Tag Archives: tummy tuck

Abdominoplasty and Tummy Tuck – Blood Clots DVT and their Prevention

The following educational writing will discuss tummy tuck surgery and blood clots (DVT), and it will help a person understand what this is and how we can minimize it. DVT is the abbreviation for Deep Venous Thrombosis. This is the medical term for blood clots. It is a risk after all operations including cosmetic surgery and plastic surgery. In particular, this writing will discuss blood clot after tummy tuck, because this operation is more prone than some operations. However, understanding DVT is important for any cosmetic operation. Overall, tummy tuck and cosmetic operations are extremely safe!

Abdominoplasty is the medical word for cosmetic tummy tuck or cosmetic mini tummy tuck. These are wonderful operations that can give a person a flat, tight, and attractive abdominal area. The operation is often part of a mommy makeover and can truly get a women back into a bikini. This is done by fixing the damages of having babies! It involves improving both the breasts and stomach at the same time. Results can be amazing! Please go to the before and after pictures in the photo gallery – category- “breast enhancement and tummy tuck.”

Like all operations, blood clots can happen and this is considered part of general abdominoplasty risks or tummy tuck risks. However, it is a very safe operation overall. The risk we are discussing is DVT or deep vein thrombosis. First, we will discuss what this problem is and then focus on it’s prevention- or ways to maximize “not” having this problem.

After all operations, blood clots or DVT can occur. This tends to occur in the legs right after the induction of anesthesia or beginning of surgery. The clots are in the deep veins and not the superficial veins that we see on the surface of the legs. If these blood clots occur, there is a risk that they can break off in the veins and travel with the blood to the lungs. This is called a pulmonary embolus or PE. It can be a serious health issue and hence prevention is important.

Risk factors for DVT include but are not limited to:

Birth control pills or hormones
High blood viscosity (thick blood)
Obstructed venous return (vein problems)
Lack of movement – (immobility after surgery)
Previous DVT
Older age
People having cosmetic operations like a tummy tuck can have some of these risk factors for DVT. However, if you have none of them, it does not mean you will not have a DVT. Notice how stopping birth control pills wil be important and early ambulation will also decrease our chances of this problem.

Many things can be done to decrease our chances of this problem. Active leg exercises, leg elevation, and the use of elastic support stockings can increase vein blood flow and decrease clotting. Early ambulation after surgery and avoidance of prolonged bed rest can promote blood flow and prevent clots. Think of the blood flow in our veins like a slow moving stream. Anything that improves flow or helps the blood flow helps prevent DVT. Even elevating the foot of the bed 15-20 degrees can help promote blood drainage. Patient positioning after surgery will be discussed to help this also.

I recommend the acronym “PAIL” to help remember things to do after surgery to decrease DVT or tummy tuck blood clots or abdominoplasty blood clots.


P-Patient Positioning.
Keep the “toes above the nose” to help blood flow. A lounge chair is not tilted back enough. Use pillows to get those legs above the heart.

A- Ambulation (early ambulation)
Get out of bed frequently. A minimum of 4-6 times a day for 5-10 minutes a day. More is good. This encourages blood flow. It is recommended to avoid twisting of the abdomen, if you are recovering from a tummy tuck. By avoiding twisting, it encourages the skin to heal to the underlying muscles and decreases fluid accumulation. Early ambulation, without twisting the abdomen, is recommended after surgery.

I- Invisible Bicycle
Despite early ambulation, we still will have a lot of time in bed. We can promote blood flow by moving the legs, like riding an “invisible bicycle.” This can be done in bed with minimal pain after surgery, even an abdominoplasty. You can’t do this enough! Do it as much as you can.

L- Leg Compression.
I use sequential leg compression machines for all of my operations to squeeze your legs during surgery and promote blood flow. Leg stocking are recommended, as well, to help with this. Knee high stockings to compress the veins are recommended.

Remember “PAIL” to help think of the important things after surgery to minimize DVT and problems.

Dr. Saunders is a board-certified plastic surgeon who practices exclusively cosmetic surgery. Please check out the tummy tuck before and after photos on our web site. Also, please come in for a complimentary consultation to learn about your choices and options!

