Tag Archives: results

Tummy Tucks for Men

 Abdominoplasty in male cosmetic plastic surgery patients

 

Abdominoplasty, or tummy tucks for men, is a procedure that is often performed on women, and most of my blogs have talked about female cosmetic plastic surgery patients having these procedures.

https://tavmd.com/2013/02/17/full-or-mini-abdominoplasty/

https://tavmd.com/2011/07/02/new-technique-for-tummy-tuck/

Tummy tucks can also be performed on males, and though the number of male cosmetic plastic surgery patients who need an abdominoplasty is significantly less than female patients, there is no substitution for this surgical procedure when it’s necessary.

 david chubby photo    tavmdphoto1_ezg_1

Tummy tucks for men

Reasons for a male to have an abdominoplasty differ from abdominoplasty in female cosmetic patients.

Typically females will have abdominoplasty for:

  • Excess loose skin
  • Excess fat
  • Separation and weakness of abdominal muscles

 

Males obviously do not have the sequelae of pregnancy to deal with and so do not have the separation of abdominal muscles that is a major reason for female abdominoplasty. They can, however, have extra fat and skin looseness.

Significant weight loss is the main reason for male tummy tucks.

 

Surgery techniques for abdominoplasty in men

Techniques for abdominoplasty in general include:

  • Excision of extra skin in the abdomen
  • Liposuction of fat from the abdomen, flanks and love handles
  • Suturing of abdominal rectus muscles

 

In male tummy tucks, liposuction and the excision of skin between the umbilicus, belly button, and pubic areas is performed in the same way as in female abdominoplasty.

The main difference is in the type of abdominal rectus muscle plication performed.

For female patients, I tighten the abdominal muscles in a diamond shape to bring the waist line in to a pre-pregnancy form and emphasize a small waist.

When men have tummy tucks, the idea is to tighten the muscles, if necessary, into a V shape, not to give them a small waist. This tightening of muscles is performed in a vertical manner.

The recovery from an abdominoplasty/tummy tuck  for men tends to be less difficult than for women because less tightening of the abdominal muscles is required. Men are typically able to resume work after 7-10 days.

 Still, the great majority of men looking for improvement in their abdominal contour and tummy shape will benefit from just a liposuction, without any removal of extra skin or a tummy tuck.  Many male tummy tuck patients also benefit from liposuction of the chest to reduce gynecomastia.

 

 

 

Morad Tavallali, M.D., FACS

Face lift Surgery by Non-plastic-surgeons

Face lift surgery by non plastic surgeons

Full face lift

 

Your cosmetic plastic surgeon is a human being with all the frailties that brings with it, including a little “schadenfreude.”

A few years ago, I wrote the post below about face lift surgery being performed Face lift Surgery by Non-plastic-surgeons under the trademark name “Lifestyle Lift®” face lift. We have all seen their late-night ads on TV for face lift surgery with amazing results and a seeming ease that baffles the mind of any plastic surgeon who performs face lift surgery. Turns out none of it was true!

https://tavmd.com/2010/10/22/life-style-and-lifts-in-plastic-surgery/

Here is an email I received today from Anne Cohen (whom I do not know, by the way) of a PR firm that is following what has been happening in Florida with the “Lifestyle Lift”  face lift company. I will let you read it, as last time I wrote about it I got another letter from the facelift company’s lawyers threatening to sue me for infringement of their trade name “Lifestyle Lift.” That is the problem. The company became a trade promoting cosmetic facelift with little regard for patients, results, ethics or just being good surgeons. What a shame that these types have now weaseled their way into our health care system.

Dear Dr. Tavallali,For some of my readers, Florida’s settlement with Lifestyle Lift® will be good news. For others, perhaps not.According to numerous articles on the web, Florida’s Attorney General, Pam Bondi, has announced a settlement with Lifestyle Lift® in that state. “Lifestyle Lift has agreed to change its marketing materials and practices to eliminate any possible consumer confusion about its services,” Bondi said.The Florida AG’s office has been investigating the company for several years to evaluate the accuracy and fairness of claims made through its advertising to consumers about its facial rejuvenation services. According to the Florida settlement, Lifestyle Lift® must disclose any compensation made to models used in its advertisements and materials, disclose the services performed on those models and comply with FTC guidelines regarding before and after photos used in endorsements and testimonials. The company can no longer use the term “revolutionary procedure” in its marketing.Further, Florida consumers who experienced unsatisfactory services between 6/1/09 and 6/10/13 may be entitled to a refund by submitting a claim form to Lifestyle Lift® by 9/8/13. You can download a copy of Lifestyle Lift® settlement with Florida via this link. The claim form is the final page of that document.As you may recall, in 2009 the State of New York charged the company with “astroturfing” for posting fake reviews on various websites, alleging they were written by satisfied customers. They settlement required payment of a $300,000 fine and promises not to post fraudulent reviews in the future.That’s the news for today!@
Anne CohenA Cohen Marketing & Public Relations845-901-5885 Cell212-330-8337 Office

 

 

Morad Tavallali, M.D., FACS

Bulges After Abdominoplasty-Tummy Tuck

Bulges after abdominoplasty-tummy tuck  or liposuction surgery,  is not unusual for the cosmetic plastic surgery patient . There are multiple reasons for these bulges; some can be improved and others are normal sequel of cosmetic surgery.

