Ask Dr. Garcia - The Archives

• Is there such a thing as a mini tummy tuck? I just have extra skin, not fat. Can this be done under a local anethestic? Thank you!

  Answer:  yes, it is a tightening of the skin belwo the belly button, I do not perform it under local anesthesia though. JG 5.5.09

• July 11, 2008 I had a full tummy tuck with breast lift/reduction. Instantly the skin around the right nipple died and turned dark brownish red and hard. It conintued to grow until it took over most of my breast. there was some on my left boob but not as much. My tummy tuck went from hip bone to hip bone, started out ok and then went bad. My incision split open, my skin died got hard like my breast. It ended up being 4 inches deep 12 inches long and about 6 inches wide. It was horrible. Had to pick out all sorts of dead skin out of it and of my boob. It was the most painful thing I have ever been through. Most of the hardening of the area occurred about three weeks after it was done. At that time my ps went on a trip out of the country for two weeks. Which i knew he was going to do, but i also thought none of that other stuff was going to happen. Was there a way to stop all that dying skin and fat? When he returned he cut out all the stuff in my stomach and off my boob. So during this time i was on a lot of pain killers, took shots in my boob for over six weeks because of this one nerve spot, and lost 35 pounds. I now have what I call a cave it looks totally riduclous and I am self conscious about it. What would you recommend doing to get it to go down at least some. It proably has a 4 inch lip then goes straight down to the vagina. He has used lipodissolve but I haven`t really seen a difference. I did however get a merca infection in one of the needle holes. I am very discouraged. I now know why they say don`t lose weight. Srry so long.

  Answer:  I think you will need to let the tissues heal and soften for at least one year and then likely more surgery will be needed. I think LipoDissolve is a waste of time and could cause further tissue damage and would advise against it. I think the hardest part will be waiting, but it is needed. What can be doen at that time, after a full year, will depend on how soft and pliable the tissue are. I am so sorry to hear about your troubles, they are rare probelms, but do happen. JG 4.14.09

• thank you doc.

  Answer:  most welcome.JG 4.14.09

• Drg. i just finish writing but i don`t think it post. anyway, we spoken before about my situation which is loose muscle sutures after tummy tuck and pain in middle of belly, all around navel. dr g. i was going to travel to same surgeon who did my tt for revision. before i decided to consult with a local hospital surgery department and one of the surgeon told me that i should just leave it alone, because my fascia was intact, that what i had is keloid and scar tissue inside and doing rvision was going to make it worse. i couln`nt believe what i heard from this lady, her diagnosis is to massage the area and shots of kenalogs in time will make it better. also, she said pain around navel is due to scar tissue and keloids which formed and nerves that connnects them. could it be that they don`t want to feel resposible for a job done in another country. remember my keloids is just at the end of scar and one side more than the other. i know i have muscle damage because i consulted early in my tt with a surgeon and he said same thing you told me, also my belly protude now like before my tt. thanks doc.

  Answer:  it might be that they are not looking forward to getting involved with a problem done elsewhere, yes. You might have to go back and see the original surgeon, sorry. JG 4.14.09

• I am planning to have a full tummy tuck soon and my ps does them using a mesh. This makes me nervous as i search the web for info on it and find so many people begging others to never get mesh put into there bodys.. as they have suffered infections and nerve damage and they say it is near impossible to find someone willing to remove the mesh. so i ask myself why would i do this for an elective surgery if it risky. My ps does not believe it is and he feels the long term results using the mesh is just great! please tell me what you think. Have you used mesh before for a full tt? weighing the risks of complications with sutures and this mesh what is more risky. I will be going back to him to talk again and get some more questions answered, i like him and trust him, just I feel he is way too supportive of this mesh and i would love to hear what you think. additional info: i am 5`4 125lbs going in for full tt and breast implants, round silicone 200cc my hope is to just restore what has changed after having my 2 children. (30 years old)

  Answer:  in massive weight loss patients the mesh is at times required but I see no reason to use a mesh for a routine tummy tuck as yours. JG 3.12.09

• Dear Dr. Garcia: I am 3 weeks postop from a belt lipectomy. Over the past few days on 2 or 3 separate occasions, I have heard/felt an internal stitch pop just above my pubic area. It was unmistakeable and I felt a little accompanying pain. Is this a safety concern? Is there a way to tell if the underlying tissue is still closed?

  Answer:  not a safety concern as there are many sutures placed below the skin and a few of them breaking should not affect the end result, no way to tell how the tissue are healing at this point. In time, there might be a small depression in the area if enough sutures broke and allowed the tissues to pull apart below the skin, but it is of little concern in terms of your health.All the best. JG 3.3.09

• Whats the cost of BB revision? thanks

  Answer:  it would need to be determined after seeing it I am afraid. JG 2.26.09

• Doctor, I did a mini tummy tuck and had some lipo on my lower abs and flanks, I am certain no lipo was done on the upper abs. It`s been 2 months and my upper abs get fat and fall over my lower abs. It`s not an even distribution as it was pre op. I have a follow-up appointment to see the doctor in 2 weeks but in the meantime, I`m very worried that this is permanent. Would I need upper ab lipo in the future to even out my belly or is this a temporary result of the lipo+tuck and my fat distribution would eventually move downward?

  Answer:  well, lipo of the upper abdomen might help in some ways, but it can also leave loose skin of the upper abdomen above the belly button. It is hard or me to say without seeing you but in some cases you might need to be converted to a full tummy tuck. JG 2.18.09

• Hello Dr. Garcia, I had lipo in my abdomen area about 3 years ago. Since, my navel is sagging(so to speak) In other words, instead of being a normal round innie, it`s more like a frown. I`m 5`6 , 118 pounds. Despite the fact that I work out, it hasn`t helped. Is this because there was too much fat removed during the lipo or because I`m 47 and that`s just what happens as we get older? If I press the area directly above my navel or pull the skin up a bit, it looks normal. Is there any type of minor cosmetic procedure that could make my navel look normal again. (a couple of small inscisions and/or sututres????) thank you

  Answer:  well, it is because the skin is loose and now that alters the skin around the belly button. If less fat had been removed it might still have happened, no way to know. In a small number of cases, a small crescent of skin can be removed form the upper part of the navel to make it look better, but it is only a small amount as too much will look obvious and the scar will be seen. JG 2.8.09

• Hi, I got atummy tuck 7 months ago and i noticed that my stomach is getting bigger, i look like i`m 5 month pregnant, i feel someone has put air inside my stomach ,it`s like i`m bloating. and the on the scar i still feel pain ,if someone put a hand on my stomach i feel the pain and on the left side of my hip ,i don`t have any sensation ever since i came out of my surgery,and after 7 month it`s the same ,if i scrath ,i don`t feel anything. is it normal?

  Answer:  unsual for that to be like that, I suggest seeing your surgeon to make sure you do not have a delayed fluid collection. JG 2.7.09

• My tummy tuck scar is healing well. However, there is an area where there is actually a flap of skin hanging over the incision and it is not sewn down where it looks like it should be, I can lift it up. It is healed underneath so it isn`t raw. it just looks like the surgeon forgot to top stitch this piece down when he cut it. Will it possibly stretch upward and recede with time or is it something I should be concerned about?

  Answer:  in many cases, yes, the skin will stretch and flatten in time. JG 2.7.09

• Dr Garcia, Hi, I had a Full TT on Dec17th. My scar from hip to hip looks ok, but under the scar feels like mothball sized lumps. I asked my PS what they were and he said most likely my stitches desolving and being pushed out. My main question is what are these lumps and will they go away?

  Answer:  they will go away, it is the sutures that were placed in the deeper layers and they need to dissolve, that can take months in some cases. JG 2.7.09

• Hello Dr. Garcia. One month ago I had a full tt. I now wear pants 2 full sizes bigger because my abdomen seems fuller. It is because everything inside the abdomen has less room now or is it just common swelling? It`s so tight it just seems like there isn`t room for anyhting. I was looking forward to fitting intoa smaller size but that doesn`t seem to be the case. Also, how long it is recommended to wear the garment? It is more difficult to stand straight with this thing on but i don`t want to rush things. I read that athletic shorts will not provide the same kind of support and isn`t recommended.

  Answer:  likely due to swellling at this point. We usualy use the garment for 4-6 weeks in our patients. Best of luck. JG 2.3.09

• My dear dr.thank you for everything!, im ready for my tt revision to fix lower loose muscle sutures, which for a year i suffered with pain. i also developed dog ears which hopefully will be fix this time. Now, i developed keloid at each end of the incision, even though in middle is fine. i heard dr can give me a shot to avoid keloid from forming again. any facts with this info. again, thanks for your honest answers.

  Answer:  well, shots of kenalog are used for keloids, but they will not prevent it from forming if doen at the time of surgery and can also slow the healing process. The soonest I would do the injections is 6 weeks afterwards and you want to treat it as little as possible for fear of the surrounding tissues developing atrophy. JG 1.23.09

• Hola Dr.Garcia,Espero q este muy bien. mi pregunta es ,seria posible hacer un tummy tuck con anestesia local? o algo q se le paresca,q me sugiere? baje 30 libras y tengo mucha piel desde hace mucho quiero hacerlo pero lo unico q me detiene es el pavor a la anestesia! q otra alternativa tengo? muchas gracias por su tiempo.

  Answer:  no creo que se puediera hacer con un resultado que uno desea. Buena suerte. JG 1.22.09

• Hola Dr. Garcia! Es posible que al realizar una abdominoplastia el doctor amarre las costillas con un hilo? Y despues de unir los musculos que se separaron, corte la parte del MUSCULO que sobra. Y no solo eso sino que la piel de la espalda la hale hacia el frente y luego cortar toda la piel sobrante. Segun todo esto se hace para darle a la paciente una cintura (aunque no la hubiese tenido nunca)! Si esto si existe, podria darme el nombre... he buscado por internet bajo el nombre de corsetplastia y no me aparece nada diferente a un tt regular! Agradeceria mucho su aporte porque tengo una amiga que se va a realizar este tt con esta nueva tecnica y pues la verdad es que no se si en realidad exista! Gracias!

  Answer:  no se debe cortar el musculo porque es el musculo cual contiene el estomago y los intestinos adentro del abdomen. La piel de la espalda no se puede corectar can halar le piel del estomago. La cintura depende mucho de la cantidad de grasa que tiene el paciante adentro del abdomen, debajo delos musculos. No creo que lo que deseas es posible. JG 1.12.09

• Is it better to only have the skin cut and tightened for a tummy tuck instead having the muscles tighened with the sutures because its seems like everyone on this site has problems with the muscles. I really want to have a tummy tuck but getting very scared by reading the emails. I have some loose skin and strech marks a the doctor I`m planning on having do the procedure said I need a full tuck with a scar that will be from hip to hip, which I`m not worried about the scar its just the internal problems. Please give me your suggestion.

  Answer:  well, in most cases the muscles should be tightened, remember whe people post on websites, you rarely hear about the good experiences and hear mostly the bad so it gives people a false sense of the problems happening. The vast majorityy of people do fine with the muscles being tightened. Best of luck. JG 1.9.09

• Hi DrG. i was just informed by my ps the reason my sutures loose on my tt was due to two golf balls fibroids pressing right lower side plus scar tissues. recomended that i should wait for revision and deal with my gyn problems first. any facts on this, or just something for to say.

  Answer:  well I agree that the gyne issue should be dealt with first before any tummy tuck touch up, but fibroids would have no effect on the looseness of the sutures, neither causing it or preventing them from staying tight, that is due to other issues. JG 12.18.08

• DrG.we have spoken before, 9 months into tt, with lower loose muscle sutures, still in pain, getting worse as time goes by. waiting for the year (march 2009) for a revise tt. have tried others ps and always sent back to my original dr which i do not trust anymore. what chances of same problem happening again and will recovery time be same or any more painful than first time. it`s a must to do revision due to pain, but i regrets what i have done to my body. thank u so much f time. god bless u.

  Answer:  recovery is about the same and there is always a chance it can happen again, the tighter they pull the greater the chance of it recurring. All the best. JG 12.10.08

• Dr. Garcia, I had an abdominoplasty about 3 1/2 years ago. Some time ago, I began noticing a foul smell coming from my navel. The surgery left me with no feeling, still, in the area around my navel, and the navel itself is so tightly sewn that i can barely get a q-tip in there to try to clean myself, nothing happens when i do. what do you suggest??? Thank you.. SM

  Answer:  might be worth trying to revise the belly button and opening it a little more so it can be cleaned better and avoid the foul smell which is likely the skin oils getting trapped. JG 12.7.08

• Hola Dr. Garcia, Hace 15 dias me hicieron un mini-tommy y estoy sorprendida que la inflamacion si me ha bajado a los costados de la cintura; sin embargo, del ombligo hacia abajo tengo una barriga como de 3 meses de embarazada!!! esto es normal? he visto fotos en internet de post operation de este tiempo y nadie tiene esa panzita todavia? favor digame si es normal y en cuanto tiempo bajara ese tamaño? gracias

  Answer:  bueno, puede ser normal, la cantidad de inflammacion y desrame de sangre aveces es grande, se mejora, pero puede tomar unas semanas. Las fotos que se ven en el internet son depues de meses casi siempre. JG 12.5.08

• Dr. Garcia - I had a Full TT and Breast reduction approximately 4 years ago. Immediately after surgery my surgeon mentioned an area he was concerned about healing. As it turned out the area turned black and they began debriding the wound. I went to a wound care specialist after a nurse at work suggested I have a second opinion. It took about 5 months for the wound to heal. My question now is when I sit for a long period I have terrible numbness in my stomach and it feels like everything is being sucked into the indenture where the wound was. (I have had numbness in my left leg ever since the surgery). I also experience painful stomach cramps that almost feel like my stomach is doing somersaults. Could all of this be caused by scar tissue buildup from the wound? Is there something that could be done to relief the discomfort? I am not sure if I would have the same problem with healing as I had before; however, I am not a diabetic and do not smoke so we are not sure why this happened to begin with. I do know I have had knee replacement surgery since this surgery and developed scar tissue very quickly. Just not sure if anything can be done or not.

  Answer:  the scar tissue from the delayed healing will affect the skin and the tissue attached to the muscle but will not cause the leg pain nor the stomach summersaults, that is likely something else. In time, as the tissues soften, it migth be possible to cut the scar tissue out and remove it with an incision in the tummy tuck location, but the skin needs to be loose to do it with good results. All I can suggest at this point is stretching and massage to see what happens. All the best. JG 12.4.08

• Answer: 

• Dear doctor my gallbladder is removed 7 years before because of stones,but still pain not stops because of gases,so plz do tel can wher will i get gallbladder back by refitting by operation and cost of same plz do help in mumbai.

