Tummy Tuck Carmel
Serving Carmel, Fisher, Avon, and Surrounding Areas
We Offer Drainless Tummy Tucks.
The goal most people who are anticipating abdominoplasty seek is a normal appearance. Some patients who work out frequently wish to have an appearance which matches their athletic lifestyle. People who have lost a great deal of weight and who suffer from skin loosening and excess merely want the reminder of their overweight days behind them. Some patients with chronic back pain desire relief in hopes that the muscular improvement in the front will help with the strain on the back.
WHO IS A CANDIDATE:
Anyone who desires an improvement in the contour of their abdomen, and who is in reasonably good health is a candidate. Disease processes by themselves rarely contraindicate abdominoplasty. However, uncontrolled diabetes, hypertension, or other chronic illnesses may delay our decision to proceed until those illnesses are adequately treated. Those with a body mass index of greater than 35 should hesitate to undergo this procedure before they lose significant weight. Greater than 40 BMI suggests dangerous or morbid obesity. Those patients should be under the care of a weight loss physician or bariatrician. A BMI of 25 is a fair body mass index to aim for if 1 wants the best result obtainable. To check your body mass index, look it up on Google. There are charts available. On-line BMI calculators are plentiful. There you enter your height and weight to obtain this information.
The decision to have elective surgery is, in 1 major way, more difficult than a decision to have surgery for an illness. Elective surgery is not immediately necessary to save life or limb. It is more of a long-term quality of life issue. Therefore, many of us will feel the weight of the decision in a special way; are we asking for trouble? Are we tempting God? There are many and varied ways that patient get through this decision. It helps greatly to talk with those whom you trust; loved ones, close friends, your plastic surgeon, and your family doctor. Not all will come off on the side of proceeding with the surgery, but all are worth listening to. Opinions from acquaintances, coworkers, or those with an agenda other than your well-being are not worth considering on the other hand. The decision process will be lonely unless you let those who truly care for you participate by being heard. Made in this way, your plastic surgeon has never seen a wrong decision. Ultimately, the decision is yours, of course.
You are a physical, emotional and spiritual being. To prepare for elective surgery, attention to each of your 3 beings is necessary.
Physically, those who walk or exercise regularly seem to heal faster. Their bodies are used to minor injury, soreness and the necessity to rise to the occasion when presented with physical stress. We now know that activity postoperatively is far more favorable in general than inactivity. Good hydration is another key to recovery. It stabilizes heart rate and blood pressure, and helps to prevent postoperative nausea. The closer to ideal body weight one is, the better all the organs respond to the stress of healing. Wide blood sugar variations and insulin resistance due to obesity prevent the proper immune function of white blood cells. Vitamins C is the healing vitamin necessary for wound healing. It is water soluble so that any amount your body does not need is eliminated in the urine rather than stored. It is a good idea to take daily vitamins with C for at least several weeks preoperative and postoperative, if not indefinitely. Finally, protein intake should be increased in those patients with poor or erratic diets, and especially in those who have lost a great deal of weight. Liquid or tablet protein supplements should be started at least 1 month before major surgery for optimal effect.
Emotionally, those who are most certain about their decision will be best prepared to deal with occasional, but nearly inevitable misgivings and 2nd guesses postoperatively. Malcolm Gladwell’s book “Blink” shows how our intuition or gut feeling decisions are far better than our over-intellectualized 2nd guesses. Many authorities in medicine, yoga, physical training and even veterinary medicine stress the importance of slow, even and deep breathing. Not only does rapid, shallow and erratic breathing indicates stress, it actually worsens stress. Preoperative practice in breathing, as odd as it may sound, prepares you emotionally for the bumps in the road postoperatively. Allow others to help you with all other matters as you heal so that he may focus. Those who try to do everything they normally do in a day as well as try to focus on healing have a more difficult time than those who accept help as they heal.
Spiritual preparation requires a serious assessment of faith; faith in yourself, your doctor, your loved ones and in having those faith in someone or something much bigger, whether it is a belief in a Creator, God, or the wonder of the universe which makes sense, the best spiritually healers recognized themselves as a tiny part of a wonderful whole instead of a big part of something far less.
