#15: Top 20 Tummy Tuck Questions Answered

This week Dr. Barrett delivers answers to the most frequently asked questions about Tummy Tucks.

Questions Answered in This Episode:

What is a Tummy Tuck?
Who is a good candidate for a Tummy Tuck?
Will Liposuction work instead of a Tummy Tuck?
Is liposuction performed with a Tummy Tuck?
What are the key components of a Barrett Tummy Tuck?
What to look for in a surgeon for a tummy tuck?
Can I have children after a Tummy Tuck?
What the risks of a Tummy Tuck?
What are the benefits?
What is an abdominal plication and why is it important?
How long do I have to wait until after having children to get a Tummy Tuck?
Can I have a Tummy Tuck at the same time as my c-section?
I have an umbilical hernia, can that be fixed during the operation?
What is the downtime for a Tummy Tuck procedure?

On this episode of The Natural Plastic Surgeon…

Dr. Barrett: Muscles widened...when we gain weight or we have pregnancy, the rectus muscle--those are the six-pack muscles--and those widen to make room for a baby, or widen to make room for the extra volume if we have a lot of weight gain…
Dr. Barrett:...their belly buttons look very fake and circular and I was, like, okay, well yeah, you, you've achieved a reduction of extra skin. And you, you know, you've done some work there, but it's noticeable. I'd like these people, I can tell that they had a tummy tuck a mile away…
Dr. Barrett: You certainly don’t want this to be done by a dermatologist. They don't have any surgical or critical care background. And you're, you're jeopardizing your health. And that's the last thing you want to do with plastic surgery. Two things you don't want to do, to bargain hunt, bargain shop for are parachutes and plastic surgery.

You are listening to The Natural Plastic Surgeon Podcast. I'm Dr. Daniel Barrett, Board-Certified Plastic and Reconstructive Surgeon located right here in Beverly Hills. I specialize in cosmetic surgery of the face, nose, breast and body. This podcast is dedicated to those deciding if plastic surgery is right for them and revealing all the latest beauty secrets. New episodes premiering every Monday at 10 am. Let’s get started.
Everyone, we've got a special episode for you guys today. It is the tummy tuck episode. And in this solo episode, we are going to condense all the information you need to know if you're thinking about getting a tummy tuck. Okay, so that's really a lot, a lot of information, we're going to condense down to probably 20 or 30 minutes to really make it worth your while. So if you have to speed this up so you can get it all in especially if you are thinking about a tummy tuck or trying to figure it out if it's right for you. So let's get started.

01:40 WHAT IS A TUMMY TUCK?

What is a tummy tuck? A lot of people think it's just removal of the skin on the abdomen after a pregnancy or after weight loss, but there's actually more to it. There is an abdominal muscle component to a tummy tuck called the abdominoplasty. That's really important...or abdominal plication.
So I've got a diagram here that, I'm kind of, referring to. And basically, the muscles widen...when we gain weight or we have pregnancy, the rectus muscle--those are the six-pack muscles--and those widen to make room for a baby, or widen to make room for the extra volume if we have a lot of weight gain…And once you lose that weight, or once you get rid of the baby, through pregnancy and delivery, those muscles stay wide and you, you can develop what's called a rectus diastasis. And that needs to be repaired to bring those muscles back together.
So you might have zero body fat but your tummy still bulges out. That's because of the abdominal wall laxity and that can't be fixed very much, typically, through diet and exercise. And so that's why people that have had multiple pregnancies typically benefit from a tummy tuck, even though they're not overweight. Now if you gain a lot of weight during pregnancy, that actually makes it worse. So a tummy tuck is a combination of getting rid of that loose skin, no, which no amount of diet and exercise is going to get rid of and tightening those muscles on the inside. Okay, so that's a tummy tuck in a nutshell.

03:00 WHO IS A GOOD CANDIDATE FOR A TUMMY TUCK?