  Answer:  There is no way to get the gall bladder back, might need something like simethicone liquid t drink to help with the gas pain. JG 11.25.08

• Had a tummy tuck almost 2 years ago. I am a 41 YO female and gave birth to triplets 4 years ago (but I am also in shape and only gained 60 lbs). I weigh 113 lbs, before and after tummy tuck. But, I now see loose skin when I sit and it is only on one side (the side that stretched more because it carried two babies on this side). Is there anything I can do when skin looses elasticity and becomes fatty looking and hangs without getting another tummy tuck? anything else that may help? Does my PS need to remove more skin on that side? My PS said something about smart lipo, but will this help? My PS also said he took enough skin off, but sure doesn`t seem like it. Should I get another opinion by another PS in my area? Thanks for your time, KGO

  Answer:  I think SmartLipo would not help,it actually might make it worse but I do think more skin removal might be a good idea and yield the better result. If there is no loose skin when you stand and only when you sit, that is an elasticity thing and removing skin might help but the scar will stretch and widen with time. JG 11.21.08

• how much weight can one gain or lose and keep tummy tuck results?

  Answer:  I would keep it under 10 lbs at the most. JG 11.10.08

• Hi Dr Garcia: I had a TT without muscle repair 1 year ago. The middle of my abdomen from the rib cage down is still quite numb. My ps could not tell me why that would be after this long of a time. Can I expect it to get better yet or after this much time do you think it will stay the same? I also had some necrosis along the scar line. If I had some scar revision done would the chances of necrosis be greater since it happened the first time even though I wouldn`t expect the tension to be as great. I have never smoked, not diabetic, or overweight. I never expected this to happen. I believe the skin was just pulled to tight with to much tension. I am not happy with the scar line or the numbness. Sometime after a long day the abdomen just seems to hurt yet. Any suggestions? Thank you.

  Answer:  it is because the nerves that give that area sensation were cut, that happens, not everyone regains the sensation to the abdomen after that surgery. I think you might get a little better over the next 6 months but likley not much. The chances of necrosis are no higher than they were the first time, wish I had more to offer. JG 11.7.08

• Dr. garcia tt for 8 months now, i wrote to you a couple of times, and the last time you told me that maybe my problems could be loose muscles sutures, and i agreed with you. i explained this to my ps and after lying to me a couples of times, finally she also agree that lms could be the case. i am suffering so much with pain. now, she wants to go back and do tt all over again. i just don`t trust her anymore, i don`t have the money to go to another ps. can you tell me why lms happen, can it happen again. is it my body rejecting, what purpose to do again, dr garcia i was happy at beginning, now i regret all. i ask because i did everything as i was told recovery wise. also, ps tell me there is no other way for her to know what happened unless she opens up again. is this true,ct scan only shows a deep space does it make sense. thank you so much for your time.

  Answer:  not rejecting, but sutures do break, I know trust is important but it might take more surgery and she might be the most affordable option for you at this time I am afraid. CAT scan will not tell much. JG 11.6.08

• Dr. Garcia, Thankyou for your helpful advice on questions i have put forth. I did ask you about the best type of treatments for loose skin after weight loss, and also have an awful tummy scar that was a vertical incision. I have been bothered with this for many years, but i am too chicken to undergo surgery! It is only for the fact that my previous husband died after bypass surgery almost 8 years ago, and i have 3 beautiful children that still need me. I know it is only vanity, but would love to have my tummy repaired, yet i read where many women have all sorts of problems after surgery, and all kinds of awful stories. Is it possible to get this repair done with a pudendal block, or is a general anaesthesia the only way?

  Answer:  A pudendal block would not be enough, even a spinal would be difficult due to potential breathing problems during the surgery. All the best. JG 11.4.08

• It is great a Dr. like you will take the time to answer questions. I logged in to see if anyone had similar problems and I found 2. I also had a tummy tuck surgery and my upper abdominal muscle sutures tore leaving a lump on my right side. Dr suggest lipo or redo surgery. He strongly believes lipo should minimize the lump and resolve the problem. Its easier for him, but I`m afraid it is not going to solve the internal problem. I also feel discomfort in that area. What is your opinion? if you had the choice which would you prefer or choose?

  Answer:  if it was flat right after the surgery and got puffy after the sutures broke, then liposuction will nto fix it I am afraid and it will take more surgery with more sutures being placed. Best of luck. JG 11.3.08

• Iam 42yr old female,I am currently menstruating but there is something moving in my stomach,I never skipped one month what could be the problem

  Answer:  I think you need to see your gynecologist for a work up. JG 11.3.08

• Thanks for answering my quest. You have no idea how much hope you have given me tonight. I stayed home because this stomach thing bothers me at the end of the day and I really couldnt stand walking with my daughter..door to door tonight in addition to not liking the idea of halloween. I cant believe you responded this quickly. wow...thanks ... so it is possible to remove sutures? I believe my surgeon is good and he came highly recommended. I just think my body is rejecting the sutures. I worry that the pulling the muscles together will now after sutures are removed..expand them more that before tt. like rubber bands. Whatever the case I want to feel better.. thanks for your help. This website really helps.

  Answer:  yes, the sutures can be removed after exposing the area. Best of luck. JG 11.1.08

• Hi Dr. I have sent you a few a questions ih the past you might remember. I had full TT a yr and half ago. One of my sutures broke and doc repaired by doing a 5 centimeter incision by my belly button. We chose that to avoid the recovery time of opening up again. He found a hematoma the size of a gulf ball.. he removed and repaired. I think he addes stitches but I am not convinced he was able to remove all the scar or old sutures. My muscles hurt and he went in again and cut the top of one and said the rest would come undone.. ok nothing has helped. He now wrote a letter to my insurance and there is a mass (maybe scar tissue) and the irritation is still terrible. My ins approve surgery. He is planning to go in the loong way and remove all sutures and clean out scar tissue. what do you think? is is possible to remove all the sutures? will my stomack stick out more than it did? It was fine before but I had a lot of extra skin that is gone. I should have only done the skin thing and not the muscle repair but too late now. Any advise suggestion etc.. I have suffered way to long ... but I am scared that removing them will be worse. HELP

  Answer:  yes, I remember, it is possible to remove the scar tissue and the sutures but it is also likely the protruberance of the intra-abdominal contents will return if they protruded before. If the muscles did not pooch before though they should not pooch after the sutures are taken out. Best of luck. JG 10.31.08

• I have a stinky fluid that leaks from my naval that gums up in my naval, and I shower everyday and I can`t seem to stop it. What is this fluid, it is constant and I try to keep it dry every time I use the restroom. I`m constantly cleaning it.

  Answer:  if you had a suture placed there long ago it might be an infected suture that needs to be removed. JG 10.29.08

• I have a stinky fluid that leaks from my naval that gums up in my naval, and I shower everyday and I can`t seem to stop it. What is this fluid, it is constant and I try to keep it dry every time I use the restroom. I`m constantly cleaning it.

  Answer:  not sure, if you had surgery and sutures there it might be an infected suture that needs to be removed. JG 10.29.08

• Dr. Garcia, I had a full tt 2yrs. ago and soon after i had my surgery i noticed that my on my right side of my upper stomach area it was a bit lumpy. the doctor told me that because i had three huge pregnancies and i was small/petite to begin with that my muscle was about 5 1/2 inches wide open and everytime he tried to put it together the facia tissue would keep ripping. he said that the bottom part of my abdomen is tighter and flater because of this. now my question is, is it normal to still feel pain. i can`t stand for too long because then my upper stomach area starts to hurt something similiar to how it was after i had the surgery. it feels like something is tearing inside. i can`t even do push-ups because i can`t extend my body without feeling a burning and stinging sensation in my stomach area and after standing for too long, my stomach starts to protrude-it even hurts to the touch. have you ever seen a case like mine and what should i do? Thanks Jes

  Answer:  it is not uncommon in some small numebr of cases to have pain from scar tissue this far out. I do not think the having trouble standing up should still be there though. All I can suggest is stretching slowly to try to get the tissues to loosen up, not much more I have to offer I am afraid. JG 10.25.08

• Hello Dr Garcia! I would like to know my options for correcting an indentation of my scar 9 months post full abdplsty. The indent is supra pubic midline and has seemed to form a keloid.

  Answer:  could be surgically revised, could be treated with fat injections to lift the tissues up, hard to say without seeing you. JG 10.15.08

• Hi Dr Garcia...I had a lipo to hips and flanks and a full tt with muscle repair done 2 months ago. Afterward, I started with biweekly massages and have continued getting weekly massages as they have really seemed to help with my healing. I have had one area that is to my right side of my lower stomach that is the only area that is still visibly swollen. However, if I wrap the area or after my massage, the swelling seems to go down a little (although never completely flat). Today, during my massage, I had a very bad stabbing pain in this area on my right side. I let my masseuse work the area and she said that she felt something pop and then seemed to disapate. The pain subsided for the most part, but it still hurts like a blister popped or something. This is happening deep underneath my incision. I`m wondering if I could have torn something or have some sort of seroma? Should I call and make an appointment with you (you did my surgery and I`m not scheduled to come in until mid Nov)? Or is this something i should wait and see? Should I wrap myself at this point or not? (I`ve been using a bandage around this area because the compression garment doesn`t pull tight enough since it`s just one particular spot). Please let me know. Thank you!

  Answer:  could be a small seroma cavity that burst, but that is good as it mihgth help speed the resolution of the seroma. Swelling in the lower abdomen can take months as gravity will pull the fluid there and hold it above the incision and that can take months to fully resolve. I think seeing you might be a good idea though. JG 10.13.08

• hi, i wonder if you could advise me, i am post mini TT of 1 year after 2 c - sections, 1 only weigh 8 1/2 stone and have done for a long long time, my height is 5 ft 4 inches, so i am not overweight by any means. After the c sections i had an overhang over the scar area and what can only be described an indentation in the scar area, it felt as if my scar was adjoined to my muscle underneath as it would not move over the scar area and pinced in deeply also. After an appointment with a reputable surgeon in Belfast, Northern Ireland i was advised that scar revision would not be enough to solve the problem and that a mini TT would be my best option, so full of faith I proceded with the operation. I am now 1 yr down the line and the same problem that had me do this operation in the first place is still there, if i pull down on the skin beneath the scar it does not move + the scar its-self is indented in ( the overhang how-ever is not as evident until i pull in my stomach or bend even slightly ). The PS seemed bewildered by this and proceeded to tell me that he had placed a layer of fat inbetween the muscle + outer layer of skin to avoid this happening + that this had never happened to him before, he then took some photographs to show some other surgeons for second opinions, but said there would be nothing he could do until i was post surgery by 1 year. i have an appointment with him in 2 weeks and could use some advise as to what to say to him, could you please give me your expert opinion as i feel slightly intimidated by him ( not to mention foolish for paying such a hugh ammount of money for something that has not been resolved. i thank you in advance :)

  Answer:  well I have seen that happen in the best of hands, the more tissue is placed between the skin and the muslce the less it tends to happen,but nothing is 100%, maybe this time since a smaller operation would be needed it might not scar in as much, I wish you the best. JG 10.13.08

• Hi--thanks for the answer previously!! One more thing. My doc is torn 50/50 on using `binder`s post tummy tuck. My sister has gone 10 days without one and done well. Now though, there are some reddened, warm areas on the side of her tummy (the size of a hand) and there seems to be more swelling or fluid over her tummy in the sides and middle. Should I push to use a binder now? Have I lost valuable time? Can a binder now still help the tissues to adhere properly?

  Answer:  I think it still might help some, yes. JG 10.13.08

• My sister just had a FTT about 10 days ago. She has been great following dr`s orders---rest, no pulling/housework and taking it easy for a week. I told her about your website. She is concerned because she still cannot stand straight, she is bent over at probably 30-40 degrees. She is afraid to stand too straight right now. Is she doing the right thing to stay bent over? Also, there are some splotchy reddish areas over her tummy? Any reason to panic? Also, one area of her tummy was red yesterday and she said it felt slightly warm. What are the best things to do or not do to ensure the best recovery?

  Answer:  it is not uncommon to not be able to stand straight as the muscles can be tight and the incision, I would not worry about that for the first 4-6 weeks. Splotchy red areas are not uncommon either. I think what you are describing is all within normal and I would not worry, just see her doctor for a check up in a week or so. Best of luck. JG 11.12.08

• I had breast augmentation (420cc`s) both sides, a tummy tuck and lipo to my flanks and hips exactly 2 months ago (I was told that about 2 liters of fat was taken and 13 x 35 of skin). I weighed myself this morning to find that I am exactly the same weight I was before the surgery. However, I am down 1-2 sizes in clothing, they fit better, etc. I can`t get over the scale not budging... Can this be swelling still keeping my weight up? Should I still wear the compression garment? Please let me know if this is normal/common? Help!

  Answer:  well, skin weighs very little and fat weighs very little too, that is why it floats, so one should not expect a weight loss, those surgeries are done for contouring, so it is common. Also remember, the implants alone weigh about 2.2 pounds together. JG 10.11.08

• DR. GARCIA what would be the process to repair loose muscle from tt. i don`t like the idea of general anesthesia as i have suffered hair falling and i cannot afford another surgery now, since my ps think that i have to be responsible financially, and what would happened if i wait too long to take care of this problem. i would like to wait at least a year from my surgery which is in march 2009. thank you, god bless you

  Answer:  it essentially is a repeat tummy tuck to gain access to those muscles, doubt it could be done without general anesthesia. Best of luck. JG 10.7.08

• Dr. garcia, god bless you. i read your coumn once a wk, maybe looking for answer to my problem, being ps does not want help. im not sure is is still swelling after 7 months or something else. no swelling in morning, but right side is more protude t left. as day goes by, belly looks like im five months pregnant, though is was fluid, but not, no other problems, can it be scar tissue or loose muscle. very unconfortable thr day, worse at night. was not like this first 2 months of surgery. getting worse as time goes by.

  Answer:  of those it sounds like loose muscle. The sutures might have torn and allowed it to get worse. JG 10.3.08

• What is the average length of time for a tummy tuck scar and breast augmentation scars to fade from red to white? What can i do to help this process along?

  Answer:  one year for the fading and ScarGuard and Mederma, along with a YAG laser will help it along. JG 10.2.08

• thanks for your guidance. for the record if i lived in nevada (anywhere in nevada) i would have come in to see you.

  Answer:  you are very kind, thank you. JG 9.26.08

• thank you for your help with my poochie upper stomach. do you think it is possible for exercise alone to correct the pooch?? i really dont want to do anything extreme. i`ll tell my mom hi. you did her eyes lids and a mini face lift and she not only looks amazing but she has been shinning ever since she came to you!!!