The operating room is one of the safest places on the plant. Where else do find yourself surrounded by at least 4 or 5 professionals who’s occupation is to keep you safe? The culture in American operating rooms is one of a team. No longer is the surgeon absolute master. Every healthcare professional has a right and duty to speak up to, comment, or to question. In this way, the patient has at least 8 pairs of eyes and 4 brains with them at all times. While the room feels cold, serious attention is paid to keeping the patient warm. Circulating air blankets, warm IV fluid and body temperature monitoring allow warm tissues to function as they should. Warming the skin prevents infection in a more profound way than any known antibiotic. The initial anesthetic goes in via an intravenous line and sleep follows within seconds. While the patient is asleep, a soft plastic tube is inserted from the mouth into the throat to keep the patient’s airway open to the flow of oxygen. Safety monitoring equipment is watched by the anesthesiologist and nurses continually. The incision across the bottom of the abdomen is made down to, but not through the muscle. The skin and fat are elevated off the muscle towards the navel. The navel is left in place by cutting skin around it. Finally, the skin and fat are lifted up all the way to the bottom of the ribs. At this point, the separation of the rectus muscles that happened during pregnancy is repaired. This reduces the ability of the abdominal contents to protrude out from the lower abdomen. Long, continuous sutures synch the waist in like an internal corset. Uncomfortable for the 1st few days, this is the part of a tummy tuck patient’s appreciate most. It helps to return the abdomen to a pre-baby or pre-overweight look. The patient is then placed in a flexed position so that a maximal amount of skin can be removed. After it’s removal, it is waited and then discarded. Almost all patients are curious about the weight of what was removed. Now for a new innovation brought about by Dr. Harlan Pollock in Dallas, Texas and brought to Indianapolis by our practice; No drains! When the average tummy tuck patient is asked after she is healed what the worst thing about her experience was, she almost always says “The drains.” We now perform Dr. Pollock’s drainless technique. It involves the placement of additional sutures to stabilize the abdominal wall and skin together. This not only closes the space drains are normally placed in to, thus avoiding fluid build up, but it distributes the tension of a tight wound closure throughout the abdomen, not just on the scar. Long-term, we feel this will give a better cosmetic result. All sutures are self-dissolving underneath the skin. The last layer is what dress makers would call an invisible hem stitch. We call it a subcuticular closure, but it is the same thing. The dressing is a clear plastic Saran Wrap looking material. It is waterproof, so showering is possible anytime postoperatively.
Healing, like preparation for surgery, is in 3 parts; physical, emotional and spiritual. The parts overlap in most patients. In most patients, the course is marked by steady but uneven progress in all 3 areas.
Physical healing involves pain resolution, mobility, and return to normal activities. Swelling is as much or more of an impediment to this process as is pain. Most patients do take narcotic pain medication such as hydrocodone in the 1st week postoperatively. Most patients say they dealt with swelling tissues for several more weeks postoperatively. Those patients who physically heal fastest are those who work diligently at increasing their activity level every day and who get professional or family member massages regularly as well.
Emotional healing seems to take less time than physical healing for most patients. It seems to involve a mental acceptance that discomfort in contour irregularities are normal parts of the healing process. Focusing on things and people outside of the physical healing process seem to help. Concentration on slow, regular breathing is helpful as well. When you are breathing in a slow, deliberate fashion, your mind tends to understand the body’s needs for oxygen and calm in good measured doses. Long walks seem to help not only with mobility, but tend to resolve swelling more rapidly and are meditative in nature. Many of us believe walking is as good for the mind as it is for the body.
Finally, spiritual healing is the process of accepting one’s importance in the world. To be a healed and happy tiny part of a gigantic everything is a good spiritual goal. Even if the result is imperfect (and we plastic surgeons do not think that we have ever gotten a perfect result) that acceptance of the outcome as improvement or elimination of what was once a major distraction, is true healing. Believing that the decision was justified helps one move forward. This does not mean that any outcome should be excepted as rapidly as possible. Sometimes complications happen or revision is desired for an improved shape or contour by the patient. True spiritual healing, therefore, takes the longest, but is the most rewarding.
My Plastic Surgery Group has done upwards of 1,000 abdominoplasty or tummy tuck surgeries in Indianapolis and Carmel over the past 10 years and find it’s one of the most rewarding surgeries to perform because patient satisfaction is overwhelming. We look forward to meeting and helping you on this journey.