So who's a good candidate for a tummy tuck? Someone who has lost weight, that has extra skin and...Tummy tuck versus mini tummy tuck. Well, you know, if you have extra skin above the belly button, probably need a full tummy tuck. How do you know that? Well, if your belly button looks like a sad face, that is a sign that you have excess skin above the belly button. If your belly button looks nice, perfect and circular, and you just have a little pooch below it, you might be okay to get a mini tummy tuck. But we'd be able to tell you that in a consultation. Or, you know, go to any board-certified plastic surgeon to get that.
Now I do get some people that want a tummy tuck for weight loss. These are people that haven't lost weight. They're currently obese or, or overweight. You're not the best candidate for a tummy tuck unless you have, you're on your way to losing weight, and you have a lot of extra skin, kind of, hanging over. And you hit a wall. Okay, so I get a lot of patients that, that aren't quite at their goal weight but they hit a wall because that extra skin is interfering with exercise and clothes fitting properly. So then, then we just focus on trying to get that extra skin gone--called a panniculectomy--so that they can continue with their weight loss. Ideally, it's best, the best candidate is someone who's at the goal weight, who's lost all the weights, not having any more children, so that we can just do a one and done. Because otherwise if you continue to lose weight after your first tummy tuck, that's great, but you might still develop some extra skin that might need to be tightened up.

04:25 LIPOSUCTION OR TUMMY TUCK

Will liposuction work instead of a tummy tuck? I get this question all the time. And it's frustrating because liposuction only removes fat. All right? So if you have extra skin, the liposuction is minimally going to tighten that skin. It is not going to give you the same results as a tummy tuck. Furthermore, it doesn't do anything for that muscle that we talked about. Remember how we talked about the muscle plication? Those muscles...and then if you have rectus diastasis, that's not going to be corrected, unless you do a tummy tuck. So liposuction is for fat removal. Which works great for some people if they just have a little bit of volume of fat. But if you’ve had children, if you have had significant weight loss, meaning 20 or 30 pounds more, of weight loss, then you probably need a tummy tuck.

05:06 KEY COMPONENTS OF A BARRETT TUMMY TUCK

All right, so what are the key components of the tummy tuck that I do, the Barrett Tummy Tuck? Well, I like to focus on key things that make it look like you haven't had plastic surgery. So when I was over in Sicily for vacation, I don't know where this plastic surgeon was, but he, I'm sure he did tummy tucks on a lot of the people that were out there on the beach. The incision was super high. It was above the bikini line for all the people I saw out there in San Vito beach in Sicily. And their belly buttons looked very fake and circular and I was, like, okay, well yeah, you, you've achieved a reduction of extra skin. And you, you know, you've done some work there, but it's noticeable. I'd like these people, I can tell that they had a tummy tuck a mile away.
And yes, I have a better eye for it. But I think the average person was able to see this. And I think there's just a better way to do it, and we know there's a better way to do it. So one of the things that I focus on is keeping the incision super low and super narrow. We don't want it to go, we don't need a tummy tuck incision to go hip to hip. You want to keep that right before, right below where the skin excess is. And five centimeters from the suprapubic area so that way it's hidden right in the bikini line. So even if your scar is bad, which it isn't here at our place, because we close in four layers, we make a beautiful closure, we do scar management and all that stuff. But even if it is bad, it's hidden in the bikini line so nobody can see it.
What is exposed is super important to take note of--that’s the belly button. So if the belly button doesn't look natural, it’s a dead giveaway, even if your scar is hidden. So combination of keeping the incision low, and then focusing on the belly button, which I spend about an hour alone, during the operation, to make sure that the belly button looks very natural and that's, it's not a circle, you guys. Look at people's before and afters. Check out my previous video about trashy tummy tucks. You can see this, a belly button should not look like a circle. It should be a kind of hooded structure with a little gentle slope on the bottom, and it should be tethered to the abdominal wall. So It's like an indent, okay?