  Answer:  sorry, but not likely. Exercise will not pull the muscles together, it will just make them stronger. All the best. JG 9.26.08

• Dr Garcia, My mom has come to you for things in the past and she speaks so highly of you that i thought i would bring my question to you. I had a tummy tuck about 2 years ago now and above my belly button i have a pooch. i know this is where my stomach is but shouldn`t the tummy tuck have been tight enough to hold this area in?! Also, during my recovery my adjustable bed pulled a lucille ball moment and the head of the bed dropped some causing the top of my tummy to burn. could the stitched have ripped out??? lost and in need of advice, i hope you respond.

  Answer:  sounds like it is possible that the sutures placed in the muscle of the upper abdominal area might have torn during the Lucille Ball Moment and that is what is allowing the pressure of the intra-abdominal contents cause the pooch. Unfortunately, that can be difficult to repair through the belly button and might need a longer incision to correct or a redo of the tummy tuck incision. Please say hello to your mother too. JG 9.26.08

• Good day Dr. Garcia I had a Tummy tuck on 8/22/08 and it was a full tt. i always had a small waistline but due to 3 kids a had a pouch on my stomach. i thought i was going to have a flat stomach after the surgery but my stomach is still pouchy and soft. i went to talk to my surgeon he said that he will fix my dog ears to to the tt and he will have to do some lipo. i paid $10,000 for my tt and know he requesting 2,000 for anesticialogist to correct his mistake. do I have to pay for his mistakes? please inform me if this is true. thanks in advance

  Answer:  well, I am not sure I would call it a mistake as such, some of the result that you see now is likely still swelling, but in some cases, there is a limit to what can be done and also in terms of the end result. Agrressive liposuction cannot be done at the same time as a full tummy tuck for fear of injury to the blood vessels needed for the skin to heal properly. In some cases a two stage procedure is needed for an optimal result. I have fouund that in most cases the surgeon can tell that to start off with, and I tell the patients that doing it in two stages is better and tell them that a one stage procedure can be done but the results will be limited. Without having seen you before and feeling the tissues, I do not want to play Monday Morning Quarterback and say what could or could not have been done. I think a frank discussion with him as to what you wanted before the surgery in terms of a result and what he felt he could deliver is warranted. Best of luck with all of it. JG 9.25.08

• I got a tummy tuck and breast aug. done 6 weeks ago and i have had alot of drainage from my tummy tuck not only that i noticed that i have 2 thumb tack sized holes on the my scar from the tummy tuck as well as right under my right breast....Is this normal? There literally holes like you can see in. I dont know weather to cover them up so they dont get more infected or let them dry. Please help me my doc. is out of town

  Answer:  well, not normal, it can happen with the tummy tuck on occasion but should not happen with the breast augmentation. I think getting started on some antibiotics is crucial in the meantime. Also, your surgeon, even if out of town, should have another surgeon covering and watching his patients for complications. If he does not, I would not go back to that surgeon as that is a very irresponsible act to not have someone watching over things when you go out of town. That is a breach of the standard of care and essentially malpractice. JG 9.17.08

• Dr. garcia thank you again, i read this forum to find answer to my problem and i can see that most female with tummy tuck suffered the same issue as myself. the pouch and or swelling between the incision and navel. With me is more protrude to the right side, lately it moves to the middle, and my whole midsection becomes swell up and tender, the only way i feel better is wearing a tight garment, my doctor cannot give me a straight answer, just that it takes time, but im 6 months on tt. what can i do. by the way ny navel stop closing and my stich fall off by itself. thanks. so, in reference to my question, it`s this normal with tt.

  Answer:  the swelling should not be moving, if it is it might be able to be removed with an aspiation using a small needle, best of luck. JG 9.12.08

• Dr. garcia you one of few honest dc. thanks. tell info as it is.

  Answer:  thank you for the kind words. JG 9.10.08

• Dr. Garcia, I had a FTT two months ago. While playing with my kids, I suddenly stretched my hands over my head as a result a small sore appeared on the incision. The sore/blister popped and I have a small hole on the incision. The hole is about the size of tip of a pen. What is your opinion on this? Is this something that I just leave alone and let heal?

  Answer:  it should hela on its own in time, clean it twice daily with half strength peroxide and apply neopsorin and keep a bandaid on it for now. I would also call your surgeon too. JG 9.10.08

• Dr Garcia thanks for your reply, the tissue is still hard and lumpy around the actual wound line. Surgery was in March 08 and wound closed by start June 08. Although due to the crease, bad odour and infection detected in July 08 and again August. Antibiotics taken again and again but seems due to the overhand this will keep re-ocurring. How unsafe would the full tuck be, highly not recommended?

  Answer:  I think it could be risky and suggest you consider just the overhang removal, it is called a panniculectomy. JG 9.10.08

• I recently had surgery of the abdominal for sterilisation reversal although unsucessful. A few days after leakage as in fluid and faeces came from my wound area. I was admitted for emergency surgery for drainage/debridement of the area and discharged following a week with a 12 inch width open wound and 9cm depth. This was dressed at home daily by nurses etc until healing itself. However it has left me with an unsightly scar which to be honest does not bother me as much as the overhang which is more evident and the fact that I now also dont have a symetrical stomach as I was cut unequal during surgery. I am experiencing sweat etc gathering in the crease which is causing discomfort etc. I am slightly overweight, do you think a surgeon would perform a tummy tuck and would it be beneficial to my problem? Thanks

  Answer:  well, it could be done but it will not be an easy tummy tuck due to the scar tissue that has developed as the wound closed after the infection. If a minimal surgery is done to only remove the overhang it might be safer but will not be a real tummy tuck. JG 9.10.08

• Puedo tener un Seroma? Dr Gonzalez, en marzon del 2007 me hicieron un tummy tuck en colombia, los tuvos de dranaje se salieron antes del tiempo previsto, asiq ue la Doctora tuvo que sacarme liquido de la parte superior del abdomen insertando una jeringa. despues de dos semanas tuve que volver a Miami donde vivo, un amigo medico inserto una jeringa pero ya no habia mas liquido. desde ese momento empezo a crecer una bola en ete sitio. Ayer estuve en el hospital pues esto me ha generado dolor y al hacerme un ultra sonido y varias radiografias me diagnosticaron un upper abdominal Seroma de 3* 0.8 * 6 . La unica explicacion que me dieron fuera que esto es un tumor benigno y que dobo ir a donde mi cirujano plastico. Mi pregunta es, puede ser esto ralmente un Seroma? si es asi puede ser drenado o debe ser sacado por cirujia. Para mi es imposible vovler a Colombia en este momento, asiq ue debo realizarme cualquier tratamiento aca enn USa. Este tratamiento puede ser cubierto por mi seguro? Gracias por su ayuda.

  Answer:  si, puede ser una seroma qual no se ha podido absorber. Probablemente necesita ciurgia pare scarlo todo. No creo que se puede aspirar y no creo que el seguro se lo va a cubrir. Buena suerte. JG 8.31.08

• hola docotro garcia, fui operada hace 3 meses del estomago y busto, un busto se capsulo y ahora tengo dolor arriba del hombligo y siento como una bola arriba del hombligo y me arrde que puede ser

  Answer:  debe de ir a ver su cirujano. JG 8.30.08

• Buenas tardes Dr. Garcia, me he contactado a su oficina para hacer una cita, pero no hablo ingles es necesario que lleve a alguien a mi cita que hable ingles??? y otra pregunta quisiera informacion de tummy tuck a cerca de la anestecia es con la llamada raquea como le conozco en mexico por mi cesarea o es anestecia gral.?? gracias y espero responda mi duda.

  Answer:  si, mis empleados no hablan espanol y yo no siempre estoy en la oficina haci que no solo para la consulta pero para todas las visitas necesita un interprete, para el tummy tuck es anestesia gral. si. JG 8.27.08

• Thank you so much! I will ask about the infected suture but what can he do about the lumpiness in the abdominal area. He did suggest to re-open and cut the area to remove the skin under it.

  Answer:  hard to say without seeing you in person, might be able to be smoothed out with liposuction though. JG 8.25.08

• I had a tummy tuck done four years ago. My belly button is leaking a yellowish smelly drain and my stomach is not flat. I have a scar and my stomach is lumpy. What can I tell my plastic surgeon to do?

  Answer:  well it has been quite some time now, I think showing him what is going and and then asking what can be done would be the best thing I believe, might have an infected suture at the belly button that could be removed and allow that issue to resolve at least . JG 8.25.08

• What is your opinion regarding a tummy tuck with mesh grafting being used? Had a consult with a CA plastic surgeon and he regularly uses this procedure. I had never heard of it before seeing him. Is this common or unnecessary? Pros vs cons, if any? Your thoughts would be greatly appreciated. Thank you for your time.

  Answer:  I cannot remember when I needed to use it unless in the case of a massive hernia, the mesh can become infected and if not needed is something that can or should be avoided. JG 8.23.08

• Hi Dr. Garcia, I had a full tummy tuck 20 months ago and i still feel a hard lump about 2 inches from my belly button above the incision. It feels like a small square bar of soap. This area is also noticably more puffy than the other side of my abdomen. My surgeon said it is nothing to worry about. I am going to have liposuction in that area in 3 weeks. Do you think I should have this checked out first? Thank you so much for all your help.

  Answer:  most likely scar tissue and a little indurated fat, the liposuction will most likely correct the firm area, all the best. JG 8.21.08

• Dr. Garcia i had a tt back on March 17 of this year in the dominican republic. I am very happy with my surgery, but as time goes by my belly botton gets smaller and smaller. a small bean does not fix anymore. I hear this is not good. I also found out a stitch is still inside it and im in the process of going to see my Dr to get it remove. Do i have t worry about it or not. luisa

  Answer:  I do not think you need to worry about the stitch, but as to the belly button closing off, you might need surgery to re-open it. JG 8.14.08

• Thank you Dr. Garcia for answering my questions-but-how long does it usually take fat necrosis to melt or liquify? I had my tummy tuck 4 months ago and the necrosis is hard as a rock.

  Answer:  sometimes a year or more if it is a large area. JG 8.7.08

• Dr. Garcia-Another question on fat necrosis-how do I know if I have fat necrosis? What should it look and feel like?

  Answer:  no way to know 100%, it is a matter of clinical history, fat necrosis will usually feel firm until the fat liquifies and then it will feel like fluid or oil. JG 8.7.08

• Hi Dr. Garcia-Thank you for answering my question on fat necrosis-but you mentioned shots-what kind of shots can I get to soften the fat necrosis?

  Answer:  dilute kenalog or 5FU is what I would typically use. JG 8.7.08

• Hi Dr. Garcia-2nd question-I have had problems with my bellybutton closing correctly after my tt done in March 2008. Mu doctor says it is a false close. He just did a revision on it 3 weeks ago and now he says my body is rejecting the stiches. Why does the belly button not close right and what happens when the body rejects the internal stiches?

  Answer:  I have never heard of sutures rejecting, they can become infected and then come out prematurely though, hard for me to tell what is going on. JG 8.6.08

• Hi Dr. Garcia-I had a tt March 2008. 2 weeks later I developed a hard ball of fat necrosis on my right side right above the incision. it is hard and sometimes it hurts. How can I get rid of it? Mu doctor says it should get soft within a year and then he will remove it. I do not want any more surgery. Do you have any suggestions as to how I can make it get soft and fade away?

  Answer:  injections might help it soften up, or maybe some liposuction if it is just old liquified fat now. JG 8.6.08

• I have had a TT and lipo to my flanks on July 14, 2008. Everything is good I think, except I have developed a seroma? My PS is on holidays and refered me to one of his partners. The doctor drained my seroma once and got about 4oz`s. This is a week ago. The fluid looked like coffee? She said I might need it drained again, and I do. Will this fluid dissolve on it`s own eventually or do I have to keep getting it drained? I`m leaving for holidays in a week and I`m worried about this? Are these seromas serious? Have I distrubed something inside that I shouldn`t have? Help?

  Answer:  I think it best to remove the fluid if it reaccumulates in order to get the skin to re-adhere to the normal location. The problem is not serious though, I believe you should follw their suggestions and get it removed as often as needed. JG 8.4.08

• Hi Dr. Garcia, i had a tummy tuck 7 months ago, and i still have somthing going on in my tummy, dont know what is going on, because my stomach is not completely flat. I have an appointment to meet another surgeon for a second opinion, and revision. Now my question is, have you ever perfomed revisions ? Are they safe and common ? I feel like i might have some scar tissue or a seroma that never got drained , not sure. But please advise on this, i just want my stomach to feel normal. Thank you.

  Answer:  I have performed revisions, they are more common when large tummy tucks are done with lots of skin being removed, as to what is going on, I hope the second opinion can tell you that as an in person consultation is usually required. Best of luck. JG 7.22.08

• Dr Garcia I had a breast implants and tummy tuck surgery in June. My belly bottom still looks a little bit red,and I feel sore around it this is normal? Now after almost 2 months, am having some bother in my nipples, around my stomach area with burning sensation, and two day I discover a stitch where one of the tubs had gotten infection(got treated). Why am I feeling this now,are all this things normal? What should I do about the stitch? Another question how good is scarguard for the scars? THANK YOU :)

  Answer:  not common, might be some degree of an infection, I think you should see your doctor to see what is going on. I use ScarGuard or Mederma for scars frequently. JG 7.21.08

• i have a question about scars. I had a FTT and then 4 months later a butt lift. Both scars are about equal now, i am about 10 weeks post butt lift and about 6 months from FTT. Is the redness actually underneath the skin? i have been massaging with silicone oil and using 3m paper tape. Wehn i push on/massage the scar, it turns white. Makes me think only time will make it fade? No topical scar creams will do anything? why does massage speed up healing? it is nice and flat finally but both are still red/dark pink

  Answer:  the redness is within the scar, it is the blood vessels that are prominent due to the scar tissue being thin and as it thickens the redness fades or decreases, pushing on it makes it look less red as it temporarilly closes off the blood vessels. Massage will flatten scars but not fade the redness, time is your best friend, and maybe a series of IPL or YAG lases to settle the vessels down. I have not found topical creams or tapes to help except for flattening them out. JG 7.9.08

• Hi Dr. Garcia, how are you? I just had a question, it might sound silly, but i had a tummy tuck 7 months ago, and i expected my tummy to be pretty flat, but its not, now my question is, after you have a tummy tuck, and you work out really hard, can you still get a flat stomach with exercise, or does the tummy tuck interfear with your results ? Because i feel like there is still some fat in my stomach, can that be removed with smart lipo or is the best thing just to exercise? Please advise, thank you so much for all your help.

