Tummy tuck combined with other procedures

Surgery called Tummy tuck is a surgery to correct sagging of the abdominal skin and subcutaneous tissue, which is associated with extreme weight loss from postpartum and obesity. Because it is a relatively large-scale operation, it is a treatment to be done after hospitalized.

At the same time as the tummy tuck, there are occasionally those who wish to perform liposuction surgery in the abdomen or correct the drooping of the breasts. However, we do not recommend doing two or more such operations together (compound surgery). The reason is that the risk of complications increases significantly.

It has been reported in the United States that necrosis of the tissues of the abdominal wall is likely to occur when Tummy tuck and liposuction are performed at the same time. In addition, when Tummy tuck and breast surgery are performed together, the operation time also becomes longer, the rate of causing deep vein thrombosis increases, water accumulates subcutaneously also in the site of tummy tuck (seroma), the healing of wounds said to be poor.

If you wish to do some of these surgeries, we recommend that you consider the next operation after a period of recovery from each surgery for safety.

Liposuction of abdomen

Our clinic director has carried out liposuction of many patients in the United States and Japan for many years. Although liposuction is already recognized such an effective treatment in the United States as an established cosmetic medical technology, but there are reports of serious complications such as fat embolism, abdominal perforation and death besides a mild complication such as unevenness of the skin surface. We do not have experience of such serious complications in our practice, but unfortunately there was report of such a case in Japan very recently.

We have repeatedly explained how to make a safe and effective liposuction for many years by invited lectures and papers at academic meetings, but unfortunately there are many self-proclaiming “cosmetic surgeons” in Japan who are not board-certified in plastic surgery, it can be said that in some cases it may be an extremely dangerous procedure.

First of all, careful counseling is essential for liposuction. Depending on the types of the supplement or prescription medicines, it may become easy to bleed, and it may be impossible to carry out safe liposuction unless these medicine are stopped ahead. Also, in preoperative examinations, especially in the case of abdominal liposuction, it is necessary to determine whether there is an umbilical hernia or scar of past abdominal surgery. Small umbilical hernias may be difficult to find even with a specialist. In our hospital, we are trying not to make a hole around the umbilicus in such a case to improve safety.

Next, during the treatment, it is a technical problem, but in case of a right-handed doctor, how to use the left hand becomes important. It is necessary to perform the treatment while checking with the left hand where the tip of the liposuction tool called cannula is heading.

Finally, close all the holes used for suction and fix it under compression. Also, in case of day surgery, after surgery, we request an escorting person to be accompanied to see the patient’s conditions until next day. If that is impossible, you will be hospitalized at a university hospital and do the procedure there.

By observing the above guidelines, liposuction can be safe and effective even if it is a stomach operation. I think that the expenses are never higher compared with slimming surgery using laser or ultrasound.

About liposuction

In Japan, there are few patients who desire liposuction even if they say slimming surgery, and if possible, they seem to be interested in partial slimming by laser or injection. Also, even with cases with a lot of fat and non-invasive methods that can hardly be treated, it may be giving the impression that ultrasound or liposuction using internal laser is better.

In the United States where the aesthetic medicine is advanced, there are still many methods of liposuction using old-fashioned hands (more than 250,000 cases per year), and there are not many methods using laser or ultrasound in combination. There may be reasons for this, and may have been written before, but in such a way, many burns (burns) due to the heat of the tip of the equipment have been reported, especially for patients with not much fat It is getting not used. Considering Japanese patients with American standards, there are not many people with a lot of fat, so it is our thoughts of our hospital that it is better not to use these devices.

Liposuction for men and women – the differences

With regard to liposuction of tummy (abdomen), we need to think separately for men and women. In general, abdominal fat of females accumulates outside the abdominal wall (subcutaneous of the stomach), and it is suitable for liposuction. On the other hand, as a man’s stomach is represented by the expression “metabolic belly”, it is often stored inside the abdominal wall, that is, between the intestines and organs (visceral fat), as it is represented by the expression of metabolic belly, There are few parts that can be taken with suction.
There are men who often misunderstand liposuction as weight loss surgery. In the case of men, improvement of dietary habits, exercise, change of stress, and sometimes diet medication may be more effective than liposuction although some men are still qualified for localized liposuction procedures.

Liposuction and obesity

Liposuction is not a procedure to eliminate obesity, it is an operation that effectively removes locally accumulated fat (lower abdomen etc.). Many people misunderstand this as well as the general public, as well as non-professional physicians.

At the American Society of Plastic Surgery, liposuction is not recommended for people with a BMI index of 30 or more. Such a person must first lose weight with diet therapy. As liposuction for patients with a BMI of 30 or more, the risk of complications (deep venous thrombosis and side effects of anesthesia) also increases, so careful response is required.

Liposuction – tumescent technique revisited

Regarding liposuction, our clinic has received various questions from many patients of different nationality.

At this time, we will discuss about slimming surgery using various accompanying devices which are said to be the “latest type” among them. For liposuction, it is famous for its wet method with ordinary cannulas using a tumescent solution that has been widely used in the United States for many years and has established safety. In this method, a local anesthetic or a drug which becomes difficult to bleed is diluted highly, injected so as to inflate the tissue in the target area, and then suctioned. In this method, it is known that bleeding volume is 1% or less of the aspiration volume (very little). Also, depending on the skill of the doctor, it is said that there is little damage to the tissues due to the equipment used, and it is a safe way. In our clinic, using this microcannula method which further evolved this method, effective results with little unevenness are obtained.

Nowadays, in place of the above method, some devices have come up that generate ultrasonic waves and lasers at the tip of the liposuction device. Japanese people are sensitive to new technologies, so treatment using these devices seems to be commonly done in Japan. Then how about in the United States? In the United States, such devices temporarily attracted attention, but it is not being used more often now that it is not used frequently. Why? The biggest problem is the seriousness of complications. Many of these liposuction plus alpha devices emit high energy at the tip, resulting in burns (burns) in the subcutaneous tissue, damage to the nerve, edema due to a delay in the course of healing (water accumulation) etc.

As a result, in the United States and elsewhere, it is true that we have returned to liposuction using a conventional tumescent-based system that does not use lasers or ultrasound.

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