07:00 GREEK VERSUS ROMAN SCULPTURE

So if you really study, you know, when I first started doing tummy tucks, I would go to the Getty Museum and I would just study Greek sculpture, Roman sculpture. You can see that the Romans did a better job than the Greeks. So they started out, like, Greek stuff looks great to the amateur person, but it's actually kind of amateurish in of itself, because they don't get the anatomy just right. And then you move to the Romans sculptures and you, you move to, like, more modern sculpture and you can see they really dial it in, and they understood what the natural hum, human body, form and function, and the belly button, in particular, is, is really key. So that's why I spend so much time on it. Barrett Belly Button and low incisions. Those are the main things.

07:35 LIPOSUCTION IN COMBO WITH A TUMMY TUCK

I also combine liposuction. I also do a lot of other things like some gentle liposuction on the front. I do high-definition liposuction, liposuction combined with the tummy tuck so you can get that vertical ab crack. So if you know Emily Ratajkowski, she has beautiful abdominal profile where you can see that little middle line going right down the middle, and that middle crease. All right, moving on. Next question.

08:00 CHOOSING A SURGEON

So what to look for in a surgeon for a tummy tuck...Well, this is a major operation. It's probably one of the biggest operations that plastic surgeons perform. Has a death rate of one in 10,000. Okay, so you have to be very careful with where you go, you want to make sure that you are, you know, you're healthy and you're fit to, to do this operation.
But the, the number one thing you need to make sure of is your, is your plastic surgeon board-certified? You should not be traveling overseas for this operation. You're basically being cut in half, and you are extremely vulnerable and making yourself vulnerable for major medical problems, if this is not done correctly. Okay, so that's why you need to go to a board-certified plastic surgeon. You do not want this done by a general surgeon. You do not want this, be done by an OB-GYN. And you certainly don’t want this to be done by a dermatologist. They don't have any surgical or critical care background. And you're, you're jeopardizing your health. And that's the last thing you want to do with plastic surgery. Two things you don't want to do, to bargain hunt, bargain shop for are parachutes and plastic surgery. Especially a tummy tuck.
So start with your board-certified plastic surgeon. Check out their before and after photos. That is the best place...do they look photoshopped? Check out the belly button. Where's the scar? How does the scar look? I got a lot of flack because I wasn't showing a lot of scars on my, my follow-up photos. So I said, you know what? Let's start showing the scars. I want to show people what my incisions look like. I close all my incisions in four layers. I tape for six weeks with Steri strips. I see my patients in the office once a week for each week after their operation. And then starting at six weeks we do a three-month, at minimum, scar gel massage therapy to make sure that the scar becomes as minimal as possible. I don't know anybody else that has that much attention towards scarring and healing. So I tell people, 50% of what I do during the operation and 50% of what they do in terms of their home protocol that we give them.

09:50 GO TO A CONSULTATION

Okay. So beyond the before and afters and finding out what they do. Go in for a consultation. Is it a good fit between you and the, and the plastic surgeon? Are you able to get a hold of somebody on the phone when you call them? Do you speak to a human person or do you speak to an answering machine or a robot? That kind of tells you, are you part of a factory...widget being created in a factory? Or are you actually treated like a living, you know, human per, human being that, that, you know, gets enough attention so that you feel like if you're going to have a problem, they can, they can be there for you, for a complication.
Complications are, are pretty rare with tummy tucks--at least in my office--but when they do happen, they can be pretty serious. And you need a doctor to be responsive to guide you in your medical treatment. You don't want to just show up to emergency room, they have no clue what to do after a tummy tuck. You need the guidance of a board-certified plastic surgeon that's available in case something bad happens. Okay, so moving on. So, I, we talked about what, what to look for in a surgeon. Let's get into some specific questions about things in regards to a tummy tuck.

10:54 CHILDREN AFTER A TUMMY TUCK

Can I have children after a tummy tuck? Yes, you can. But, guess what, babies stretch out what we just did. All the work that we did, okay? So you can still have children. But ideally you want to, kind of, wait till after you're done having children. I get some people that want to, kind of, sneak in something. So we'll sneak in a little bit of lipo. But don't waste the money on doing the plication and removing all that extra skin. If you're going to have another child or if you're not at your goal weight, postpone until you're there. And that way, we can get you a much better result. But if you do happen to get pregnant afterwards, and you had a tummy tuck, it's not a big deal. It's not going to hurt anything. It just might be a little stretched out.