  Answer:  well, it not being flat could be from the fat below the muscles, called visceral fat, for that to go flat you need to lose that fat, tightening the muscle with exercise and not losing that fat will not make it any flatter I am afraid. If you are not flat due to the muscles being loose but no fat in the belly, then working out will help, correct. Liposuction can remove fat below the skin but not that fat inside of the abdomen I am friad. That is diet controlled. JG 7.8.08

• Hi Dr Garcia, I have a lot of excess elbow skin, Ive actually had excess elbow skin since the age of 9 but it has obviously now become much worse. My upper arms are OK but i would like the excess skin removed i dont mind if there is a scar as it would definately look better than loose skin.Are there any surgeons that would do such an operation and if so how much approx does it cost?

  Answer:  I am afraid the scars from removing skin in that area will leave very unsightly scars that will be difficult to hide and will not be thin good quality scars. JG 7.6.08

• If you do a tummy tuck, are you doing the area near female genital as well. or is that more for a job for a gynicolojist.

  Answer:  the mons, or the area where the pubic hair is, is actually treated with most tummy tucks, anything lower than that, the non-hair-bearing areas are not treated during a tummy tuck but can be treated seperately by a gynecologist or in some cases by the plastic surgeon. JG 7.2.08

• Dr. Garcia; Hola.Cuando el cirujano plastico hace tummy tuck/lipo, en la area abdominal ustedes aspiran la grasa con la canula de la liposuccion o solo estiran el pellejo y cortan el exceso de piel? Porque yo me hize la tummy/lipo pero noto que tengo 5 meses y tengo un poco de grasa. Mi segunda pregunta es si me queda un poco de abultamiento del estomago despues del year, Me podria hacer la lipo y entonces quedare completamente plana?

  Answer:  no se puede aspirar la grasa debajo dela piel ques se levanta. Se tiene que hacer antes o despues. Se se hace la liposucion despues, si es una cantidad pequena, la piel luce bien, si es mucho se puede quedar con piel flacida. JG 6.11.08

• Buenos dias Dr. Garcia My lipo-tummy fue hace 6 meses. Esta bien o no que siga usando la faja durante el dia. O esto impediria a que mi cuerpo se adapte a estar sin faja? Gracias.

  Answer:  no creo que la tiene que usar y no creo que le va ayudar mucho a este punto. JG 6.11.08

• Dr. Garcia Yo estuve una abdominoplastia y liposuccion en noviembre 26 del 2007. Hace 6 meses. De size 10 estoy en size 6. Pero el problema es que me sigo sintiendo la piel como acalambrada en el area encima del ombligo e inflamada. Esta Hinchason dura para siempre o deberia quitarse? Yo conozco dos amigas que una lleva 2 years y la otra 3 y se siquen inflamando. Esto me da un poco de miedo. Tambien me doy cuenta que al hacer ejercicio en la thread mill o elliptical me inflamo mas. Usted cree que no debo hacer ejercicio. Mi cirugia fue en el Ecuador y el doctor me dijo que usara la faja hasta los tres meses. Pero Yo me la pongo por el dia porque sino me siento como si la piel no fuera firme y me siento como rara sin la faja. Siento como si la piel se me fuera abrir si hago alguna furza sin la faja. Por favor ayudeme digame que deberia o no hacer y si deberia preocuparme o no. Mi idea es que yo iba a tener un estomago completamente plano ya para este tiempo (sin inflamacion). Y las experiencias de mis amigas que tienen 2 y 3 years me tienen atemorizada.Fui a un medico aqui en Estados Unidos y me dijo que no tenia fluidos. Gracias Luz

  Answer:  se quita con tiempo, pero despasio. La inflamcion despues de ejercicio es normal y mejora con tiempo.JG 6.10.08

• Hi Dr. Garcia, i had a tummy tuck 6 months ago, and the left side of my stomach is bigger than my right side. My stomach is lop sided. I have been told it can be scar tissue or swelling? Is scar tissue after tummy tuck pretty normal? Does that happen a lot ? When i feel my stomach it is hard and when i feel the upper left side of my stomach, and push down, it feels like i could kind of feel a muscle, but im not sure ? Could this still be swelling? And if it is scar tissue and i get it removed, will my stomach than be flat, or will the scar tissue still come back? Thank you Dr. Garcia.

  Answer:  scar tissue happnes after all surgery but usually it is fairly even unless something has happend to make it uneven, like a pseudobursa from a post operative fluid accumaulation. I doubt it is swelling at this point, and the scar tissue might be removed if excessive but some degree of new scar tissue will form though. JG 5.30.08

• Dear Dr Garcia I had a TT done in May 2007. My addominal muscle was also repaired and I had hernia. I did this surgery as the hernia was causing me frequent pain. Since the surgery, my tummy looks like they are sectioned into 2 areas- above naval and below, by a depression line across the naval section. After about 4 months, a bump occurred above the naval area. And it hurt. It stayed for abot 30minutes before it subsided into the cavitiy. I knew my hernai was back. According to the PS, hernia recurrence are common (40-50% rate) but I could not find any website that supports this statistic. He also suggested to repair it with a mesh . What does this entails, what are the risks, what about recurrence? And if you have the time, please also help me to understand why I have a 2-part tummy?

  Answer:  a mesh is like soft chicken wire placed over the hernia to assist in the repair. As to why you have the 2-part tummy, it might be because they were not able to remove fat from the upper abdoemn as that is where the blood vessels come from. It sounds like you will need a revision of all of it with the repeat hernia repair. JG 5.25.08

• Hi Dr. Garcia, i wanted to know if scar tissue after a tummy tuck , would hurt? Would`nt i feel pain? Also i had liposcution 5 months ago, and i could still see a little bit of faded bruising on my side only. Will this completely go away? Im afraid it is going to stay like that. Thank you Dr. Garcia

  Answer:  it can hurt occasionally, all depends how attached it is to nerves and the underlying muscles. The bruising should go away, but it can take a long time in certain individuals. JG 5.22.08

• Hi Dr. Garcia, thanks for answering all my questions. This has helped me so much. In regards to my tummy tuck. If i do have scar tissue, should i get it removed? Or should i just wait? Will it obsorb on its own? I had my TT 5 months ago. What would be your best suggestion? And if i do get scar tissue removed, is it prone to come back? And lastly how does the surgery to remove scar tissue work, and is it a long recovery? All your answers are greatlly appreciated. Thank you.

  Answer:  I would wait the full year and see how it feels, scar tissue can be remvoed but new scar tissue can form. Scar tissue will never totally go away. The removal of the scar tissue will depend greatly on where it is, in some cases it is almost like doing the tummy tuck all over again. JG 5.22.08

• Hi Dr. Garcia, i had a tummy tuck 5 1/2 months ago, and i still have hard swelling .I have talked to people that say it can take up to a full year for the swelling to go down. From your experience , would you agree? How could i tell if it is swelling or scar tissue.? How could i tell the difference? In addition, if i do have scar tissue, and it is removed, is there chances that it would come back? Thank you Dr. Garcia.

  Answer:  in some cases, where the amount of work was extensive, yes, one year can be the time period. Scar tissue also forms and also will go down in terms of getting softer. As to telling the difference, if it is hard, it is likely scar tissue and if soft most likely swelling. If it moves around or comes and goes it is swelling and if it is in the same place all the time it is scar tissue. JG 5.21.08

• Hello, I hada tummy tuck 2 years ago. My belly button still looks like a Red upsidedown horse shoe. Cortisone shots there have helped it be softer but can my belly button be redone to look normal? :(

  Answer:  ypu might be able to improve the redness with either a YAG laser or a VBeam laser. JG 5.21.08

• Dr. Garcia, Hace 4 semanas me hicieron una abdominoplastia, a las dos semanas me salio una bola como la mitad de una bola de golf, entre el ombligo y el costado izquierto (como una pulgada arriba de la inccision) y con mucho dolor que se exparce hacia arriba rumbo a las costillas, siento como que me quema por dentro, fui a ver a mi medico y me dijo que no sabia que era, pero que tomara penicilina en caso de que fuera fluido y que no me fuera a infectar, ya termine con las pastillas pero el dolor sigue ahi, la bola(que por cierto estaba muy dura y luego se puso como moreton) ya bajo en un 80% pero el dolor sigue, usted cree que pude ser una hernia, o no me debo de preocupar? Pues hoy volvi a ver al Dr. y me dice que le de tiempo, necesitare un ultra-sonido? Gracias Doctor, pues no se que hacer.

  Answer:  ne se tiene que preocupar, fue un desrame de sangre que con el tiempo se mejora, el dolor es porque la inflamacion le halla alos nervios, todo se mejora con tiempo y un poco de calor, una tuallas con agua caliente para que la sangre se desuelva. JG 5.19.08

• Hi Dr. Garcia, so if i do have something called a pseudobursa that has formed around the fluid,and it can still be aspirated but there might be a sac of scar tissue that might need to be cut out to get it totally flat. Where do i get cut ? How does that procedure work? To get the sac of scar tissue out. Can you explain. Thank you so much Dr. Garcia.

  Answer:  an incision needs to be made to cut the pseuodbursa out, sometimes it is made in the smae incision you already have. JG 5.18.08

• Hi Dr. Garcia, i had a tummy tuck and Lipo 5 months ago, and i have a concern. I have already asked you about. However, i have further questions. I am so confused, i still have hard swelling on the upper left of my stomach, and right above my pubic area , that looks like a little popped out pooch. I am getting very unpatient. When seeing my PS, he said to just wear a very tight garmet, and message the area. However, i have been doing that for a week now, and i see nothing different. And i think wearing such a tight garment, is cutting my circulation, because now my feet are swelling. Now , my question is , do you think i can get aspirated with a needle , even if its hard? What could it be? But when i stand and walk around the left side of my stomach feels like there is somthing there? It feels like something is kinda popping out. What could it be? What do you advise i do? Thank you so much.

  Answer:  if it is fluid accumulated there, it can still be aspirated even now. If something called a pseudobursa has formed around the fluid, it can still be aspirated but there might be a sac of scar tissue that might need to be cut out to get it totally flat. Massage might help the fluid but I do not think the girdle will do much at this point in time. JG 5.17.08

• Hi Dr. Garcia, I am scheduled for a TT this Friday. I had a cold that started last week which I am just getting over. Is it safe for me to still go through with the surgery?

  Answer:  I think it is likely OK to proceed, best of luck. JG 5.13.08

• How long before a scar from a butt lift(Brazillian thong incision) to flatten out, especially the part that dips down to the crack? what do you think about the adhesive silicone strips to treat scars? also, Scar Guard, the brush on silicone treatment, does it work? it is recommended by PS s. I usually scar well, no keloids, but this one is prety aised in spots, i am 10 days post op. thanks for your time.

  Answer:  it can take months and in some case it might never flatten out. I do not think the adhesive strips do much but I do think Mederma is a good product but to reduce the redness only. JG 5.10.08

• Hi Dr. Garcia, i had a tummy tuck 5 months ago, and i recently went to follow up with my PS, because of swelling. I only have swelling on my left side, and it is very hard. Is that normal? How should swelling feel? And long could it take for it to completely go down? Please advise, Thank you .

  Answer:  not normal, but it can happen, usually is is scar tissue from fluid that was slow to absorb. It might take a full year for all to soften up. In some cases if there is still fluid, it cna be removed with a needle to flatten the area too. JG 5.9.08

• Hi Dr! I have asked you several questions in the past regarding a rev. abd. scar that needs revised as well as a L. breast crease that needs redefined due to the pulling from the rev. abd. I am scheduled to see my ps at the end of the month. He is planning on addressing these issues with another surgery in the fall. If I still have any hesitations afrer my appt. with him. how do I find the names of the best ps that would redo a rev. abd scar, redefine a breast crease etc. What types of ps would be considered the expert in these procedures---breast reconstructive surgeons? (the ones who deal with post-breast cancer pts) or massive weight loss patients (where upper body lifts are performed more commonly? Although I trust my ps, I need to make sure that I have one of the best who is experienced in `clean-ups` of a rev. abd. I have come to learn that a rev. abd is a uncommon procedure. I am guessing that going to another ps in my area may not be effective as they may not be very experienced with the rev. abd procedrue, nor the clean-up needed. At what point do I start making consultations with other ps in the North Carolina area? Is it smarter to stick with the original ps who did the procedure? At what point to I start researching rev. abd experts all over the nation? I really need to have peace of mind. How do I access this info?

  Answer:  I do not think there is an expert but I think seeing someone who does alot of breast surgery and tummy tucks is important, some surgeons do mostly faces. Surgeons that do reconstruction after massive weight losss would also be good choices. JG 5.6.08

• I am 6 months post op from my tummy tuck. Of course when I stand my stomach is flat as a board. When I sit down my stomach bludges out. I have noticed this in the bath tub or when I bend down to pick up my child. Is this normal?

  Answer:  it is normal, due to the amount of fat inside of your abdomnem most likely, that is not treated with a tummy tuck. JG 5.4.08

• wondering if youcan answer my question below about butt lift? i noticed you stopped answering at mine. Any advice would be appreciated.

  Answer:  sorry, for the delay, I am out of town at a medical convention and have limited time at present. JG 5.4.08

• Dr Garcia, i had a butt lift 4 days ago, no fat grafting or implants, just a lift. I was wondering about a couple of things. My but crack is definately more open than it was. will this close up when things settle? also, i have all internal stitches with just clear tape over, no drains. I can see the incision. In places, it is definately shelf like. Will this flatten out? I know for my FTT 4 months ago, i had this same thing down low in the hip area, and it did flatten out. And is it normal to have pain/burning just above and below incision, and only when i get up from sitting? also, i feel like siting is bad for the healing, but ps didnt give me any restrictions on posisitions. i have been sleeping in recliner with pillows above incision to keep pressure off. will i heal funny? thanks!

  Answer:  usually as swelling gets better that will get back to normal. The uneven surface of the incision is common and will also flatten out wiht time. The pain is not uncommon either, all normal. JG 5.4.08

• WHAT IS YOUR TOTAL COST FOR A MINI TUMMY TUCK?

  Answer:  I would need to see you in person to give you an accurate quote. JG 5.3.08

• I asked yesterday about a tummy tuck with an epidural instead of GA, I guess my question is would you do it with an epidural? My friend had her breat lift through you and she`s ecstatic with the results and highly recommends you.

  Answer:  that is really more up to the anesthesiologist, we can ask them, some are very comfortable with that technique, but not all of them. I am willing to do it with that anesthesia though. JG 5.1.08

• I am 28 years old and would like to have a tummy tuck, I had twins 9 years ago and am not happy with my tummy now. I am very nervous to be put under, can this surgery be performes with just aa local or an epidural maybe? Also what is the average cost for this surgery?

