clots in your legs or your lungs. Also, parts of your lung can collapse and cause fevers.
  • 10. You may return to normal activity and exercise in 4 weeks following surgery.
  • 11. You may feel “funny”, tingling sensations over your abdomen a few weeks after surgery. This is normal recovery of some sensory nerves in your abdomen.
  • 12. If you are constipated, take over-the-counter laxatives. You do not want to strain over the toilet. This will place pressures over the suture line which may result in loosening of the inner layer of sutures within the abdomen.
  • 13. Call with any questions or concerns. Dr. Baros is available through the office phone number 24/7. Don’t ever feel badly about calling.

BRACHIOPLASTY - UPPER ARM LIFT

Reduction of the upper arm perimeter by removing the excess skin an the subcutaneous fat tissue.

The operative approach can be from the armpit, along the inner side of the upper arm or, as needed, in both places. By the previously marked drawing planned in detail, the removal of the excess skin and subcutaneous fat tissue from the mentioned region is performed. The drainage is usually not needed. In some cases, the reduction of perimeter can be achieved only by liposuction of that region or by combination of these two techniques.

The surgery is performed in total anaesthesia and lasts around 1.5 hours.

The sutures are removed between the day 10 and 14 after the surgery. Wearing of an arm fastener for up to 2 weeks is necessary.

Swelling, bruises, mild numbness of the arms.

BOTTOM CORRECTION

Enhancing, or lifting of the gluteus region or the bottom is performed by means of silicone implants or with the own fat tissue. Reduction and lifting of the same region is performed by liposuction described under body liposculpture or by bottom lifting (tanga lift).

The implants are inserted through a small vertical incision in the upper part of the gluteus fold, immediately under the pelvic bone, and that incision is common for both sides. The prostheses are inserted through it into the space under the gluteus maximus. A simpler way is to enhance the bottom with the own fat tissue previously extracted by liposuction from the region where it is in surplus (cellulite correction).

The surgery is performed in the peridural blockade and lasts around 1.5 hours.

Sitting difficulties in the first days after the surgery, the sutures are removed after seven days.

Swelling and discomfort at sitting in the first weeks following the surgery, as well as the implants positioned too high. Fast fat absorption or formation of small cysts is possible due to a large quantity of the fat tissue that has to be inserted.

BODY LIPOSCULPTURE

Re-shaping the body by removing fat deposits from various body parts, such as hips, thighs, back, upper and lower abdomen, “saddle-bags”, internal part of the thighs and knees, lower legs, ankles and inner part of the upper arms. The removed fat tissue may be filtrated as needed and put back into those body parts where there is a need for it (bumps, dimples, natural wrinkles, lip, cheekbone, bottom enhancing, etc.)

Through a minor skin prick, with special instruments (cannulas) inserted under the skin, aspiration of the fat tissue is performed. The cannulas should have various sizes and shapes (2-6 mm in diameter) in order to extract the fat evenly from all the layers. The aspiration process can be previously facilitated with inserting (infiltration) of the physiological solution with adrenaline for prevention of bleeding, as well as possible ultrasound breaking of the fat tissue.

Depending on the affected regions, the liposuction can last 1–5 hours and is usually carried out in the peridural anaesthesia along with analgo-sedation.

Return to normal activities after 5-7 days. Right after the intervention the patient puts on the corset that should be worn for at least three weeks for shrinkage of the excess skin.

Transitory appearance of bruises, suffusions (haematomas), as well as swellings that gradually withdraw within up to two weeks; transitory skin sensibility disorders, as well as possible smaller bumps, due to which an early post-operative massage and lymph drainage are recommended.

Fat Removal - The Liposculpture Technique Like everyone else you are born with a specific number of fat cells in your body and regardless of your height, size or shape, only the same number of cells remain in your body for the duration of your life. Unfortunately, for some people these fat cells can expand, and so called "fat" as it is referred to, is not the growth of new fat cells in the body, but simply the swelling of the existing fat cells. With the Liposculpture technique, we are now able to remove the fat cells from specific areas of the body and, with less fat cells to expand in those areas treated, the possibility of an increase in size is therefore significantly reduced.

Liposculpture is an advanced, more refined and sophisticated version of Liposuction. Finer instruments enable fat cells to be removed in a more accurate manner in specifically defined areas of the body, in a procedure generally carried out under Local Anaesthetic. Liposculpture can be the answer for anyone who has unsuccessfully tried to remove specific areas of fat from their body through regular dieting and exercise alone. Now Liposculpture can offer both men and women great improvement in body shape.

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TOTAL BODY LIFTING – LIFTING AND SHAPING OF THE ENTIRE BODY

Removal of the excess skin and subcutaneous fat tissue on all the body parts occurred as a consequence of a massive weight loss. For this operative intervention, the patient should be well prepared, should have had a stable body weight for the last six months and should not suffer from other severe illnesses.

Due to the large volume, this surgery is most frequently performed in two acts. The first act is significantly larger and includes abdominoplasty or removal of the sagging abdomen with strengthening the muscles of the anterior abdominal wall, removal of the excess skin from the hips and the back with shaping of the sitting region which gets a more rounded contour, as well as reduction of the perimeter of the thighs by lifting the skin and liposuction. In the same or in the next act, brachioplasty or lifting of the upper arms is performed, as well as possible liposuction of the lower legs. In the second act, several months later, a correction of the breasts is performed by reduction of the excess skin and adding the volume by silicone implants if necessary. In the same act secondary corrections of smaller irregularities are performed remained after the first surgery.

The surgery is performed in total anaesthesia and lasts 6 to 8 hours. The patient usually remains in the hospital 3 to 4 days, and up to one week if necessary, in order to be under constant medical surveillance. The autologous blood transfusion is almost always applied in this period, due to a comprehensive surgical intervention, as well as administration of other preparations and strong antibiotics necessary for faster recovery. The sutures are usually removed in two weeks’ time, while the elastic corsets are worn for one month approximately.

Decline of the blood count values in the immediate post-operative course that is solved by quick blood transfusion; swelling bruises, irregularity of scars, slow healing of some parts of the wounds are usual, but rare complications of each surgical intervention.