11:30 RISKS OF A TUMMY TUCK

Let's see. What are the risks of a tummy tuck? So we talked about death, the death rate for a tummy tuck is one in 10,000. And, just to be clear, that, these are patients that are typically overweight, or they have pre-existing heart conditions, and I don't…I pre-screen all my patients for pre-existing heart conditions. If you had a heart, like, if you remember in the media, a famous rapper’s mom died because of a tummy tuck. Well, guess what? She just had a heart attack in the previous year. And that's a big no-no, you don't operate, you don't put people under physical stress of this operation if they just had a heart attack, okay? So that's, that's really negligent of the surgeon to undertake a tummy tuck procedure on someone who is medically not stable. So if you, if you categorize people into ASA category one, meaning that they don't have any health problems, your rate of death is actually really, really low.
But again, you want to, it, it all starts with going to the right surgeon, making sure that they use accredited surgery centers. They’re not trying to do this under local, which would be crazy. Local anesthesia, while you're awake, not going to happen. Some people do that, by the way, by the way, they try to do a tummy tuck without anesthesia to, kind of cut corners and cut costs. That's a, I can't imagine a more horrible thing.
And beyond that, after, after death, you can get, the most common thing to have happen is you can have a little bit of wound breakdown. That's the most common complication. It's treated, again, by a good medical staff and good surgeon. We get that hap, happening maybe one in 100, where we have a little bit of wound breakdown. We treat it with a little local wound care and everybody heals up just fine. I've had about less than 1% get an infection of some sort, meaning like an abscess where they had to have some kind of drainage procedure. And that's not a huge deal as long as you catch it early enough and it doesn't affect your whole body and you might need additional antibiotics if that happens. And then lastly is hematoma. And that's a scary one. I've had one hematoma of the thousands of tummy tucks I've done. And that can happen if there is bleeding inside the abdominal cavity that you just created and you could lose several liters, I'm sorry, several pints of blood from a bleeding tummy tuck incision. Okay, so that is a medical emergency you need to be taken care of right away. And, and the one patient that I did have, he did just fine. He was a massive weight loss patient so he had big blood vessels so we were able to find the bleeding blood vessel, and cauterize it and, and stop the bleeding. Again, and this pretty, pretty small complication rate compared to the thousands of tummy tucks that we do here, okay?

14:00 SENSATION AND SEROMA

Now, other things like bad scarring can happen and then sensation. Sensation, something to know that you don't, you lose sensation for the first six months. Because we are lifting up the skin, and that disconnects a lot of nerves that are going to the skin. But that all regrows, typically, by one year, up to two years for some people.
And other things such as seroma which is a fluid buildup, that's why you can either use a drain or not use a drain. If you don't use a drain, that requires additional sutures that I don't particularly like that causes little dimples that are temporary, but those little dimples stop you from needing to have a drain. But I recommend just to use a drain because allows your stomach to, kind of, heal flat.
But I can do either way. I can do drainless tummy tucks or I can use a drain. Bottom line is you want to drain off that serous fluid to prevent that complication of seroma, which, I again, I've had about a dozen of those, and it typically requires a little bit of removal of that fluid once a week until that, the whole area settles down and heals. But it's a, it’s another caution not to remove, if you do have drains, not to remove them soon because if you remove them too soon you can develop that fluid building up underneath. But that's the, the main reason why drains are necessary is to drain that fluid. So it is a hassle but it is totally crucial in terms of your healing.
Now when can you remove the drains? Typically I wait until about 20 cc's or less of fluids is coming out of the drains per day. And then once we hit that, once we hit that point, we can remove the drain. It's a painless procedure. These are smooth little silicone noodles, and they just pull right out without any pain. And a lot of people feel like it's supposed to hurt when they remove the drain. It doesn't. So don't think that going into it. Because I basically just pull it out while we're talking, you don't even know. And they're like, oh, it's out already? I'm like yep, I just pulled your drain out. And they're like, oh, I thought it was going to hurt. I'm, like, well that's why I just did it, so you didn't get anticipation.