  Answer:  some docotrs will do it under an epidural, prices vary widely so you need to decide on a surgeon to get a fee. JG 5.1.08

• I am 39 had FTT 8/07. My scars are brown and pink with hardness in center of incision. I had scar revision 6wks ago, due to dog ear on ends and widening of scar in center.Is there a laser to lighten the dark/pink scars? I know I will have a white scar. i am OK with that. Also, at times it looks like I have a pooch or bloated in lower abdomen. I am considering IPL or Varilite laser. What are your thoughts? Thanks

  Answer:  I usually use a YAG laser for that problem, it takes a series of treatments, I do not think the Varilite or IPL will be enough. JG 4.29.08

• Hi Dr. Garcia, i had a tummy tuck 5 months ago in Tijuana. And this week i went for a follow up appointment with my Surgeon, do to having hard swelling on the left side of my stomach, and right underneath my belly button. I still have a pooch and it feels hard. The Dr. said it could be one of two things, either i have torn my muscles, or it is swelling. He said he had a patient who took 7 months before all the swelling went away completely. He has advised me to message the area twice a day for 20 minutes, each time, and wear a tighter compression garmet. He says there is no way of telling if i have torn muscles unless he goes in and does the surgery again. Is that true? I dont want to have a tummy tuck revision if i dont have to.Can the swelling take that long ? Should i just give it more time? How long should i wait before considering a revised tummy tummy? I also had lipo , can it be because of that i am taking longer to heal? If i do have torn muscle , is it dangerous? And if i leave it with the torn muscle, will my stomach feel soft again, or stay hard ?Please advise, i am worried and just want to make sure i do the right thing. Thank you Dr. Garcia , i appreciate it.

  Answer:  swelling can take a long time, I doubt you would have torn the muscles though, if that were the case the pain would be unbearable, you migth have a hematoma though and that might need to be aspirated with a needle to reduce the swelling and fluid that has accumulated. I think what they have suggested should show some improvement in a month if that is what it is. JG 4.29.08

• Regarding the round, totally flat scar. You stated that you would need to examine me. Have you ever heard of such a thing happening? I am in Florida, so I was also curious if you had any advice on what type of qualifications I should look for in a surgeon to fix this.

  Answer:  I have heard and seen it, it can happen. JG 4.28.08

• Dr. G, I had a full TT with MR done in March 2007. My belly button did not end up right. It is a round, totally flat scar. It was repaired by the original PS using a purse string technique. This did not work. It only made it a little smaller round, totally flat scar. The PS said he shortened the stock as much as possible and there is nothing else that can be done. I am a petite person at 5`2 105 lbs. Before the TT, I had no fat except belly bulge from pregnancy. Post TT, I have no fat at all. My stomach is hard as a rock. There is not fat under the muscle or between the muscle and skin. Can my belly button be repaired somehow? I am devastated. If it can, what type of surgeon should I be looking for?

  Answer:  hard for me to tell what if anything could be done wihtout examining you, sorry. JG 4.27.08

• Dr.Garcia, I had a tummy tuck april 2007, My wound opened up towards the middle, they said due to tension and poor wound healing . It was revised in Nov 2007.I have asian skin , and prone to Kelloids. MY belly button had to be revised twice. It still looked raised. I am now getting steroid shots on it every month.MY doctor had now relocated and I am being followed up by his partner. MY belly button still does not look good. What do you recommend to improve it. I heard you could probably tattoo over it. How soon can you do it. Or should I try laser first?Also I have been putting kelo cote on my scars for a couple months . I am not sure it is working. thank you so much

  Answer:  in most cases cutting it out again will result in the same keloid. Tattoo over it will not help it either, but it will have a different color. The tatoo can be done at any time. I am not impressed with the Kelokote either. JG 4.21.08

• Hi dr. Garcia, been awhile. Have had a FTT with MR, fab results, next is my butt lift in a week and a half. I forgot to ask my PS at my preop if the butt lift is done one cheek at a time? I know the incision goes along the lower back and will connect with my TT incision. He knows i am a fanatic about scars being exactly where i want and EVEN, but if each side is done separately, is that possible to be even, since i may not be symetrical back there? he said he will take about a 3 inch section out and sew together, no drains, all internal stitches and clear tape over that with a lipo type garmet on when i wake up. I am only 114 lbs, so he siad too thin to bother with drains, i had 2 for my FTT with MR and hardly drained at all, never more than 15 ccs in 24 hrs so he knows i wont need them this time. sound right to u? Main question is about butt chheks separately or together? Thanks so much! JR

  Answer:  they are done together and I will tell you that even if the scars are marked very carefully, due to gravity, the scars on your buttocks lift will likely be similar but not perfectly symmetrical. As to the drains, it all depends on how much undermining is done, if it is minimal, like possibly in your case, they might not be needed. Best of luck. JG 4.19.08

• Dr Garcia I am highly allergic to latex of any form due to costly overexposure to latex. Since then I suffer greatly with all sorts of reactions whenever inhaled or exposure to latex. My question is are there any Latex materials used inside of the body for a normal abdominal plasty. Stitches and etc...?

  Answer:  no, there are not, should be OK to have it done. JG 4.18.08

• Hi Dr Garcia: I`m wondering if you recommend any type of silicone sheets for scar treatment. I have an abdominoplasty scar but more concerned about the scarring from some necrosis to the skin. I used a sheet from my Psurg. for the past two months and I`m not sure I`m seeing much results. I have seen several different types on line but they seem much more expensive. One is called rejuveness. Do you recommend these at all?

  Answer:  I do not use them as I have found they offer little advantage unless firm constant pressure is applied at the same time and that is really hard to do on most surgical wounds not on the arms or legs. JG 4.17.08

• Hi Dr. Garcia: I had a modified tummy tuck 6 weeks ago with oblique muscle repair. My scar looks pretty good already. Very fine and not that red. I was wondering at what point can I start using the silicone strip on it. I have been keeping the micropore tape on it but was wondering if I should change to the silicone strip at this time. And how does the silicone work differently from the micropore tape. Thanks in advance.

  Answer:  you can start now if you wish. I think they work about as well. JG 4.14.08

• please accept my apology on not being clear on previous tt question. am due for cirf.lipo in june due to the fat shifting fron 11 months out tt.a roll has developed below bra when sit;as was told lipo should have been done first to thin out underneath to be able to pull more skin. again so sorry for the previous confusing email. i appreciate the thoughts you give. thank you again DR, Garcia....terry

  Answer:  no problem, I just wanted to make sure I could answer your question. Firstly, fat does not shift, it gets bigger or smaller, but it does not move. If you gained weight after the surgery, since some areas were removed, you will gain fat in the fat cells that remain, so some areas might get bigger. In many cases,I agree that doing liposuction first yields a better result as it thins the skin and gives a better contour. It might lead to more skin tightening, but the main reason to do it is for better contour, less thick skin. JG 4.10.08

• 2nd part to lower question. weight has remained the same. and am healthy.otherwise. previous ps stated could not answer me as to why this fat shift happend. agian thank you for the forum it is very helpful and much appreciated ter

  Answer:  fat does not shift, but weight or fat gain will go to other areas not treated. Most people think if they weigh the same after liposcution that then the fat should not have grown, that is not correct. If you have had liposuction, there should be a decrease in bodyweight. If you weigh the same after liposuction, then you have, by definition, gained weight. JG 4.10.08

• thoughts on circumf.lipo?ter in pa.post tt i yr ago.donut roll below bra due to no lipo prior to tt.this is to be done in june.told only need ten days off. is lipo this advanced.is it rx just like a lap.chole?this ps has exper.in cal,with wt loss,srgy,&burns came back to pa thanks alot for your in put...very satisfied with this one. due to previous ps. approach not so great or wouldnt need this... lipo for the donut roll above umbilicus.. thoughts?

  Answer:  your question is difficult to understand, I do perform circumferential liposuction in some isolated cases, but it cannot be done on all cases. JG 4.10.08

• Who do you recommend in Tampa, FL for a full tummy tuck and breast lift with augmentation (gummy bear implants are preferred). Could you please give me a estimated dollar cost for these procedures done in a combined surgery. Thank you for your website, it is a treasury of information!

  Answer:  gummy bear implants are still not availble. Due to potential legal issues, and some doctors wanting to know why I referred a patient to someone else and not them, I think you are best to go to this website and look for a plastic surgeon in the area you desire. I wish you all the best. JG 4.8.08 http://www.surgery.org/public/findasurgeon.php.

• I had a full tummy tuck with lipo to my lower back and sides on march 15th. I wore a drain for 7 days & about 7 days ago my stomach has gotten so swollen, parts of it are very hard mostly the center & above my new belly button. Is this normal & when does the swelling start to go down? also, where the lipo was done it feels very hard too like a ball! should I massage the area? I was told to wear the tape on my incisions for as long as I can, is that okay as well? Im feeling a little dissapointed because my stomache is flat but raised if that makes any sense I dont feel normal.

  Answer:  it is not uncommon and it can take 4-6 weeks for a lot of that swelling to resolve, you might need to get some fluid drianed in that area with a needle. Tape on the incisions is OK and massage is a must. JG 4.8.08

• Hi Dr. Garcia, I emailed you back in January regarding a very large seroma that formed on my abdomen after a laproscopy hysterectomy. It was from my breast bone to my pelvic floor and wrapped around my waist. The intial drain was inserted 1/11/08 and was finally removed 3/5/08. Now that it has been removed a have a semi-hard lump under my breast bone that protrudes only when I lay down flat on my back. It does protrude when I`m standing and looking in the mirrow (side view) Also, the drain was placed right beside my belly button. It seemed like it should of been placed lower so that it would of drained better. I also have a really soft area right below my belly button. Is it likely that each of those will get better in the months to come? Could the semi-hard lump be scar tissue and the soft spot under my bellybutton in my lower abdomen be a small collection of fluid left over? Is there anything that I can do to relieve either of these? Natural treatments?

  Answer:  most likely they will get better with more time, yes. The semi hard one is either scar tisssue or a pseudobursa from where the fluid used to be. Hopefully the lower spot is just fluid and not a hernia as the hernia will not fix itself. No natural treatments I can suggest though, just time. JG 4.8.08

• I am 4 1/2 months past a modified tummy tuck. (no muscle repair) My upper abdomen is still very tight and seems to feel worse (tighter) as the day goes on. Also I still do not have much sensation straight down the middle of the abdomen. How much longer should I anticpate this going on before it gets better? I also had a few open areas above the scar line which have healed over but left quite a red scar. I`ve been using a silicone sheet since February but it doesn`t seem to be getting any better. Any other suggestions? I`m not scheduled to return to my PS until the end of summer. Thank you.

  Answer:  it might take a full year to get to the end result in terms of sensation. Might consider a YAG laser for the red areas. JG 4.6.08

• Today my PS injected cortisone into my belly button and tummy tuck scars to reduce the inflamed look they have had for 1.5 years. How effective will the shots be and how many visits for injections does it usually take for the inflamation to go and stay down? I had these shots about a year ago, but just one visit and it didn`t seem to do much. Also, I recently started using your eye cream I love it but it does sting a little, is that normal? How long does it take to notice reduced lines and dryness below the eye? Thank you so much! :)

  Answer:  it will be a series of shots, but in many cases it does help, even after this much time. Usually if it is kenalog it is done every 4-6 weeks. One shot will not do the trick. As to the eye cream, that can happen in sensitive skin, but it gets better with time. You will likely see inprovements in 4-8 weeks, some people see it sooner if their skin is really dehydrated and damaged. JG 4.3.08

• I have to have a capsulotomy, nipple revision and a abdominal scar revision this fall. My PS says it will take about 2 hrs. How long should I wait to undergo a laproscopically assisted hysterectomy? THere will be 3-4 small incisions on my abdomen (one being the umbilicus). Also, I have had a mini tummy tuck in 05/06 and a touch up tummy tuck in 01/07. Are there contraindication to performing laproscopic surgery through my abdomen this fall? Circulatory risks? Nerve damage? Improper healing?ucau . toas fsca

  Answer:  I would give it at least 2-4 weeks after the plastic surgery if you can. No contraindications or unsual risks. JG 4.3.08

• I wrote recently about a rev. abd. that has pulled the crease under my breasts down and caused a flattening effect and loss of some of the creases of both breasts. I have plenty of loose skin in the abdomen (it has relaxed a lot since my rev. abd in jan 2007). My PS does not want to redo the rev. abd. because he feels the same cycle will happen: pull loose skin up; create tension; scar thickening and tension will pull breasts creases down. I agree. I don`t want this happening again. But, he would like to `recreate` the breast creases by gently taking the loose skin under both breasts and `tacking` it up about 1/2-1 inch and redefine my breasts creases. Questions: won`t it just drop again and further tug on my breasts? (although my skin is much looser this time, he will be careful to not create any more tension). Can this create a weired looking crease that may look strange? Is it worth doing it? I don`t like looking at my breasts straight on naked because you can see that both creases have lost a lot of definition. But, I don`t know if I am ready to possibly create any more problems................In a bra, they look great because the underwire gives the crease it`s definition back

  Answer:  well, the less tissue he lifts the less chance of the problem recurring. Might be worth to try to hide the scars a bit and creating a fold, but not to correct the loose upper abdominal skin. JG 4.3.08

• Dr. Garcia: I just sent you a personal email. Please see the email.

  Answer:  will do

• I am 48 and have had two previous abdominal surgeries for colon cancer. I have a vertical incision since 2001, and a horizontal incision from a liver resection in 2002. Although I developed a large hernia in the midline incision, I have been colon cancer free. In October 2007, I had a bilateral mastectomy (for DCIS) and immediate reconstruction (DIEP); the plastic surgeon repaired the hernia with a large piece of mesh and finished the abdomen off with an abdominoplasty. I had some seroma formation and some incisional healing problems. One month after the procedure (after several seroma aspirations), I developed an abscess. The abscess drained through the already open part of the incision, but had trouble healing. The surgeon opened up the area and allowed it to heal from the inside out; it took at least 8 weeks to completely close. Since then, the incision above my pubic area looks like a roller coaster; also, I develop a considerable amount of swelling (bloating) after eating anything, or even standing for most of the day. The swelling seems to be a bit less if I wear compression underwear. I bulge in a tire-like fashion above the incision, and also feel a bulge right over my pubic bone. I am concerned these are hernias forming along the horizontal incision. I think it is too far out from the initial surgery to just be post-op healing. I am certainly hesitant to have more surgery but am convinced this problem needs to be fixed, as the swelling really gets uncomfortable. Do you have any ideas or suggestions? Would wearing a compression garment help at this point? (none was recommended after surgery). Thanks

  Answer:  sounds like recurrent hernias in the incision from the previous surgeries, I think attempt at repair will be a high risk issue too. JG 3.24.08

• I just had a tummy tuck with liposculpture my lower part of the abdomen near the pubic hair line where the incision is located is hard as a rock how long will this be if my surgery was a month ago? also my back still hurts from the lipo in my back the doctor says is because he removed alot of fat ? how long will the swelling and pain last? Also how soon can I start aerobics?

