+�-�Just finished a very interesting case.+�-� Patient had an upper Tummy Tuck (Abdominoplasty) about 5 years ago by another Plastic Surgeon.+�-� The Tummy Tuck is performed to remove excess skin over the abdominal area and to tighten the abdominal muscles.+�-� She was never really happy with the amount of excess skin that remained after the procedure.+�-� We had removed her Saline Breast Implants, that had encapsulated making the breasts+�-�hard and mis-shapen+�-�and replaced them with slightly larger ones over a year ago.+�-� Today she was back to flaten out her abdomen with another Tummy Tuck (Abdominoplasty).

+�-�I’m not a big fan of the upper Abdominoplasty because the scar goes across the top of the abdomen but she had already had the procedure perfomed using that incision and approach.+�-� In simple terms, the blood supply to the skin of the abdomen comes from above, below and the sides.+�-� Once an incision was made along the top, that blood supply wass compromised so…if I made an incision from below, as is done in a standard Tummy Tuck (Abdominoplasty), the blood supply would have ben compromised from top and below.+�-� The result could be dead skin and a big mess.+�-� So reluctantly, I made an upper incision for the Tummy Tuck.+�-� This illustrates an important point in my line of work…sometimes you are forced to do things differently then you would like by the patients previous surgical history.+�-� This was just such a case.

+�-�The procedure went very well and she should be happy.+�-� I tacked the upper edge of the skin incisioin to the deep tough tissues of the chest to keep the incision and gravity from pulling it downward.+�-� I also placed multiple quilting sutures that go between the underside of the elevated skin and the underlying muscle fascia (thick tough layer over the muscle).+�-� Placed one dain to drain blood and fluid from under the skin flap that exits on the side of the belly button where it shouldn’t leave a noticeable scar.+�-� Abdominal binder for a couple of weeks and no strenuous activity for 6-8 weeks.+�-� Closed the incision in multiple layers with dissovable stitches.

+�-�The patient+�-�had a Laser Face peel elsewhere that left a line of demarcation on the neck, so I used some 30% TCA to feather that edge.+�-� Also used the TCA to perform a lower lid chemical peel.+�-� She’ll go to the after care facility for several days where muscle relaxants will make her comfortable.+�-� I’ll see her postop after my surgery cases tuesday.+�-� I will follow up with her after replacing her Breast Implants a few months back….she had them done years ago by another plastic surgeon and just wanted them slightly smaller and more shapely.

+�-�While I was busy in the OR…Robyn, my wife and Master in Nursing, was busy doing Botox and Restylane injections one after the other.+�-� Warm weather makes people more conscious about their skin and Botox, Restylane, Radiesse and our Francis R Beverly Hills Skin Care Products get very…very…popular!

Read more about Abdominoplasty (Tummy Tucks) here:

http://www.drfpalmer.com/Abdominoplasty.html

Read more about Breast Augmentation with Breast Implants here:

http://www.drfpalmer.com/BreastAugmentation.html

Dr. Francis R Palmer, III