Here are some previous posts about tummy tucks:

https://tavmd.com/2010/10/26/tummy-tuck-abdominoplasty-or-liposuction/

https://tavmd.com/2010/10/27/how-is-a-tummy-tuck-done/

abdominoplasty

 

 

 

 

Swelling

Normal post-operative swelling after abdominoplasty and liposuction may take up to four months to improve. Though the swelling is initially all over the abdomen and hips, as the patient moves around, the swelling will settle down in the area just above the tummy tuck scar of the pubis and cause a bulge. Lymphatic massage can help remove the swelling bulge.

Abdominal scar

The way the cosmetic plastic surgeon closes the scar of the abdomen will also lead to temporary bulges of the skin.

For a tummy tuck, the incision over the pubis is usually smaller than the incision of the upper part of the abdominal skin that is removed. The relative excess of skin in the upper parts of the abdomen means that the skin needs to be folded into the lower incision of the abdomen, causing small bulges of skin. If a longer incision is made in the pubic area, the bulges can be eliminated at the time of surgery, but at the expense of a longer abdominal scar. However, with a little patience, the bulges will flatten out and a straight scar can be achieved without making it longer.

 

Abdominal hernias

Patients who have tummy tucks and abdominoplasty by definition have a weakness of the abdominal wall muscles. This is what causes the roundness of the shape of the abdomen. With tummy tuck surgery, the muscles are tightened to give a flat abdominal contour. In some patients, the muscles themselves may be very thin and not strong enough to hold the abdominal contents, leading to hernias. These hernias require a specific and separate procedure for closure. Sometimes it can be performed at the same time as an abdominoplasty, but at times it may only become apparent after abdominoplasty and liposuction remove the fat covering the belly.

Excess fat

Some surgeons, such as myself, routinely perform liposuction at the same time as abdominoplasty surgery to get more contoured results. Other cosmetic plastic surgeons do not perform any liposuction with abdominoplasty, and still others perform it as a second procedure 6 to 12 months after the tummy tuck surgery.

With any liposuction it is possible to leave a little extra fat on one side or the other that may require a touch up later. The reasons for this are that patients have different amounts of fat on either side of the body and the tumescent solution injected for the liposuction swells the area up and makes it difficult for plastic surgeons to achieve a symmetrical result.

 

Scoliosis

The curvature of the spine called scoliosis, which many of us have, leads to the appearance of bulges on the abdomen only because of the way we stand. There is the same amount of fat on the abdomen on the two sides, no hernias or skin fold, just a curvature of the spine that makes the body curve to one side and cause an apparent bulge!

The causes for bulges after abdominoplasty and liposuction are many but can be identified and corrected with a little patience.

Morad Tavallali, M.D., FACS

Effective cosmetic surgery is in eye of beholder

Do you see a difference in plastic surgery results?

 

The effectiveness of cosmetic plastic surgery procedures is in the eye of the beholder, just “deformities” that a patient sees in him/herself are.

I have written on what plastic surgery patients see when they look at themselves in a mirror:

https://tavmd.com/2012/08/13/the-eyes-have-it-not/

Aesthetic plastic surgery learning

Today I am writing about what you and I see as observers when we look at plastic surgery results and if effective cosmetic surgery really is in the eye of the beholder..

Every month, the American Society for Aesthetic Plastic Surgery (ASAPS) puts out a journal with the latest cosmetic plastic surgery articles. This is how plastic surgeons performing cosmetic surgery stay abreast of new techniques and research. The annual ASAPS meeting, to which I am going in a few days, is another way to learn what is going on.

 

ASAPS journal

This morning I was reading the March journal in between appointments. Some of the articles were excellent, and I learned a thing or two from them. I was also struck by several articles in which I saw:

  • no change after a plastic surgical procedure
  • a deleterious result after cosmetic surgery
  • an aesthetically horrible result after a procedure

All this is, mind you, in my opinion. I thought it would be interesting to see if you, the non-plastic-surgeon public, see beneficial changes worth the surgery!

 Case 1

Injection of Juvederm, a dermal filler, into the lips to make the lips larger. Boy, did the plastic surgeon make this poor woman’s lips larger! The lower lip is too large and the upper one has hardly been filled!