  Answer:  it can take another 4-6 weeks for that area to soften in some cases. Pain should be better in the same amount of time. We let our patients start aerobics after one month. JG 3.24.08

• How long can you wait to ask a PS for a revision. I had a full TT 1.5 years ago and the longer I wait, thinking it just needs to heal more to look better the more I think I need a revision. The scars are all lumpy and crooked. My belly button is off center about 1/2 inch. I still have fat on my hips that could have and should have been lipo`d when all the other was lipo`d. Thank you Dr. Garcia

  Answer:  I think more than 1 1/2 years is too long. JG 3.22.08

• Hi Dr. Garcia: I was wondering if you can explain a few things to me. I had a modified tummy tuck two weeks ago.Now my pubic hair is raised some. I had a perfect triangle of hair since I had laser hair removal. Now, it looks long and skinny. Does that mean he pulled the skin up instead of down?Secondly, I had excess fluid which felt like a waterbed, so yesterday, he drained some out with a needle. Since then, I have a divet in the middle in one area and still fullness in the other areas. Will this dimple go away? And, my stomack is not flat yet. I am a thin person 5`3 and 103 lbs. so I did not have much fat, but mostly some loose skin from a pregnancy.I paid the price of a full tummy tuck, but did not get that. Will I still get as good a result, and how long will it take for me to see this fullness disappear from the lower parts of the abdomen? His report saus An extended pfannenstiel incision was performed and the plane ofdissection taken lateral to the umbilicus bilaterally. The umbilicus was notamputated. Hemostasis was securedand the wound thoroughly irrigated in routine fashion. A transverse plication was then performed using an interrupted#1Ti-Cron suture. The redundant lower abdominal pannus was amputated, and the subscarpel fat resected along the line of resection and in the midline. Is that saying that he tightened the oblique muscles since he said that the vertical muscle was good and did not need tightening. Can you explain to me what was done? and will this dimple clear up, and why is it there? Thanks in advance.

  Answer:  it is likely that they pulled both ways, the upper skin was pulled down and the pubic area, when sutured to the newly downwardly pulled skin rose higer once it healed due to tension. The dimple should go away but you might have other small areas of fluid too that might need to be drianed, hard for me to tell without examining you in person. It sounds like they tightened the muscle in a horizontal fashion, somewhat unusual, rather than the normal vertical orientation. The dimple is there because there is likely swollen tissues around it and as the tissues heal and soften it should get better. If they did not move the belly button then you had a limited or mini tummy tuck, not a full one, that is where the belly button is cut and the hole fo the belly button and the skin above the belly button is pulled downward. JG 3.20.08

• Why wouldnt the PS use the original bellybuton when performing a TT? If performing a repeat TT because muscle came undone could it still be used then? Thank you so much.

  Answer:  it can stil be maintianed unless an umbilical float procedure was done where the stalk of the belly button had been transected before. JG 3.20.08

• I had gastric bypass surgery and need to have the skin removed. I still have 40 pounds to lose before I have this done, but my question is about how much will the plastic surgery cost to remove the skin from my tummy and thighs? I know that insurance will not cover it and I need to start saving because I have worse body image now than when I weighed 368 pounds!!!

  Answer:  I think you need to pick your surgeon and then get the fee quotes from them as they will vary greatly,but figure about $18,000 to $20,000 in some cases. JG 3.20.08

• Is there an ab procedure where the skin is pulled up instead of down. When I pull up, seems like I would just need a tuck on either side,it makes a huge difference. Anything like that? Anchoring the skin seems like it would be a problem. thank you

  Answer:  yes, a reverse tummy tuck cna be done, but it can leave visible scars on the ribcage. JG 3.8.08

• I wrote you earlier about my reversed abdominoplasty concern about whether I should have a Rev. abd. redo or mini TT redo etc. I saw my ps yesterday and he strongly feels that the best situation is for him to `revise ` the rev. abd scar and leave it alone. He feels that trying to tighten the skin even more, or trying to anchor it up into the fascia using permanent sutures may only create more problems (thick scars, further scar migration etc). I am at peace with this decision. Could you give me your best recommendations for how to `best` heal a revised scar in the rev. abd position? Please keep in mind that the first time he did NOT have me wear any garment or binder or support after. He felt it was not needed. Since then my `scar` has lowered 1-2 inches. In terms of binders/compression/silicone sheeting, cream etc. I really want to know how to make this as pretty a scar as possible. Thanks a bunch!

  Answer:  I am not a believer in silicone sheets and I do not think the binder will do much besides reduce swelling. For the scar about all I can suggest is Mederma or Scarguard after the sutures are out. Best of luck. JG 3.6.08

• Hi, Had a full TT with muscle repair and lipo of flanks 6 weeks ago. Wore the binder steady for 4 weeks. I only took it off to shower. Then I went to buy a body shaper to wear constantly for the following two weeks/ per doctors orders. I bought 5 different ones and none were comfortable, mostly due to the seams. I noticed my lower abdomen was a little swollen after 1 week of these crappy garments. I then went and purchased the most awesome comfortable bodyshaper with no seams. It definitley has compression but I wouldn`t say too much compression. It feels like I am wearing nothing but I noticed the following after wearing it for about 8 hrs when I would sit back or lay down. It feels like fluid trickling under your skin. This fluid runs from my lower abdomen over my hips and into my back and legs. This feels kinda neet, fluid sometimes seems to be cold. This has continued for 5 days now. Is this my bodies way of absorbing extra fluid? It doesnt seem like a seroma, I only say that cause I think a seroma would remain at the surgical site. HElP P.S. I feel fine, scar has closed up completely. I can walk straight and my muscles are good, only get a little stiff if I sit for too long.

  Answer:  it might be the fluid or it might be the small nerves of the tissues starting to come back alive, nothing I would worry about and should go away in time. JG 3.6.08

• My ps told me that when he performs my upper body lift, he will use `permanent` sutures into my tissue and deeper layers to hold everything up. Do the permanent sutures literally stay in there forever? Are they more effective than the dissolvable kind? He said that in order for the upper abd. skin to hold, I need them. How does that all work? Do you agree? What are the possible complications?

  Answer:  the stitches do stay there forever but the tissues can tear through and the sutures remain in the location where they were placed but the tissues can sag. I think they can at times be a better choice, but one should not believe that using a permanent suture will yield a permanent result of support. The possible complications from permanent sutures is that a granulomna can form and then they can,at times, need to be cut out, where dissolving sutures form granulomas less often and tend to dissolve over time and go away. JG 3.4.08

• Hi Dr. Garcia: I was wondering what the difference is between a full tummy tuck versus a modified tummy tuck and a mini tummy tuck.My surgeonm says he would do a modified and tighten the oblique muscles. because my vertical muscles feel like they are already real close together. Also, if I was to do a reverse tummy tuck instead, is it as much work, and are there any muscles to tighten in the upper part like on the ribs, or would he be removing only skin?What should be the price difference between the full tummy tuck and the reverse? Thanks i advance.

  Answer:  cannot give you price differences as they vary from surgeon to surgeon. Muscles can be repaired durig a reverse tummy tuck if needed, but generally the reverse tummy tuck is a reverse mini tummy tuck as the belly button is not moved. Which one you need is dependant on where the skin is in excess and what the muscles are like. JG 3.3.08

• Dr Garcia, Thank you in advance for taking the time to help people like me. I had a ftt/mr last February. It was over a year ago. The past couple of months I have been doing serious workouts with lots of crunches. Two nights ago, my stomach was extra tender to the touch, and had an area of about 6-8 diameter around my bb that was red and swollen. Can it be my muscle repair that has torn, and if so, can it be fixed without major surgery? thanks Dawn J

  Answer:  might just be a couple of sutures that tore, might not need a repeat repair if there is no bulging, but a repeat repair might be a big undertaking if all of the sutures tore through. Give it some time and see what happens. JG 3.3.08

• Hi Dr. thanks for your answer. I will give it time.. I am the peson that had the gulf size thing removed. I was reading your ans. to other people. what is intra- abdominal fat? Thanks again. I will give it 3 months before worrying about this again. Gracias...

  Answer:  all the best. JG 3.3.08

• Thank you for your complete honesty regarding my first entry. I just have a couple more questions before I make this tough decision.One thing I did not stress the first time was that I am fairly confident that I do still have some loose skin. My abdominal area does not look like the tight post tt pictures that I have seen. I actually have a `hooded` looked to my umbilicus. The best way to describe my tummy is that it looks like a regular tummy that has not had any surgery--a fairly soft look. When I take my hands, grab my skin just under my breats and lift up, I can easily grab 2-3 inches freely. When I do that, my `hooded` umbilicus disappears and looks nice,flat and tight. SO....I do think there is some free loose skin. I probably have loose skin because after my 1st rev. abd, (at the time of surgery I was only 105 pounds,)I have gained 15 lbs. and I am now at my `normal` weight of 120 lbs. So, the skin has probably stretched and pulled due to the weight gain. Since my goals are threefold: (1) bring the scar back up into the breast crease as much as possible (2) revise the scar so it can heal into a fine, thin line and (3) remove the loose skin that still remains around my umbilical area and upper abd. area----- how do I need to approach this? What about the possibility of having him redo the mini tt at the lower pubic area to further tighten the skin and umbilicus and have him just revise the rev. abd. scar without pulling or tugging more skin at the upper abd. area? Cost is not an issue--we are willing to see any plastic surgeon and travel anywhere to get the best results. We just finally want to `get this right` Thanks for your patience with all my questions-----after your response I am going to make a final decision and move forward--- Thanks-

  Answer:  I think neither option will fulfil all of your three wishes. If you do a regular tummy tuck again, the upper incision will move down and not be hidden, if you repeat the reverse tummy tuck, the scar might be able to stay hidden but I am afraid it will never be a thin line. I think in your scenario, the lesser of the two evils would be to repeat the reverse tummy tuck and accept the permanent scars. I a afraid in your case there is no great option, there will be a serious compromise. JG 3.3.08

• Dr. Garcia, Here we go again. I had full TT last March. One of my sutures broke somehouse causing a hemotoma. It trapped some blood in my body and hardened. My Surgeon repaired it 3 months ago. He removed the hardened blood which was the size of a gulf ball and repaired the stitch. He said I would be fine. I have been careful like you would not believe. However the recovery has been slow. I feel a residue of the lump or maybe scar tisue deep inside. and it feels so tight there. I am swollen..somedays more than others. My muscles feel lumpy ...like . Lumpy and irritated. I think the muscle repair was done too tight. Do yo think it will get better. I am so worn from the whole thing. I know the last surgery was only three months ago but I ran out of patient. ... I am destined to be miserable? Do you think this will improve. By the way my ins did pay for repair surgery.. all of it. So should I be consulting with another surgeon or waiting a little longer. Estoy desesperada y deprimida.. le juro que no sabe como me arrepiento de haber echo esto. Gracias.

  Answer:  give it time, it takes longer to heal from the second one than the first, all too soon to do anything else. JG 3.1.08

• Dr. Garcia--- Your information came up during my struggle to find information concerning `reverse abdominoplasty`.....I will give you a quick medical history. I am a physician in Concord, NC. I consider myself to be healthy and in shape (5 ft. 6 and 120 lbs, very active and good dietary/exercise habilts) I had a breast augmentation and mini-abdominoplasty (same surgery) in May 2006 with a board-certified plastic surgeon in Charlotte that I respect and trust. He called it a `mini` abdominoplasty (not a full tummy tuck)because he left a small scar--although he still managed to tighten all of my muscles and remove a lot of skin. Unfortunately after the mini-abdominoplasty both the surgeon and I agreed that there was a lot of skin above the umbilicus that still remained. He suggested a `reverse abdominoplasty`. It seemed like a simple solution to remove the extra skin and we could position the scar within my breast crease. I agreed that this would be a good option for me since the main problem was extra skin above the umbilicus only. I had the reverse abdominoplasty in Jan 2007. Initially, the scar was hidden right within my breast crease (he did a great job shaping the scar to match the natural crease of my breasts). It was a thin, small scar that looked hopeful. I even refrained from all exercise for 3-4 months to allow the tissue/fascia and scar heal. However, within about 4-6 months after the surgery, I noticed that I noticed that the scar began to `drop` to a lower position. Today, it now sits at least 1-2 inches lower than it was originally. I can no longer wear a bikini top because the scar is in full view. This has been emotional for me because I used to `live` in my bathing suit in summer. The scar also widened in thickness quite a lot (3-4 cm) in the lateral portions and the central portion of the scar is fairly raised and rough looking. I discussed this with my surgeon. He graciously offered a `redo` this upcoming April 2008. His plan is to use `permanent sutures` this time (the first time he used the dissolvable kind)suturing the fascia/tissue to the rib cage underneath. He is hoping that this will `hold` the new scar in place high up into the breast crease. What are your thoughts? I don` think I have enough skin left to have a complete TT redo. Plus, I now have this upper reverse abd. scar that needs to be revised anyway. It sounds like you are familiar with this procedure and I would like your professional opinion. What would your best suggestions be for this situation in terms of the surgery? The care for the scars/sutures afterwards in terms of activity/brace/binders/scar treatments? I am really concerned about this procedure because I had no idea initially that there was a risk that this scar could drop so much and be visible. I really don`t want to have to go through this procedure/healing process again just to see the scar `drop` one more time. It has been an emotional journey. My goal is to have the scar `raised` back up to within the crease and stay there permanently. DR -------------------------------------------------------------------------------- Looking for last minute shopping deals? Find them fast with Yahoo! Search. DeleteReplyForwardMove... Previous | Next | Back to Messages Save Message Text | Full Headers

  Answer:  well, I think permanentt sutures will help some but will likely not totally avoid the recurrance of the problem I am afraid. The sutures might hold but they can tear through the tissues and then essentially there is nothing to support the tissues together and hold then to the ribs. The reality is that the tissue will be pulled downward and in time the scar will migrate, especially when pulled tightly. In your case, since it is a redo, the skin is likely already tight and further tension will likely cause more downward pull and also a greater chance of thicker scars. The longer you wait and allow the skin to get looser the better. It is a well known issue with reverse tummy tucks and I do perform them on a limited number of patients, especially ones after massive weight loss where the scars are less of a concern. Those scars from the reverse tummy tuck are almost impossible to hide in any kind of bathing suit short of a tube top. Wish I had more to offer. JG 2.28.08

• i had a baby 2 yrs ago and I am really unhappy with my abdomen above my belly button. I didnt get any stretch marks but my skin looks stretched to me. I had lipo on my tummy but that didnt seem to do anything, i also work out a lot. i dont have any skin to pull down for a traditional tummy tuck. Do you do the upper tummy tuck? How long is the recovery on an upper tummy tuck? Is an upper about the same as a lower, @$5-6000? Also is the scar between your breasts or right below? THANK YOU!