15:50 BENEFITS OF A TUMMY TUCK

All right, so what are the benefits of a tummy tuck? Let's talk about the fun stuff. Well, I, this is one, is one of my most favorite operation, one of my common operations, because it is, it is getting your body back, okay? We're not changing you, we’re not making you a different person. We're helping you getting your body back, whether it's through weight loss, or whether it is through having multiple pregnancies. I feel great about that, because moms make the ultimate sacrifice for their bodies, in terms of having children. And it definitely takes a toll in terms of that skin laxity, and it feels really good when I see my patients go out there after they're fully healed six to, six to eight weeks later. They're in their bikini, they're at the beach, and they're sending us photos, and it just looks fantastic. They're super happy, their confidence is back. And they actually feel stronger too. Because remember that plication that we do in the middle that helps bring that core musculature back together. So it helps your posture, helps your core strength and it makes everything flat. Just a really good feeling and it's one of those just really feel-good operations. So benefits...you can actually remove stretch marks below the belly button, you can get rid of the loose skin, you can tighten the muscles, make the tummy flat and increase the core strength.

17:06 ABDOMINAL PLICATION

So let's dive into a little bit...what is the abdominal plication, okay? So that, I, I mentioned that briefly. That's that space that occurs in between the muscles when you have a pregnancy or weight gain. And that space is called rectus diastasis, and a plication is performed to, kind of, bring those muscles back together. And that has to be done very carefully. I, I use two layers of sutures to do this. Because there's some people out there that throw a little brief absorbable suture layer and it pops open and patients can even, they’re like, yeah, like, I sneezed one time and I felt this pop and everything just kind of relaxed back out. And that to me is a, is a huge mistake.
It takes, it takes a good hour to do a really good plication, you guys. We use a Prolene suture, which is a permanent suture. It stays in there forever, but you'll never feel it, ‘cause we bear the knots. And then we do another suture on top of that, just in case. Just in case there is a, is some kind of sneeze or something that happens that might break one of those sutures. We've got a whole other backup layer of sutures. And that's the difference between me, and guess what, you will never know if your surgeon does that, okay? Unless they tell you.
There's a lot of surgeons out there that do these really, and I talk about it in that one video, Trashy Tummy Tucks. They do these really brief plications that take about ten minutes. And it's, it's, it's garbage. Because it doesn't, it hard, hardly does anything. And it typically will fall apart after a first couple months or any kind of physical activity. And, that, you're, you’re not doing anybody a favor with that kind of surgical work.
Which is why I show it on one of my videos, I show you exactly how I do that plication. I don't advance more than five centimeters down, every, half a centimeter down every time I take a new loop of suture. So you can, kind of, just see exactly how I do that in, in some of my videos, which I think is, is really important to make sure that that plication is strong and taught.
Now the plication can be done at different tightnesses. So the most I've ever done was 12 centimeters. I brought it in about 12 centimeters and sometimes as low as four centimeters. It just depends on how much laxity you have. And we could tell that based off of the consultation.

19:10 WAITING TIME AFTER CHILDBIRTH

How long do I have to wait after having children to have a tummy tuck? Well, there's a lot that happens when you have children. And I'm gonna combine this with another question is...Can I have a tummy tuck at the same time as my C-section? Well, yes, you can. But there's a lot of water weight gain, there's a lot of gain that goes on with pregnancy. And I think it's best to wait until you're done having children to get your tummy tuck. And I would wait at least six months for a lot of that, that body swelling, and the normal pregnancy weight to, kind of, go down before you have a tummy tuck.
Because, again, if you go to the tailor and you lose ten pounds right after you just got fitted for a suit or fitted for a dress, you're probably gonna need to be taken in just a little bit more. And that's what we want to avoid. Furthermore, combining a C-section with a tummy tuck I don't recommend, I think there's too many moving variables. And you really need to focus on recovering from the pregnancy and the delivery and taking care of the baby that first, that first initial time. I know there's some people that do it. But I, I do think it's not that, in the best interest of the patient, because you're not going to get the best result from that timing.