Body Lift Surgery and Body Contouring Surgery: Part Four

Recovery and Summary – Delaware and Pennsylvania

Body lift surgery, lower body lift surgery, and body contouring surgery are operations that can give fantastic and wonderful changes for many people. Understanding and learning about the cosmetic operations is always important for all people interested in the surgery. This educational series has four parts and will, in this section – Part Four, go over recovery from surgery and a general summary. Please review the three earlier parts and the “Procedure Info” section of my web page.

As discussed before, body lift, lower body lift, and body contouring operations can vary depending on what operations are done. Which specific operation you choose to do will determine the recovery for you. For example, a thigh lift operation alone will have a different recovery than a lower body lift or an operation that includes a tummy tuck or an arm lift also. Some patients choose to do larger operations than others. Larger operations will require more time off work and will have a longer recovery compared to shorter operations. First, general recovery from these operations will be reviewed and then some specifics for individual operations.

For those interested, detailed post operative instructions are available on my web page for all the operations I perform. Please see the instructions under “Patient Forms and Survey” in the menu. Then click on “Body, Thigh, and Buttock.”

General instructions for lower body lift recovery are to have ample time to rest and heal. It takes time to recover from these operations and people who try and rush back to their busy schedules can increase problems. It is recommended to have about 1-2 weeks off from most activities. It will be a month before unlimited exercise can resume.

We want to decrease our chances of blood clots in the legs or DVT. I have an acronym that will help people remember some of the important instructions after the surgery.

It is “PAIL.”

P – Patient Position. Keep the legs elevated. Venous blood flow is slow and dependent. Keep the legs elevated above the heart to promote drainage and blood return. “Toes above the nose.”
A – Ambulation. Early ambulation is very important. Moving the legs encourages blood flow and return. Get out of bed frequently and walk around. Usually you will need some assistance the first couple of days. The instructions are “Out of bed with assistance.”
I – Invisible Bicycle. When those legs are elevated, pretend you are riding a bicycle. Move them and pump them. This encourages blood movement. One leg can be done at a time so it won’t even hurt. Most find this is really helpful.
L – Leg compression stockings. Ted hose or other brand leg compression stockings should be worn until about two weeks after surgery. These help compress the veins to decrease clots.

Specific instructions for body lift recovery or body contouring recovery depends on the specific operation done. Please see the operations under “Patient Forms” in the menu section of my web page. Some specific instructions will be reviewed now.

Tummy tuck operations often involve muscle tightening. This is the part where the muscles are sutured together. This can cause pain, so a “Pain-Buster” is used. This device is fantastic! It trickles in Lidocaine to the muscle site for 72 hours or three days. It really works! I believe it has been one of the most significant advances in recovery for tummy tuck in the last decade. Most people are really surprised at how well it works.

Thigh lift, buttock lift, and tummy tuck operations usually require drainage tubes. These tubes collect fluid and prevent fluid accumulation. In my opinion, most people find them annoying but, overall, not that bad. I believe they lead to extra “flat” results and are well worth the minor discomfort involved.

Body Lift and Body Contouring Summary:

Benefits: The operations can give dramatic improvement to the stomach, buttocks, flanks, and thighs. This improvement might not be as much as desired, however. Realistic expectations are always important for all cosmetic operations.

Options: A complete review with the doctor is essential.

A woman may review options and decide against proceeding with any surgery.
A women may proceed with liposuction and “not” a body lift. This is easier surgery, but the results will not be as significant or dramatic.
It is important to understand the different incision patterns when considering a thigh lift.
Aesthetic Risks: A person must understand the incisions that are required for these operations. Different incision patterns can be used. The incisions turn into the scars. Other risks are important to understand and will be reviewed by Dr. Saunders in detail.

Recovery: The recovery is 1-2 weeks. Sometimes it is much longer than expected. The recovery requires a significant period of leg elevation and the use of a compression garment.

Body Lift Surgery and Body Contouring Surgery : Part Three

The Surgical Incisions and Results – Delaware and Pennsylvania

This educational writing on body lift surgery and body contouring surgery is part of a four part series. It is important to learn about the operations and all aspects about them. I specialize in exclusively cosmetic surgery and operations like body lift, lower body lift, and breast lift. Patients from Delaware, Pennsylvania, New Jersey, Maryland and surrounding states will find the these writings helpful. Similar concepts are reviewed for breast lift and can be seen in the writing “Breast Lift Surgery and Breast Reduction Surgery : Understanding the Incisions.”