  Answer:  I have done them but the scar over the breast bone can be hard to hide in bathing suits or certain clothing. Recovery is the same as for a traditional tummy tuck, two weeks of no activity and then two weeks of light activity. Price is about the same as a regular tummy tuck. The scar is below the breast and also across the breast bone. JG 2.27.08

• Hi Dr Garcia, I am writing from the UK, I had a full Tummy Tuck & Lipo procedre done last October, my tummy and abdomen are still protuding the amount varies from day to day, is this normal??? or do I need amymore work done in this area. Regards Carolynn

  Answer:  not common, sounds like you might need something done, but it can also be some intra-abdominal fat that might not be able to be improved without weight loss, hard for me to tell long distance. JG 2.25.08

• I am 61 and have a large complicated ventral hernia.. I have had previous mesh repair in 91 and it held until I had a hysterectomy in 2000 and it was not replaced in that operation and the running sutures broke. I have lived with it for 8 years. It is at the point now of being unsightly and I am asking Should I have it repaired at this point with no real problem in case a future problem develops and I cannot do it... What are the risks....

  Answer:  well, if it is large, it will not get incarcerated so the issues are mroe of appearance and back pain, I will say that it might be difficult to fix after this much time too. JG 2.25.08

• I just found out from my ps that my muscle repair came undone. I get a football lump when i try to sit up. He will do it again, but i am curious if it failed once will it be more likely to fail again? I have no idea why it happened or when it happened. I am pretty happy with my results. My upper abs protrude, but I had thought this was due to weight, which I do carry in upper abs. What factors should I take into consideration when considering whether to redo the TT? Yes, I need to lose about 20 more pounds.

  Answer:  I think losing the weight first will place less tension on the muscle repair and might be better and hold better too. JG 2.12.08

• I had 5 c-sections,one pregnancy was a twin pregnancy, a hysterectomy, and then later also had ventral hernia surgery that was repaired with mesh three years ago. I presently have major pouching of my entire abdomen and absolutely no muscle tone. I consulted a plastic surgeon and was told that my rectus abdomis muscles needed to be pulled back together but that the surgeon could not perform the surgery because I had a mesh patch across the muscles and it would be too dangerous to have to peal back the mesh to connect the muscles together properly. Is my case hopeless? Will I have to live with a belly that looks like I am about 5 months pregnant forever? I also have excess skin from the twin pregnancy. Is there anything thing I can do to look better? I am not overweight. I just have a pouch.

  Answer:  I think the risks of doing a muscle repositionng is very high and there is also a high probability that the ventral hernia repair would fail because of it. JG 2.11.08

• Hello, I had a tummy tuck 14 months ago. I have developed a very hard lump above my pubic area incision. It feels like a small bar of soap. I felt this shortly after tummy tuck. My doctor drained area with a needle for about 4 weeks. I am concerned because it seems to be getting larger and harder and the area next to my belly button is slightly swollen. What could this be? Thank You.

  Answer:  sounds like something called a psuedobursa that forms like a large cyst where fluid collections are and it can form some hard tissues, in some cases it has to be removed to get the hard tissues out. JG 2.11.08

• Hi Dr. Garcia, I just e-mailed you about the tummy tuck question. If the muscles are only held by the sutures, dont they disolve? Are people able to return to their normal excersizing activities like lifting heavy weights and doing abdomen crunches without the sutures tearing? And what is this thing that could happen with the belly button? Thanks for your prompt response :)

  Answer:  most times the sutures that are used are permanent, non-dissolving sutures. After about 6 weeks we let our patients go back to working out, including their abdominals, actually the sutures bring the muscles into better alignment and they work better. I am sorry but I get lots of questions and I do not remember what we had discussed about the belly button, can you repeat the question.Thanks. JG 2.11.08

• Dr. Garcia, I am considering a tummy tuck. I have had two children, one is ten years old, and one is only a year old. My question is when you sew the abdomen muscles together, do they grow back together? Or is it only held by the stiches? Also how long before I could hold my daughter who weighs 23 lbs?

  Answer:  it is only held by the sutures, I think you could lift her after about 2 weeks. JG 2.10.08

• just wanted to thank you for the answers as i didn think of the scar tissue stretching. nurses let their mind wander...so lipo ist then 6 months later tt so the lipoed skin has time to settle? again much thanks for the awesome website t

  Answer:  yes, that will thin the skin and allow the contour after the tummy tuck to be better, thanks for visiting. JG 2.8.08

• hi again!also my upper abd skin is hangin down from in this so called shift that i am not pleased about.this is 2n pr to lower quest,have you had pts have shin hang down 9 months post tt with no weight gain?how common is 2n tt after 1st due to shifting? and should lipo be done 1st,on upper abds then wait till skinclms down?then redo 2nd tt? thnk you ter

  Answer:  it can happen if not enough skin was removed at the first surgery, sounds like you are going to need a touch up all the way around. If the amount of fat is large, I suggest the liposuction first and then followed by the tummy tuck revision 3-6 months later. JG 2.8.08

• is it normal to feel a pulling sensation at5pm postion 9 months after tt?can a hernia dev this long after?am seeking 2nd opinion.,fat has shifted down,ps states doesnt know how this happened..ter in pa.just pulled a blue stitch out of bb,kept wondering why qtip had caught on something.do folks have compaint 9 mos after due to natural settling?,am healthy,would abd sono show stitch not right at the 5pm area?am frustrated.. thank ou so much

  Answer:  most likely the scar tissue on the muscle just stretching, it does not mean you have a hernia. I do not think the fat has shifted but likley there is some swelling in the fat underneath the skin of the lower abdomen that might be helped with soem liposuctin, Best of luck, JG 2.8.08

• I am a petite woman whom had both upper and lower belly fat after having one child. I had a tummy tuck just a little over a year ago and the loose upper skin is still apparent. I don`t know what to do. My Docter have tried differnt no surgical techniques and still no change. Most of the loose skin is right above the naval, can an umbilicoplsty be done to help this?

  Answer:  I think an umbilicoplasty will have limited improvement and you likely need more skin removed with the tummy tuck being done over again. JG 2.4.08

• Hello Dr. Garcia, Thank you for answering my question about my seroma that my doctor didn`t drain completely. I went back to the doctor (he is a intraventanalist radiologist) yesterday. I asked him again about aspirating the fluid and expressed my frustration and confusing as to why he won`t drain it off completely. He originally planned to just inject some fluid into the cavity to see how big it was. My question prompted him to do a quick ultra-sound. After looking at that he told me that the cavity is empty but it was still large (not thick just in diameter) and because I am still producing 20cc of liquid every 24 hours, I need to leave the drain in or the cavity will fill back up. My question is: Can the cavity be empty? How does he know? Did the ultra-sound show that it was empty? Or is he just telling me this to shut me up? Do I need a new doctor?

  Answer:  he can see the cavity with the ultrasound in order to tell if there is any fluid in it. I think with your history though it might be a wise option to inject something to close it off if it continues to drain like that. JG 1.31.08

• Hello Dr. Garcia, I had a tummy tuck 10 years ago and developed a large sermona. My ps inserted a drain and manually drained it in his office 2X per week. Recently I had a laproscopy hysterectomy and developed another even larger seroma. 20 x16 cm, this one was hard and I ran fever. My ob\gyn kept telling me that they had to blow extra gas in me because of the scar tissue from my tummy tuck and because my tummy would not distend because it was in pretty good shape. He said it took him 45 minutes just to get into my tummy so the procedure went from an hour procedure to a 2 hour procedure. My ob\gyn kept tellin me to go home and put a heating pad on my growing tummy. Even though I was running fever. After 4 days of fever and a belly that was growing larger and larger, he prescribed an antibiotic. All it did was lower the fever from 101-102 to the 100`s. Tummy still growing larger. Finally I got him to call my old PS. He advised to get me in for a cat scan, I was admitted within 30 minutes of the cat scan with an abcessed seroma. Here is my question. The radioligist on call drained 235 cc out of the cavity. He did not drain it completely. My ob/gyn asked why he did not and he said that is what the drain is for. Why did he not drain it completely? Now he has me coming in weekly for a cat scan to see how big it is? Last week it was clogged and started to fill back up. He changed the drain from a 10 to a 12 and irrigated with 30 cc of liquid. When he pulled it back out he said he drawed out 31 cc? When I asked him why he didn`t go ahead and get the additional fluid out, he said that is what the drain for. Why won`t he drain it out to relieve the pressure and the soreness? I am misearable and I don`t understand why he can`t use an ultrasound guided aspiration to relieve my symptoms. Your thoughts are really appreciated!!!

  Answer:  I really do not understand why they did not drain all of the fluid out in the setting you describe, that does nto make any sense to me to be honest. Ultrasound guided aspiration, at this point, especially since they know it is above the muscles is certainly safe and should be adequate for what you need to have done, sorry to hear about all the problems. JG 1.29.08

• I had a torsoplasty two years ago and I was told that I had 8 inches (wide)of skin removed 360 around. Now, my lower abs are really flat, I have no waist,the measurement under my bust is 35 inches, so is the measurement of my waist, so are my hips. This makes it really difficult to buy clothes...but the real problem is in my upper abs. They bulge, especially after just drinking water let alone after dinner. Very uncomfortable, besides the weird shape I was left with. Is there something I can do to rid myself of this upper abd bulging? No more surgery, lipo, just too risky. Is it fat resettling, my colon? was it deep abdominal fat which has been redistributed? I had no post op complications. HELP

  Answer:  very difficult for me to say without seeing you in person, but anything that could potentially make you look better will likely involve more surgery. I think intra-abdominal fat is certainly a contributor to the issue and futher weight loss might help some issues and might make others worse I am afraid. JG 1.27.08

• At 2 weeks pist op FTT with MR, is it ok to wear just a snug body shaping cami for compression? The ab binder is too uncomfortable and bulky for me at this point.

  Answer:  OK for daytime but should wear the compression garment at night then to help get the swelling down. JG 1.14.08

• Dr Garcia, when do the little darks spots in belly button go away? I have internal stitches, with just one i can feel poking out. It has and looked the same from the beginning, dry, no oozing like i have heard of alot, and no pain ever. Just the dark spots that look like scabs but dont come off, even when i clean it with hydrogen peroxide. I am 2 weeks post op today.

  Answer:  it is likely the sutures below the skin are causing the irriation and when they dissolve all of that should go away. JG 1.14.08

• I recently asked you about the naval leakage and you stated that a suture was infected and needed to be corected. Can this be done without surgery? Thank you

  Answer:  nope, but it is minor surgery, under local anesthesia. JG 1.13.08

• Hi Dr Garcia, I am the smallish one who was considering a lower body lift, but instead have separated my surgeries, having the FTT with MR almost 2 weeks ago(tomorrow). And the finishing touch will be the butt lift in the spring. Love my FTT results so far, btw, couldnt imagine being able to be pulled so tight, with just the tiniest lowest, vertical scar way down in my pubic area, along with super low horizontal incision! My question is, at his stage(2 weeks post) Is it really necessary to wear the binder 24/7? I slept without it last night(still in recliner) and feel i am more comfortable without it. I will wear it if necessary for better result. I feel i am still hard and slightly swollen(drains have been out since day8). I have no external stitches, and incision seems healed. When is it ok to start some sort of scar management? Also, is there a point when i should force myself to stand straight, or just let it happen? My only pain/discomfort is my very upper ab muscles, they feel super tight and burn if i try to stand too straight. Also, for the butt lift in the spring, it is out patient(i spent the night for FTT) and takes about 2 hrs, have been told by several PS s that it is a relatively simple surgery/recovery, compared to the FTT with MR. very little, if any, uplifting of skin, maybe no drains(i can only hope), simpley cutting a 3-4 inch strip from across lower back, and sewing edgetogether, leaving a string thong shaped scar, connecting with my existing FTT scar. no mention of garmet. Does this description sound realistic to you? I am trying to convince my husband and kids to go away for that weekend(surgery is on Friday before Mem day, May 23) since it is a big weekend here in Indy(500 mile race). My surgery would be in the a.m. they would fly out in after noon. I would have full time help for the whole weekend. What is you opinion of this plan? DH not too keen on it. Sorry this is so long but if you could be sure to anwer all my questions, i would appreciate it. I know how busy you are. Thanks so much! JR

  Answer:  after two weeks we like at least 8 hours per day of the compression garment. I think it is OK to start scar management creams now. I would wait until you are more comfortable to stand up stright, let it come on its own. We do the same care for the buttocks lift and also use compression garments and drains just like the tummy tuck. I think as long as you have full time help when your family leaves I think it is OK. Best of luck. JG 1.13.08

• I had a tummy tuck in 07. Since then, my naval, (which had to be reconstructed), at times, leaks a terrible smelling fluid. I frequently must clean it so the smell wont be as bad. why is this happening and what can I do about it?

  Answer:  sounds like you have an infected suture that needs to be removed to get rid of the problem. JG 1.12.08

• Is it safe to have a baby after a tummy tuck, because I here it is dangerous. Is this because the scar can tare?

  Answer:  the muscles can tear, not the skin, and then the tummy tuck will have to be redone. JG 1.11.08

• Dr. Garcia, I had a TT May 2006 and subsequently developed a large seroma and fat necrosis along the incision line. The wound was reopened and debrided and the seroma drained, and the wound was closed....cut to the chase here... my belly was aspirated several times for 160+ ml. Everything healed, except the divet left by the debridement. May 2007 we tried a fat graft to no avail, but also, it seems as though the skin where the seroma was will not shrink up...it is loose and flabbier on the left vs. the right. Do you have any suggestion as to how to help that skin shrinkage along...it is driving me CRAZY! Maybe laser, photolaser, heat...please help? Thank you, RB

  Answer:  I think it is hard to tell without seeing you in person but if the skin is flabby it might just need to be cut out to smooth it all out. JG 1.10.08

• there is pinkish looking flesh/skinish showing now and feeling of twitching and some minor burning, does this mean there is beginning of blood flow and will start to close? (necrosis hole)

  Answer:  all good signs. JG 1.8.08

• in regards to the necrosis, what is a VAC....?? AND HOW IS IT USED, AND DOES THE PS HAVE TO PRECRIVE IT.

