Contours Count: How Technology Has Improved Tummy Tucks
There are few plastic surgery procedures as versatile and customizable as the tummy tuck. New York area board-certified plastic surgeon and professor of clinical surgery at New York Medical College, Dr. Kaveh Alizadeh has spent years perfecting his own techniques, combining time-tested methods with newer advances to create the NaturaTuck™ that minimizes pain and scarring, improves recovery, and creates natural-looking results. His significant research into the procedure, technically known as an abdominoplasty, has given him a reputation as a go-to resource for women and men looking to find out more about the surgery in general. Dr. Alizadeh published a complete review of the field in a chapter entitled Abdominal Plastic Surgery and Adjunctive Procedures about novel approaches to both cosmetic cases and patients after massive weight loss. (see it here on Google Books )
While every tummy tuck is unique, they all draw from the same general group of potential elements. Abdominoplasty patients can expect a long, low, horizontal incision – typically positioned where it can be hidden by bikini bottoms or underwear – that allows the plastic surgeon to make any number of adjustments to the targeted skin and tissue.
A traditional tummy tuck may have involved removing fat cells, excising excess skin, rejoining abdominal muscles that have been separated, “relocating” the navel by creating a new belly button in the proper position, or all of the above. This procedure is also combined with umbilical hernia repair or a ventral hernia repair in cases with massive weight loss.
Most recent advances in technology have expanded this list by allowing for more precision contouring. This gives a plastic surgeon with the necessary experience and talent the ability to shape an internal corset of sorts, as well as a classic hourglass look as desired.
The key is in effectively using underlying contouring with progressive tension suturing to sculpt living tissue in three dimensions. Dr. Alizadeh’s technique, for example, utilizes a novel triplanar approach to pull in the waist from the ribs, thereby narrowing the waistline while contouring the sides and mons at the same time. Dr. Alizadeh goes one step further to numb the skin for the first three days with Exparel which uses micronized lidocaine to minimize pain and discomfort in the immediate postoperative period. Importantly, Dr. Alizadeh minimizes the use of drains to ensure a more timely recovery for all patients with this technique.
All fat needs to be loosened or broken up prior to removal, and there used to be only one way for that to happen: tumescent liposuction. This involves firming up the targeted area with a sterile, anesthetizing, and vessel-constricting solution. A hollow wand called a cannula was then inserted through an incision and gently probed through the fat cells to dislodge them much like shaking grapes from the stem. Once the material is “separated” enough, it could be suctioned out via that same cannula.
Other methods for this step have been developed over the years, using everything from heat to sound waves to break up the fat cells. The more focused applications or energy allow for greater precision.
Ultrasound, for example, uses sound-based energy to disrupt fat cells that cluster immediately around muscle tissue. The procedure is more akin to using fine brush strokes than a broad paint roller. In other words, it is ideal for sculpting and toning, especially for patients who have well-defined muscles that are hidden under a superficial layer of stubborn fat.
Laser energy can also be used to generate well-defined results. The heat from the light-emitting device may also have the added benefit of stimulating collagen production in the skin. Increased levels of this important protein cause the skin to feel firmer and sit tighter over the tissue below, allowing it to better conform to newly slimmed-down areas as opposed to hanging slack and sagging.
Other, more physically demanding methods can cause more significant trauma to the tissue around the fat cells, which leads to bruising and a longer and more painful recovery time. By focusing on the fat cells with a less traumatic technique, the plastic surgeon can spend time and energy sculpting the area as opposed to working to free the fat. This also means the patient is less likely to experience unwanted side effects and is more likely to enjoy a shorter, more comfortable recovery.
As with all fat-removal surgeries, patients should know that laser- and ultrasound-based treatments are for body contouring only. Women and men who are considering a procedure that would involve their application should be at or within 20 percent of their ideal body weight.
By combining three-dimensional sculpting techniques, contouring liposuction maneuvers, use of long-acting anesthetics, and minimal to no-drain techniques, Dr. Alizadeh has pioneered the NaturaTuck™ specifically to have a consistent long-lasting outcome for abdominal rejuvenation.
Anyone who wants to find out more about the many variations of liposuction, tummy tuck surgery, or any plastic surgery procedure can contact Dr. Kaveh Alizaeh’s Cosmoplastic Surgery by sending a message or calling us at 646-665-1915.