Body contouring or body lift operations are composed of many different operations that can be combined or done separately. These operations include arm lift, breast lift, tummy tuck, buttock lift, and thigh lift. Lower body lift surgery usually is the combination of a tummy tuck and thigh lift surgery. Sometimes staging of operations is required as they all can’t be done at one time. Please see the “Procedure Info” section of my web page under Body Lift, for further discussion of this topic and staging surgery.

Thigh lift surgery typically has one of two incision patterns. The first pattern involves an incision high on the thigh in the groin crease. The incision length is typically 6 to 9 inches long. The second pattern involves a “stocking seam” incision from the groin to the knee area. This pattern has a longer incision. People all want the shorter incision. The cosmetic surgeon does also. This first incision pattern is the shorter one, but does not work as well as the second pattern, with the incision down the leg. This is because the second pattern allows for significantly more skin removal and usually dramatically better results.

The first pattern in the groin area is placed in a well hidden area, and this is the main advantage of this incision. New techniques involve suturing the deeper layers of the thigh skin or flap to the bony tissue of the pubis. This new technique, that I use, is reported to give superior results than standard thigh lifts. It is sometimes claimed that this thigh lift gives better scars, without spreading of the scar with time. The “Real-Reality” or truth is that thigh lift incisions can spread, regardless of which pattern or surgical technique is used. Most of the time the incision fades well. Most people are very happy with the operation and the results. But it is important to understand that a risk of the operation is the incision not fading as well as hoped or spreading of the incision.

Now that we understand what the thigh lift or lower body lift scar might look like, it is important to understand what type of results we can expect from surgery. In general, the thigh lift with the incision pattern in the groin, usually involves lower thigh liposuction. This operation typically gives moderate improvement to the upper inner thigh area. The improvement is best in the 4 to 6 inch area near the groin. Beneath the 6 inch area and further down the thigh, the results are from liposuction alone. The results are best in that small distance, very close to the groin. Further down the thigh, there is going to be persistent looseness of skin. This is because it is not removed by the smaller incision pattern that does not go down the leg.

Liposuction, which is done to the lower thigh, makes a person “a smaller version of you.” Please see the educational writing on liposuction titled “Delaware Body Contouring – Understanding Liposuction.” There is minimal tightening of skin with liposuction in this type of situation, with loose thigh skin to start. With incision pattern one, with just the groin incision, the thigh lift result or lower body lift result is improvement for a short distance in the upper inner thigh with substantially less improvement further down the thigh.

The second incision pattern is a stocking seam incision running down the inside of the thigh. This incision is along the inside of the thigh and tends to be longer. However, it allows for significant excess skin removal and hence significantly better results. A basic concept in plastic surgery involves the understanding of the relationship between skin removal and incisions. Small incision patterns allow for small skin removal. Larger incision patterns allow for larger skin removal. Larger skin removal gives better and more dramatic results.

This concept is very important when it comes to thigh lift results or lower body lift results. The same concept applies to tummy tuck surgery when comparing mini tummy tuck versus a “classic” tummy tuck operation. With the mini tummy tuck, less skin is removed. The results will not be as dramatic as with a classic tummy tuck with the longer incision. When it comes to the thigh incisions, longer incisions give better results. The stocking seam incision or the second incision pattern discussed for thigh lifts tends to be associated with much better thigh improvement and results. These patients tend to get much more substantial and dramatic improvement in the appearance of the thigh.

The best candidates for this procedure are patients who really want improvement, and typically need it. Significant weight loss for example is a good indication. These patients typically have major or significant looseness of the skin. Patients might say, ”I don’t care about the incision, just get rid of all this loose skin.” When they have this much loose skin, patients tend to love the result of the thigh lift, with the stocking seam incision. The operation gets them back into tighter pants and clothing.

In contrast, women who have minimal loose skin in the thighs, with some excess fat, might not want the longer incision. They might want less dramatic changes, and hence the long scar can sometimes outweigh the benefits achieved by the thigh lift. This patient might choose liposuction only or the shorter incision pattern. The doctor will review these options in detail with you.