To me they look deformed. However, as the text says, “Both the investigator and the subject were very satisfied with the result.” Shame on them both, in my opinion, but what do you think?

before lip injection
before lip injection
after juvedrem injection
after juvedrem injection

 

juvederm injection

Case 2

Lipolysis, the destruction of fat from the skin by a series of injections of bile and other strange products that no one really seems to know much about, is another of those plastic surgery ideas that just will not die. Every so often it raises its ugly, dangerous and inefficient head. A group of followers, both plastic surgeons and patients, wishing for the wonder cure for flab end up mushrooming and then wilting away in disappointment. In this article, these were the before and after results provided by the proud authors. They see a difference and charged the patient several thousands of dollars no doubt. I see none.

Also, in the CT scan of the abdomen, where the fat is the white band going around  the dark area, do you see that there is some fat loss on one side but not on the other? They injected both sides, so what happened? Lipolysis is a technique that has no controlled or titrated result. I can inject anything into your skin and kill some fat cells. The difficulty is doing so in a measured  and efficacious manner. That is not what is happening here.

before lipolysis
before lipolysis

 

 

after lipolysis
after lipolysis

 

 

 

before after lipolysis photo

 

Case 3

Ever since I was a surgical resident, plastic surgeons have been trying to come up with a tissue glue that would miraculously cause tissues to adhere during surgery—a noble aim.

Tissue fibrinogen glue and similar products are supposed to be sprayed at the end of a facelift surgery between the skin and the muscles below to allow for attachment and healing. I even tried it once years ago, but I saw no difference in results or the patient’s bruising, swelling or pain. These are what the authors of this article were claiming to improve. They see a difference between the two sides of this patient, one side treated with the tissue fibrinogen glue and the other not. I won’t tell you which is which—peek at the caption if you want. I see no difference.

right side without tissue glue
Without glue

left side treated with tissue glue

Cosmetic plastic surgeons—or, for that matter, any author of a scientific article—cannot help but bring their desires, wishes, expectations and hopes to bear on their research. Where they see a huge difference, skeptics like me see none. Where they see progress, nihilists like me see their defeat, and where they see beauty, I shudder.

Make your own judgments and tell me if I am being too harsh. If you disagree with me, you may be easy pickings for some cosmetic plastic surgeons.

Morad Tavallali, M.D., FACS

Think Yourself to Health

Yoga mumbo jumbo may actually work!

 

Healing after cosmetic plastic surgery is affected by many different factors. None is more important than the patient’s attitude toward surgery and healing.

Here is a list of some factors that influence healing after plastic surgery:

https://tavmd.com/2011/01/04/healing-after-cosmetic-plastic-surgery/

 

Yoga and plastic surgery

Positive thoughts and attitudes toward healing will improve a patient’s cosmetic surgery results. Plastic surgeons have always known this, but now comes the first glimpse into research that may one day actually prove this notion once and for all.

If you have ever taken a yoga class, you know that the first thing they teach you is how to breathe. You breathe in through your nose, expanding your belly, and then exhale through your mouth, letting the air out of your lungs and and relaxing your abdomen.

Breathing exercises are supposed to relax you and get you in touch with your inner being… etc., etc. Recent research shows that all this breathing stuff may actually work to make you healthier!

 

The vagus nerve and plastic surgery

   vagus nerve
 nerve

 

 

 

 

 

 

 

 

 

One of the main nerves in the body is the Vagus nerve (Latin for wandering nerve), which wanders from the brain down to the heart, lungs and intestines,  regulating their function. If the Vagus fires off, heart rate and breathing are slowed, blood pressure is lowered and stomach motility and emptying of the bladder is increased. It can be thought of as the nerve that relaxes everything! Too much firing and we faint, a so-called “ Vaso-Vagal” reaction. The opposite system to the “parasympathetic” action of the vagus is the “sympathetic” system of nerves in the spinal cord. When these nerves fire, we have a  “flight or fight” response. We get all excited!

Researchers have measured what is known as “Vagal tone,” which is associated with health.
When we breathe air in, our heart rate slows ever so slightly, and as we breathe out, our heart rates speeds up a bit. The difference between these two rates is known as “vagal tone.”

Now, it turns out that vagal tone is higher in patients who are healthier and happier. Also, it seems that if you think of yourself as happy and healthy, vagal tone increases—it’s a feedback loop.

Low vagal tone is associated with disease, heart attack and stroke—that is the thready rapid pulse that is barely palpable.

The research showed that patients who thought good thoughts—happy , kind, loving thoughts—were able to increase their vagal tone, which may lead to a more relaxed and stress-free existence. Think those thoughts over a lifetime and you may actually be able to ward off disease and illness.

