Helena O. Taylor, MD,PHD,FACS & Stephen R. Sullivan, MD,MPH,FACS
Named Among the Best Plastic Surgeons in Boston
Abdominal recontouring is one of the most powerful procedures in aesthetic surgery. Despite diet and exercise, an improved abdominal contour is not always possible, particularly after childbirth. With age, pregnancy, or weight changes, patients commonly develop diastasis recti (separation of the abdominal muscles) with abdominal bulge, as well as stretched out skin.
Diastasis recti frequently cannot be corrected with exercises or physical therapy, while surgery can be very effective at restoring muscular position, and when necessary removing extra skin.
Tummy Tuck (Abdominoplasty) is an operation for removing excess skin, stretch marks, and fat from the abdomen. At the same time, the umbilicus (belly button) is positioned within the re-draped skin, and the position of the rectus muscles of the abdomen is restored. The scar is placed low on the abdomen at the pubic hair line, similar to, but longer than a c-section, so it can be hidden with underwear or a bikini.
A tummy tuck is usually combined with fat reduction by liposuction of the "love handles" or waistline to remove common areas of excess fat. A midline depression can also be sculpted with liposuction. Patients undergoing abdominal hernia repair (umbilical hernia or ventral hernia or incisional hernia) might also consider having a tummy tuck at the same time to avoid extra operations and improve abdominal contour.
Diastasis recti is the separation or widening of the space between the rectus muscles of the abdomen. These are the muscles that for a “6 pack”. Excess separation often happens with pregnancy, but can also occur with age and changes in weight. This widening results in a bulge, and weakening of core strength. Unlike a hernia however there is no hole or opening, just a stretching.
Diastasis repair plays an integral role in most tummy tuck or cosmetic abdominoplasty procedures, but may also be performed to reinforce a hernia repair. While we often feel that this muscular repositioning is a functional or reconstructive procedure, insurance carriers consider diastasis recti repair to be a cosmetic procedure.
Every operation is tailored to the individual patient and no two operations are the same. There are some general types of abdominoplasty and these include: mini-abdominoplasty, full abdominoplasty, lipoabdominoplasty, and abdominal wall reconstruction. In all types, a scar is traded for excess skin or fat. The scar is placed low and covered by underwear or a bikini. For women who have had a previous c-section, the abdominoplasty scar is lower. The overall goal is to ensure a fitter and flatter appearing abdomen.
Patients often benefit from the experience of two board certified plastic surgeons working together to improve safety and efficiency. Unlike many surgeons who have physician assistants helping or performing parts of the operation, top Boston Mass board certified plastic and cosmetic surgeons Dr. Taylor and Dr. Sullivan work together to perform tummy tuck operations. They are also among very few plastic surgeons in the Boston area to use the latest and most effective medications for pain control and opioid reduction, including Exparel® (liposomal bupivacaine).
Post-bariatric weight loss surgery with Dr. Taylor and Dr. Sullivan can restore your figure after you have successfully lost weight.
If you have deflated areas of your body after weight loss, you may be a candidate for an operation with Dr. Taylor and Dr. Sullivan. Exercising and weight loss are important, but they can't remove excess skin or stretch marks. Only post-bariatric weight loss surgery can remove the excess skin.
Patients often consider a tummy tuck (abdominoplasty) for removal of abdominal skin and fat, breast lift (mastopexy) for women to lift and make the breasts perky, gynecomastia surgery for men to create a masculine and muscular chest, arm lift (brachioplasty) to tighten the arms, or thigh lift to remove excess skin from the upper-inner legs.
Each patient is carefully evaluated and if Dr. Taylor and Dr. Sullivan consider you to be a good candidate for an operation, they will customize a tailored surgical plan for your body. Dr. Taylor and Dr. Sullivan, Boston board certified plastic and cosmetic surgeons, work closely with the team at the Mount Auburn Hospital Weight Loss Center, where they give informational seminars to interested patients. It is never to early to consider your reconstructive options.