If a patient is considering a thigh lift or body lift, she must understand the “Real-Reality” of the scars and the “Real-Reality” of the results. If a patient has significant loose skin, then there is a good chance they will be happy with the dramatic results that can be achieved with a thigh lift. However, if a patient has minimal looseness of the thigh skin, then they must be very careful when deciding to proceed with this surgery, other options must be considered.

Delaware Mommy Makeover – Look and Feel Better than Ever

Dr Saunders performs the latest and newest techniques of liposuction. In his opinion, tumescence and liposculpturing give the best and smoothest removal of fat!!

The result is a flatter, smaller, and more attractive area.  However, a person needs to have realistic expectations. Liposuction might not give a person as much fat removal or as flat a result as they hope. The result can be limited by excess skin, weak muscles, or poor elasticity. For example, in the stomach area, a cosmetic tummy tuck or mini tummy tuck might be a better option. Theses operations address weak muscles and loose skin.

It is extremely important to understand that liposuction has limitations. This is part of understanding realistic expectations. A patient interested in liposuction cosmetic surgery or other Delaware plastic surgery will be helped by understanding this important point.

A consultation is recommended with Dr Saunders to thoroughly discuss your desires. Contact us today to begin your transformation!!

Compression Garments After Tummy Tucks in Delaware

An abdominoplasty is the medical word for the tummy tuck procedure. The purpose of the cosmetic operation is to give a person a flatter, thinner, and more attractive stomach. Dr. Saunders believes that extra muscle tightening, which he calls the “California Corset,” gives an extra flat and sculpted tummy tuck. Dr. Saunders specializes in this procedure, and he uses the latest techniques to achieve his results. After tummy tuck surgery, Dr. Saunders will go over the important postoperative instructions to maximize your healing. There is also a section on his web page under “Patient Forms & Survey” that has the postoperative instructions covered in detail.

The compression garment is one of the requirements after your cosmetic abdominoplasty. Patients often want to know why it has to be worn and what purpose it has for healing. There are three main reasons why we wear compression garments to help with tummy tuck recovery. The first is that the pressure of the garment helps with bruising, swelling, and discomfort after abdominoplasty surgery. The physical pressure helps shift the balances of fluid in our body to encourage absorption. The pressure helps “push” the fluid out of the tissues. This leads to quicker resolution of the bruising and swelling normally seen after tummy tuck surgery. This is an important for about one month. The first two weeks is very important, but during the second two weeks the garment can be taken off for periods of rest and comfort.

The second reason compression garments are important after abdominoplasty surgery is to promote healing of the scar. Pressure has been consistently shown to be important to give an attractive and smooth scar. The pressure also minimizes the chance of keloid scars or hypertrophic scars. This can be an important factor to give the best healing and scar. An interesting fact is that burn doctors treat their burn patients  with compression garments for one year!! This is done to maximize healing of their scars.
During tummy tuck recovery, the pressure from the garment really helps healing. It is usually not mandatory for one year, but does underscore the importance of pressure for long periods to give the best scar.

The final purpose of the compression garment is that it promotes proper eating and weight control. Abdominoplasty surgery can not replace diet and exercise. Weight control is an important part of healing. A compression garment helps with diet by making us feel full. It is not uncommon to eat less with these types of garments because of the pressure. Just like when you eat too much and your pants feel tight, the garment encourages proper eating. This is an extra benefit of compression garments and is an old fashioned, but it helps us to eat healthy.

Many people ask what garment is best. A binder or girdle can both work! The concept is “put pressure” where you had surgery. Spanks tend to be too light weight. A stronger pressure is recommended.

Dr. Saunders has West Chester plastic surgery patients and Media plastic surgery patients who have recommended the following brands.

1: Cass  (from Nordstroms)
2: Flexees  (from Kohls)
3: Ardyss International

Dr. Saunders is a board certified plastic surgeon who practices exclusively cosmetic surgery in Delaware and Chadds Ford, Pennsylvania. Please check out the tummy tuck before and after photos on our web site. Also, please come in for a complimentary consultation to learn about your choices and options!