So the next time you do those “silly” yoga breathing exercises, you may not be as silly as you think.

Morad Tavallali, M.D., FACS

Cosmetic Surgery Results Differ for Plastic Surgeons and Cosmetic Patients

Cosmetic Surgery Results Differ for Plastic Surgeons and Cosmetic Patients

In previous posts, I have discussed how our mind affects cosmetic surgery results and perceptions. See https://tavmd.com/2012/06/11/mind-games-and-cosmetic-surgery/

Today I am looking into the differences between what your cosmetic plastic surgeon sees and what you see in your cosmetic surgery results.

My eyes, my perception

I started wearing glasses when I was in medical school in the early 1980s. All through my childhood I had perfect vision, and then suddenly in medical school I could not see the board anymore. Mind you, I was the eager type who sat in the front row! I went to the ophthalmologist, had the usual eye exam and was told that I really did not need glasses as I had minimal deficit in my vision. I begged for relief from my blindness and the doctor acquiesced to make me one of the “glassed.” My eyesight has remained remarkably stable over the past 30-odd years—not much worse than the first exam—and I’m still not really in need of glasses, but without them I am as blind as a bat for seeing things farther than 10 feet away. Walk into a room farther than that and all I “see” is a blur.

Blindness occurs in eyes and brains

We all “see” things, of course, unless we truly have a physical problem with our eyes such as blindness or cataracts. But there is also another type of blindness known as cortical blindness that can occur in some patients, especially after strokes. Their eyes are fine, but parts of their brain concerned with interpreting visual stimuli that come from the retina of the eye is damaged. The brain does not perceive the stimuli. Think of it as the computer sending a signal to a screen but your screen is turned off. You see nothing.

My eyes are fine, more or less, and someone else with the same eyes may have no problem seeing clearly. For me, the problem is in my brain—it does not perceive  stimuli coming from my eyes well enough. My brain demands a clearer picture. It is bothered by the slight decrease in visual acuity provided by my eyes.

That was just my own personal example of how perception affects our surroundings, and for cosmetic patients, the way we see ourselves.

How patients experience cosmetic surgery results

Patients are always telling me that their friends tell them they look great, amazing, young, etc. before they have had any surgery! Yet they are sitting in a cosmetic plastic surgeon’s office  for a facelift consultation because when they look in a mirror, they see a tired, old, haggard face. Each cosmetic patient has a view of him or herself that may be crueler than objective reality.  In extreme cases, their perception may be so different from objective reality that it becomes a disease process; body dysmorphic syndrome and anorexia are two such conditions, in which patients see themselves in a distorted way that no one else does. They see a mountain where there is a pebble.

What you see

What others see

 

For the typical cosmetic plastic surgery patient, the viewpoint is usually pretty reliable. It can have objective findings on a physical exam by a plastic surgeon that corroborate the patient’s perception—a slightly droopy set of jowls that can be corrected by a facelift or a bump on top of a nose that a rhinoplasty will fix.

We know our brains can play tricks on us and that we are at times hard-wired to see things that do not really exist. When it comes to looking at our faces and bodies, the same is true.
We each see things that no one else sees, seeing life through our own eyes. Plastic surgeons are here to help you get the cosmetic surgery results you want and also help others around you do the same!

Mind Games and Cosmetic Surgery

Mind Games and Cosmetic Surgery

 

No matter which cosmetic surgeon you talk to they will tell you of patients they have operated on who were unhappy with their plastic surgery results. The cosmetic plastic surgeon thought they had a fantastic result, and the patient thought it was a waste of time and money.

These differences in the perception of cosmetic surgery results are based on multiple factors but may be a result of nothing more than the basic emotional makeup of our brains and visual systems and how they work.

Our emotional state determines our expectations, and our expectations in turn change with our daily feelings. If you get out of bed on the wrong side, you will see nothing but ugly; on a good day you are a god or a goddess! The levels of pain, your facial expression and your levels of stress in  daily life will all affect your perception of your cosmetic surgery results.

Our visual system is also open to manipulation by our emotional state, but also by its basic hard-wiring. In the video in the link below, follow the instructions on the page. Stare only at the cross in the middle of the faces of the two celebrities (a difficult thing for a human to do, as we are also wired to look at other human faces over almost any other parts). You will notice grotesque monsters form in front of you from the brain-morphed mixtures of popular celebrities and movie stars. This illusion comes from a process occurring in your brain. It only exists in your brain, and arises because of the way the two sides of the brain are interpreting the information given to them. Why do they appear grotesque? For some of us, it may be our emotional side mixing some envy in with the visual stimulus. For others, a psychiatrist will be able to tell you. Have some fun by clicking below:

http://www.ritholtz.com/blog/2012/05/celebrity-illusion/

 

Morad Tavallali, M.D., FACS