Patients recover quickly with limited discomfort and are able to leave Mount Auburn Hospital on the same day as the operation. You will be walking on the day of the operation and may shower the next morning. Some discomfort and tenderness is normal, though when compared to a caesarian section, for example, most patients tell us that a tummy tuck is an easier recovery. Before, during and after the operation we’ll prescribe multimodal non-narcotic medications to minimize discomfort and limit the need to use opioid medications such as oxycodone.
Most patients benefit tremendously from our use of long-acting numbing medicine, known as Exparel, to limit discomfort for several days following the operation. Our treatment regimen is also guided to prevent symptoms such as nausea, vomiting, and constipation to ensure a gentle and comfortable recovery. For many patients, surgical drains are necessary and are the most annoying part of their recovery. These are typically removed about five - ten days after surgery.
Every patient is unique, both with planned procedures as well as potential risks. General risks of abdominoplasty can include bleeding, scar, infection, fluid collection, pain, and blood clots in the legs that could embolize or travel. With careful patient and procedure selection, and detailed attention to perioperative care, most potential complications are thankfully rare with tummy tuck.
Our preference is to perform most liposuction with sedation or general anesthesia in the operating room as a day surgery procedure. Patients wear compression garments for several weeks after surgery. Bruising and some swelling is common, but varies in severity. It takes several weeks to months for the swelling to resolve. Patients report being sore the first week, but significant pain is rare.
Dr. Taylor and Dr. Sullivan make safety their top priority. We will provide specific information and instructions to help you prepare for your procedure. We take precautionary steps to minimize risks and complications from surgery to help you recover with the least amount of discomfort and time.
Tummy tuck trades a scar for improved body contour. The trade-off is typically a good one and the scars can be placed in the least conspicuous location. The scar from a tummy tuck is even lower than that of a C-section scar, and although longer, the scar can usually be hidden by underwear or bikini bottom. We use dissolving buried sutures to avoid the need for suture removal or unnecessary suture scars.
Tummy tuck is considered cosmetic and not covered by insurance (at least until women become CEOs of all insurance companies!). When you come in for your consultation we will evaluate your condition to determine if you might qualify for some coverage by your insurance company with a simultaneous hernia repair. Depending on which procedures meet your goals, your policy may provide some coverage.
Although a tummy tuck will not affect your ability to have more children, you should consider postponing procedures such as tummy tuck until after you are done having children. Nevertheless, operations can be performed again in the future.
Women or men with excess skin and abdominal fat and bulge from diastatsis recti are potential candidates for a tummy tuck. The ideal candidate is a nonsmoker, in good health with a BMI less than 30, and, if a woman, is finished with childbearing. Safely lose the weight you can and be at a weight that you can maintain. If we determine you to be a good candidate and you wish to proceed, we will be in this together with you to help you to achieve your goals, as quickly and as safely as possible.
ACTIVITY
GENERAL OUTCOMES
It is important to be seen by Dr. Taylor or Dr. Sullivan after your operation. They will see you in follow-up appointments at 1 week, 2-4 weeks, 3 months, and 1 year or as often as needed post-op. Call Taylor and Sullivan Plastic Surgery to schedule your appointments at (617) 492-0620 between the hours of 8:30 – 5:00 or visit our webpage at www.massplasticsurgeons.com. We are always available for postoperative concerns or emergencies and can be reached through our paging service 24 hours per day at (617) 492-0620.
Download our Abdominoplasty (Tummy Tuck) postoperative instructions.
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To schedule a private consultation with Dr. Taylor or Dr. Sullivan, please call the office or request an appointment using our form. We welcome your visit and your questions.
300 Mount Auburn St. Ste 304, Cambridge, MA 02138
300 Mount Auburn St. Ste 304, Cambridge, MA 02138
Monday - Friday 8:30am to 5:00pm — 617.492.0620
© 2019 Dr. Helena O. Taylor & Dr. Stephen R. Sullivan. All Rights Reserved.