20:20 UMBILICAL HERNIA

So, moving on. I have an umbilical hernia, can that be fixed during the operation? An umbilical hernia is, a hernia is an outpouching of abdominal wall fascia that allows intestine to, kind of, poke through the abdominal wall. That can be a life threatening situation and you want to get that fixed. So typically, if it's reducible, meaning that you can push it back in, it's not life threatening, but if it stays out and get starts to get painful, it's an emergency and you need to get that taken care of right away.
Yes, that can be done at the same, that can be fixed at the same time as your plication and when we do the tummy tuck, and I do it all the time. Might as well go in there and fix it. And if, if you don't know this plastic surgeons, we fix hernias all the time. In our training, we fix the most difficult hernias, you know, gigantic whole abdominal wall hernias, all the way down to inguinal hernias and umbilical hernias. So we can fix all of them. Typically, we just, that's just not our main field anymore, especially if you're in cosmetic surgery. And so we do, we do fix these small little umbilical ones when they pop up during a cosmetic operation. But if we know about it ahead of time, we can certainly fix it at the same time.

21:27 DOWNTIME AFTER TUMMY TUCK

What's a downtime for a tummy tuck procedure? This, this is a good question. Now everybody's different. I would say average, it's a good two weeks of downtime, meaning you're not working for two weeks. You're just chilling or relaxing. You're not even doing, you know, no heavy lifting around the house. No, no dish work. No, you know, vacuuming, all that other stuff can just kind of stress your body. I have some people that, that only need a week of downtime. But I recommend to everybody to take two weeks off for a tummy tuck procedure.
We do inject a lot of numbing medicine. We use a product called Exparel, which is a three-day long acting pain medication into the plication. So that's the most painful part of the operation. And if you numb that area, you don't get, you don't even need to take pain medication when you wake up. Like, people are, like, wake up and they're like, are you done with the operation already? I'm, like, yep, we're done. You just have a lot of the pain injection numbing medicine inside so that you're not feeling the results of the plication. So make sure you ask for that. If you're getting a tummy tuck asks, ask for that Exparel solution so that you don't have that pain. You don't need to take opioid pain medication after your operation. Because imagine you're taking a pill that's going to affect your whole body when all you really have pain is right in that plication area. And, and furthermore, about downtime for tummy tuck procedure, no heavy lifting for six weeks, even though you might go back to work at two weeks. If you are in a manual labor type of job or nursing, you can't be lifting until that six week mark and that's just to allow that plication to heal and develop its own strength.

22:53 STRETCH MARKS

Will a tummy tuck get rid of stretch mark? Yes and no. Depends on where the stretch marks are. If you look at where your belly button is, that's typically where the top part of the incision, at most, can get to, in terms of removing stretch marks. If you have stretch marks above your belly button, it depends on your exam whether or not we can actually get those. But just, as a general rule of thumb, stretch marks below the belly button we can get rid of. Above the belly button are a little bit harder. Just depends on your consultation and your measurements.

23:24 REACHING GOAL WEIGHT PRIOR TO SURGERY

Do I need to be close to my goal weight for a tummy tuck? Yes, please. If you can. If you can't, it's no big deal. If you've hit a wall and you've tried everything and nothing seems to be working, and you just wanna get that boost and you want to get that extra skin removed, let's do it. But let's just know that you might need, you know, you might need that further touch up once you get that loose skin. And we do that all the time and it can be done under local sometimes, you don't need the full on tummy tuck.

