| ...99...100. Breathing a little heavier, glistening (as
they say in the South) with perspiration, and feeling the "burn" after
struggling through those dreaded sit-ups, you’re hoping that the image
staring back at you in the full length mirror will have miraculously shed
the unwanted |
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pounds and will show off the desired sleek torso. Once again, you’re disappointed
and frustrated with the "paunch" that defies everything but gravity.
Just about everyone sees something they don’t like when they look in
the mirror. In fact, research study after study reports that the majority
of us -- that’s more than 50 percent of both men and women -- are dissatisfied
with our body image. The main source of this dissatisfaction is more often
than not the hips and abdomen.
Body image plays a major role in how we see ourselves, and can color
our perception of how we think others see us. If this overall image is
negative, it can drag down self-esteem, cause depression, interfere with
intimate relationships, and generally get in the way of day-to-day life.
Reinforcing this self- absorbed misery is the media’s message that the
fountain of youth, health and happiness is accessible only to those who
are thin. Every now and then, in obvious disregard for the "rules," a happy,
well adjusted, full-figured model like Elle will appear on the scene, but
they are sadly outnumbered and eclipsed by the legions of anorexic McBeal-lookalikes.
| In today’s fitness and appearance-obsessed society, many
women reaching their middle years simply want to regain a more youthful
appearance. Unfortunately, after having several children and gaining and
losing the same 20 pounds over the years, they soon catch
on that neither dieting nor exercise will restore the desired profile.
When the skin is badly stretched and abdominal muscles separate at the
midline, they finally discover that no amount of sit-ups will fix the problem.
Abdominoplasty, the medical term for tummy tuck, can be performed
to remove excess abdominal skin and to tighten underlying muscles |
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that have stretched apart to the point where they provide little or no
support for internal organs. The surgery -- which is designed to improve
the contour of the body by flattening the abdomen and narrowing the waist--
is a major surgical procedure that is usually performed in a hospital setting
under general anesthesia. A tummy tuck is not, however, a substitute
for weight reduction.
Women (and yes, men too) who are in relatively good shape but have weak
abdominal muscles and localized excess skin and fat make the best candidates
for the tummy tuck procedure. It can be especially helpful for women who
have had multiple pregnancies which stretched skin and muscles to the point
that no other remedy can return them to normal. There are some other factors
-- age, obesity, skin tone and whether or not the patient smokes -- which
can have an impact on the results of the surgery. These are just some of
the topics that are discussed with the patient during the initial consultation.
In some cases, these factors could have such a negative impact on the possible
outcome that the patient would not be considered a good candidate for this
elective procedure.
According to plastic and reconstructive surgeon Michael V. Kelly,
II, M.D., "If someone is going to undergo surgery to improve their
appearance and to flatten their tummy, they are certainly going to want
the scars to be minimal. While there are many surgical techniques for performing
abdominoplasty, I use a special incision that allows good access to the
surgical field and is especially conducive to repair. I also sculpt the
fat away from the umbilicus (belly button) and ‘replant’ it in such a way
to provide a trim, lean and muscular appearance that so many of my patients
request. In the pre-operative consultation, we go over the specific details
of what a patient might expect -- the technique, the risks, what kind of
anesthetic will be used, the costs, and a candid evaluation of what the
surgery can accomplish -- so patients can make an informed decision."
"I cannot stress strongly enough that while this procedure can indeed
enhance a person’s appearance," cautioned the surgeon, "it cannot change
their life...it cannot change the way others treat them or care about them.
That’s why I urge patients to really think about and analyze their expectations
and motivation for this surgery so we can have a candid discussion about
this during the initial consultation."
There are some preparations -- eating, drinking, smoking and avoiding
certain vitamins or medications, for example -- necessary before surgery.
Once in the surgical suite, the anesthesia is administered and the procedure
begins. Abdominoplasty usually takes two-and-a-half to three hours, depending
on the extent of the work to be done.
Once the incision is made, the skin and fat are separated from the abdominal
wall and lifted to expose the abdominal muscles. The muscles that are loose
and stretched apart are sutured together to tighten them up. Then, the
skin flap is lowered over the abdomen and the excess skin and fat are cut
away. Before closing the incision, the navel is reconstructed. After the
sutures are in place, a firm elastic bandage is applied to the area.
"Patients usually remain in the hospital for two days," explained Dr.
Kelly. "Sutures are removed about two weeks after surgery and, as soon
as appropriate, the bandages are replaced with an abdominal support garment
which is then worn for several weeks."
After the surgery, it is important for patients to refrain from any
heavy lifting, straining, or over-activity. While most patients are up
and around one or two days after surgery, each case is different. It is
therefore important to follow the physician’s recommendations about when
normal activity can be resumed.
There are thousands of abdominoplasties successfully performed each
year. The amount of improvement depends on the extent of the surgery, the
patient’s body build and the individual’s healing process. Complications
are relatively rare and are thoroughly discussed with the patient before
the surgery.
"This is one surgery where following the doctor’s orders can really
make a difference in the recovery period," said Dr. Kelly. "Patients often
feel so good they are anxious to resume their normal activities earlier
than they should. Taking it slow and easy is usually best, but if the patient
has any questions about whether or not an activity is OK, they should contact
their surgeon."
Abdominoplasty is a cosmetic procedure. Sometimes it is scheduled in
conjunction with gynecological surgeries such as bladder re-suspension
or hysterectomy. This minimizes the patient’s expenditures for the operating
facility and anesthesia, and requires only one recovery period instead
of two.
"In scheduling this or any other plastic surgery procedure," Dr. Kelly
advised, "patients should try to be realistic in their expectations. The
goal is improvement, not perfection."
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