23:50 BEST TUMMY TUCK STORY

What is my best tummy tuck story? This is great, actually. I, I had one patient and I think we did a video on her. But she was born with an omphalocele. And basically that means that her intestines were outside of her abdomen when she was born, as a baby. And that's a medical emergency and needs to be fixed right away.
So the surgeon at the time put all of the intestines and all the organs back in, closed up the abdomen. But, and, and she did fine and she, she healed. But he goes to her the next day, this little child and mom was there. And he opens up the dressings and looks at everything and he's like, ah, I forgot to put the belly button there. So he forgot to bring out the belly button. Even though he saved her life and brought all the organs back in and all that stuff. And mom was just so happy to have her baby back. She was, like, you know what? I'm not going to go back to surgery. And she grew up her whole life without a belly button.
And then when she, when she turned 40 years old, she came to me in consultation for a tummy tuck. She had gained and lost a little bit of weight, so she had some skin excess. But she had no belly button. I was like, well does that ever bother you? And she's, like, yeah it’s bothered me my whole life. I never wore bathing suits. I never wear bikinis. And here she is at 40 years old and she's a successful woman. But this is something that I took for granted my whole life. I grew up with a belly button. I wore a bathing suit and I never had to worry about it. Here's someone who, you know, something as simple as not having a belly button can make such a big difference in someone's life.
And so I was actually able to do her tummy tuck, take some of her old skin, her old scar tissue and recreate a belly button for her. So you can, you can see her before and afters on our website. And that turned out really well. She came to me crying, her mom came in, and was like, you know what I never, I'm so happy that you were able to give her that belly button back that she never had growing up. And I guess it's never too late to get your belly button back. It's something as simple as a little belly button can make a huge difference in your confidence. And she's out there. She's got sun tan lines. So she's out there in bikinis and bathing suits and super happy now. Obviously we made her tummy flat and we did all those other good things but created a new belly button was super awesome. But that's my best story.

26:00 FLEUR DE LIS TUMMY TUCK

What is a Fleur de Lis tummy tuck? A fleur de lis is, it's kind of like that, think of the New Orleans Saints. That's a fleur de lis pattern. Okay that's, that's like a, it's almost like a cross. The New Orleans Saints emblem is, like a, is a fleur de lis. So it has, has a line going straight up in the middle vertically and then the traditional tummy...so imagine a traditional tummy tuck horizontal line, and then a vertical line going up the middle.
And, and that's used for patients that have lost a lot of weight. I'm not a big fan of it because that vertical midline, unless you've had an exploratory laparotomy, and you have a scar there to begin with, I wouldn't make that incision because it is just so noticeable.
I do reductive techniques with just using a horizontal technique or a 360, an incision all the way around, versus going and doing that fleur de lis pattern. I'm, I’m not a huge fan of that, ‘cause it's just extremely noticeable in the middle. Doesn't look great cosmetically, and is just a very difficult incision to heal because you're, you're, you're cutting off 75% of the blood supply to that flap, right? You make one incision, you're cutting off 50%. If you make another incision, you're, you're cutting off 75%. And so you get a lot of skin necrosis in that situation.
Which is why I don't use abdominal binders right after a tummy tuck surgery. A lot of surgeons don't do this, they'll actually use in a binder. And, and, and what you'll notice is you can get skin necrosis on a regular tummy tuck incision if your binder’s too tight. So that's why my, a lot of my patients ask, how come you don't put me in a binder? It's not because I'm trying to save money, ‘cause I do give you that binder at two weeks. It's because you can have higher risk of skin necrosis if you make it too tight that first two weeks. You need time for that blood flow to reestablish to those incisions and allow it to heal. Okay?
So that's it for the most, those most common, common questions you guys. Where can you learn more about tummy tuck procedure? You can check out my website, BodybyBarrett.com. I've got tons of before and afters on there. You can also check out my main website, DrDanielBarrett.com to learn all about tummy tucks. You can also check out some of my YouTube videos about tummy tucks, so you can see how it's done. Check out the Trashy Tummy Tuck video. And if you have any other comments, questions, feedback, please feel free to, to leave those comments, questions, feedback right on my YouTube page or through the, or through the podcast menu. And again, thank you again for tuning in for tummy tuck. I love to, to see you in person if you think tummy tuck is right for you.

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