  Answer:  it is a vacuum machine that is applied to the wound to remove the fluids and pull the edges together, you walk around attached to a small box until it closes. It has to be prescibed by the doctor. JG 1.8.08

• well, would any other plastic surgeon want to treat the necrosis (3 inch deep, after tummy tuck remember). went back to this ps because he is the one that performed the surgery. question #1 do you not feel packing hole with honey will work? question #2 after 3 1/2 weeks should it have started to close up? what is your opinion, please help me. There is no sign of infection and black skin completely peeled off

  Answer:  well, the honest truth is that not many surgeons like to take over failed cases from any other surgeon but there are some out there that will do it to help you out. I absolutely do not feel that packing the wound with honey will help in any way, especially if there is no infection. As to when it will start to close, once there is pink granulation tissue present, it will start to close. Using a VAC system will help greatly as will hyperbaric oxygen treatments if the tissues are still lacking good blood flow. JG 1.7.08

• Hi Dr. Garcia, I have written you twice and I will brief you on my situation to refresh your memory. I had a circumferential body lift on Sept. 10, 2007. I had wound dihisence at 3 weeks post op. and a large seroma drained for nearly a month while I used a wound vac and then packing to get it to close. You suggested surgery to close it and my surgeon took your advice. He opened about a third of the incision and removed a psuedobursae. I am now 9 weeks post op my second surgery and a few days ago I noticed that the area where my incision opened before, on my back, rebounded like a water bed. 25 ml. of serous fluid was aspirated and then 5 days later 20 ml. of serous fluid was aspirated. My surgeon seems to be frustrated now and that really scares me. He said it is possible that I will need another surgery to remove a psuedobursae and he also discussed the possibility of using tetracycline to sclerose the pocket. I know I risk tissue necrosis with the sclerosing agent and I know that I am at risk for infection with repeated aspirations. I am also suffering with generalized joint pain and breast tenderness intermittently but my surgeon does not think it is related to this seroma. Please tell me what you think I should do at this point. If I do have another surgery do you think it feasable to do a CT scan to see just what is going on before I have a surgery? Do you think that a 20 ml. accumulation of fluid over 5 days is a small enough amount that I should just wait and see if it will resolve on it`s own. I want to believe that my body will take care of it. Please guide me Dr. Garcia. Thank you for all the advice that you give to us.

  Answer:  I think the risks of repeated aspiration is small so I would go with that first, and tetracycline should not cause any necrosis of the skin, all the best. JG 1.7.08

• remember the 3 inch deep necrosis, well, its been 3 weeks (tummy tuck) and the hole is still deep without any sign of filling in, but no infection (thank god). My ps recommended I stay at the clinic for 4 days and they are packing the hole with honey and saline....how does this sound to you...Should it not have started filling in from the inside out by almost a month? what is your opinion of this and the honey?

  Answer:  I would go somewhere else, there are many more legitimate options than honey. JG 1.6.08

• I forgot... since my TT in March of 07.. I have not been able to work out. I have felt better while laying down and have put on weight. I want to feel normal.

  Answer:  I think you need to bring all these things up with your surgeon as it is not normal. JG 1.2.08

• Doc, I wrote to you a while back about a lump on my upper belly,having a CT and that they told me I had seroma. Seroma turned out to be a blod clot the size of a gulf ball. Ok as I read things on your website..I wish I had chose a TUMMY TUCK without muscle repair. The only thing that bothered me was the skin. I regret doing this..I am tight and uncomfortable. Now I know I just had suture repaired and that it will take some time for discomfort to end. It has been a month. How long before the tight sore feeling goes away? and what is a reverse TT? can I have surgery to remove sutures? I want to feel normal. I am so depressed and feel doomed.

  Answer:  it might take a couple of months for the tightness to feel better and a reverse tummy tuck is where the incision is done under the breast or thereabouts and rather than pulling the skin down, it is pulled up, done in cases where there is loose skin above the belly button but the scar is not as good as a regular tummy tuck and harder to hide. The sutures that were placed can at times be removed or cut through the previous incisions. JG 1.2.08

• Hi,I wrote before about my prob. I had TT in March of 07. I had a bulge. I saw my doc who stated I should wait to see if resolved on its on. It didnt. I had surgery again last month. My Plastic Surgeon state a suture had broken which cause a hematoma that dried up leaving a gulf size dry blod clot . That made me miserable. My doc made a 3 inch incision on my upper stomach area. He removed the clot and fixed stich. I am drained and depressed. I am worried that the suture will break again. I feel traumatized as I suffered so much during the last 8 months. I am careful..way careful. Do these break easily. I dont even want to bend down or sleep on my side.. I am scared. any info.

  Answer:  they are not common, and I think that if you are careful you will likely heal well without any further problems. All the best. JG 1.2.08

• Hi, I had a tummy tuck in March 07. I`am finally back in the gym and want to know whether it is safe to do excersizes on the upper and lower stomach (crunches). Is this harmful to the tightning of the muscles after the tummy tuck? Also, is it normal for the upper stomach to protrude slightly more than the lower stomach?. Lastly, After having surgical injections performed on keloids on the skin; how long does it take to see long keloid scars up and down the abdomin improve? Procedure was done in the hospital on December 5, 07. Thank you.

  Answer:  yes, OK to work the abdominals at this point. It is not harmful and at times the upper area of the abdomen can pooch out a bit more as the lower abdominal muscles can be tightened more easily than the uppers. Keloid injections take a series of injections and you should see some improvement after 2-3 sessions. All the best. JG 1.1.08

• Hi Dr Garcia: I am 4 1/2 wks post tt. I`ve been using bacitracin and gauze on 3 small areas of necrosis near the incision line. Is it safe to continue using the bacitracin or could I develop a sensitivity to it? Is there anything else I can do? It seems to be filling in slowly. My husband feels It will never fill in and I will be left with holes since there is no skin there. I realize there will be scars but should this heal over? Also what would keep this from happening again in this area if once this is healed some follow up was done on the scars?

  Answer:  it is generaly safe, if it starts to cause a problem you will develop a little rash, but that is rare. It will eventually close, albeit slowly. The skin pulls in from the edges and will look like a falrly straight line in time. The human body is amazing, just give it time. Once it heals the skin that closes is nearly as strong as the non-necrotic areas. Hang in there, it will get better. JG 1.1.08

• Dr. Garcia, I have a hernia that needs repair, and I want to know if it`s possible (and safe) to perform a hernia repair AND a tummy tuck (with lipo) at the same time?

  Answer:  yes, not uncommon to do them together when needed. JG 12.29.07

• thank you so very much for your prompt replies and taking the time to care for the confused, afraid and frustrated . HAPPY HOLIDAYS AND GOD BLESS !

  Answer:  you are very welcome and the best to you for the New Year! JG 12.26.07

• so even if the 2 inch deep necrosed hole is packed with gauze, the gauze will not interfere with healing process, I mean it will not be in the way of the skin growing back, it is hard for me to see how the gauze will not prevent the skin from growing by being the way? what is the purpose of the gauze being packed in the hole for healing purposes? What do you recommend to apply on the gauze before putting it in the hole (gauze does not prevent the hole to breath/to be able to heal?)

  Answer:  no, actually the gauze will absorb excess fluid and when removed it will bring with it any devitilaized tissue that needs to be removed in order for the wound to close. As days go by the amount of gauze you will be able to pack into the wound will be progressively less and less, the tissues will grow a uniform pink and become more and more superficial. We recommend soaking the gauze in sterile saline that the doctor can get for you. They should have done that. The gauze should be removed dry though in order to allow the devitilized tissues to stay attached to it and be removed. JG 12.27.07

• dr. garcia as far as the necrosis right after tummy tuck, leaving a deept almost 3 inch deep hole...what is the best way to treat it for a safe and quick recovery, what is your recomendation to aboid infection and more complications?

  Answer:  the quickest way to get it to close is to use something called a Wound Vac which your doctor can order for you, not all insurance companies cover it, it is burdensome to use as you are attached to a vacuum device all the time except when they clean the wound. Most young healthy people with wounds that do not drain much are OK to treat with wound dressing changes at least twice daily though. As long as the wound is open and draining an infection is difficult to develop. JG 12.26.07

• Dear Dr. Garcia On 12-13-07 I had a tummy tuck and as soon as I was out of surgery my skin started to turn black. Today I returned to the doctor and he performed debribment on it leaving a hole about 3` wide 2` deep. How long do you think it will take to competely fill in and what types of food should I eat to help with the healing process? thank you for your time

  Answer:  as to the food, good quality protein and lots of vitamins, as to how long it will take to heal, hard to say but at least 6 weeks from the size you describe I am afraid. Best of luck and sorry to hear about the problems. JG 12.26.07

• I previously asked about a pregnant looking lower stomach after a tummy tuck and your Answer: might be that the muscle repair of the muscles down on the lower part did not hold and the sutures broke, allowing it to make you look like that. JG 12.26.07 My next question: If the muscle needs to be tighten again will this be a major surgery or can it be done without the full incision ? What exactly will need to be done to repair this?

  Answer:  the length of the incision might be able to be limited but it will not be a small incision overall. The skin needs to be lifted from the incision to the belly button, the muscle and fascia tightened with sutures and then the skin reclosed again, so it is almost a partial tummy tuck again. JG 12.26.07

• Dr Dr Garcia: I`ve written previous about some necrosis resulting from a tt. Again I`ve never smoked, am not diabetic so was not anticipating this. I am about 3 1/2 wks post op and since all the dead areas were trimmed off to me things look worse than I expected. I have 3 areas, one probably as big as a quarter and deep below the bb area. How long can I expect before things start to heal and look better and do I need to be concerned about infection? I treat it 3 days daily with bacitracin and keep covered with gauze. Will this evenually fill in or will the gulges be there permanently? I`m not even sure if there is enough good skin left between the scar and bb button to have it corrected in the future. And what would say that it wouldn`t happen again with corrective surgery? I`m heading to the Bahamas the first week in February and am hoping to be able to go in the water. I`m getting very nervous that this will not be healed.

  Answer:  infections are rare as the wound is open and the bacteria cannot form an abcess, as to how long it will take to heal, it will be weeks, no way to tell exactly though. The depression typically fills in quite a bit and the skin edges get pulled in from the surrounding area. I think if the areas are superficial and pink by the time you go on vacation the water will be OK if you rinse it out after going in the ocean or pool. JG 12.26.07

• I had a tummy tuck 1 year ago and a touch up to the tummy 5 weeks ago when I also had the lower lift for the tights and butt. (just for an external issue to tighten a small amount of skin bulge on the tummy) I still have a pregnant looking lower stomach. Sometimes,frst thing in the morning it does not appear as pregnant looking. Could there be something else going on that could be causing this? It is discouraging especially after a tummy tuck. My grandmother at 90 looked like she was pregnant with this basketball shapped tummy. Hereditary? I will talk to my doctor also in about two more weeks but kinda wondering if this could be something else causing this that you have encountered before. My lower lift is fabulous and I just want a flat tummy. I noticed I can suck in my stomach quite a bit and make it flatter by doing this. Is this normal after a tummy tuck to still be able to do this? Thanks for any light you can give me on this.

  Answer:  might be that the muscle repair of the muscles down on the lower part did not hold and the sutures broke, allowing it to make you look like that. JG 12.26.07

• I had a tummy tuck with muscle tightening two months ago. I am pleased except for a concern about a kidney shaped swelling about the circumference of a deck of cards at the bottom of my rib cage and 3 or 4 inches above my new belly button. A couple of weeks after the surgery, my plastic surgeon aspirated the area. He removed some dark colored blood, indicating that I had a hematoma. He suggested that I could have popped a stitch (or stitches) or that a blood clot might have broken loose. The area is now softer and it doesn`t bother me (looks or feel). I have two questions: (1)If the swelling is merely caused by remaining blood that my body has not dissolved, is this a problem (and will my body take care of it in time)? (2)If the swelling is caused by muscle tear, will it be necessary for me to have more surgery, or can I just leave things as they are? Thank you so much for your time. I have read all you have written here on abdominoplasty. You and your site are impressive!

  Answer:  not a problem, long term for the area. I do not thik it will require more surgery either. I would just leave it alone. Thanks for visiting and Merry Christmas and a Happy New Year. JG 12.25.07

• Hello Dr. Garcia, I`m having a hysterectomy done in a few days, would it be wise to get a plastic surgeon to do a tummy tuck and liposculpture while at it? How long would I have to wait to have a tummy tuck if I decide to wait? Thank you for all your answers...I wish you a Merry Xmas & a Happy New Year!!!

  Answer:  I would avoid it due to increased potential problems, like blood clots in the legs, Merry Christmas! JG 12.22.07

• Dr. Garcia spray tans are safe after my tummy tuck correct? SD

  Answer:  yes, they are safe. JG 12.22.07

• Hello. I am 4 weeks post op from my tummy tuck. I would like to lose 7 pounds when I am feeling up to working out and dieting. Will this effect my tummy tuck in anyway? SD

  Answer:  I think if you lose more than ten pounds the skin might be a little looser than desired, less than that will likely not cause any difference. JG 12.21.07

• Dear Dr Garcis: I am 3 weeks post moderate tummy tuck (no muscle repair) I have two areas along the stitch area with some necrosis. Maybe slightly larger than a dime. Everything I read before this was that it was very uncommon for non-smokers to get this. I`m curious as to what other reasons there may be for this as I have never smoked. It is pretty much below the bb area which is where the skin above the bb area ended up. I did have several stretch marks in that area and one physician did state that the skin was quite thin there. Could that be a reason for this? I was not expecting this at all.

  Answer:  it is due to poor blood flow from many cause, it is more common in smokers but can happen in everyone, the thin skin could have contributed to it, in most cases it all heals in time with pretty good scars though. JG 12.20.07

• My daughters ps stated that she will be discharged tuesday the 18th, she stayed at the surgical center since last thursday when the tummy tuck was performermed (remember necrosis problems). well nothing was done these 4 days that she was there except for the nitro cream. the necrosis area, dead skin looks like a pyramid in the middle of her incision and another piece the size of a penny around her belly button, above the pyramid dead skin. he is sending her home with instructions only to come back in one week to see if they have to cut again! this sounds ridiculous to me since I fell because too much was cutt off there were blook flow problems. this does not sound right to me and my daughter is DEVASTATED AND SCARED...SURGERY was performed by Dr. Buenrostro in Tijuana. Please educate us on this we are sooo worried an she is depressed, confused and very scared!

  Answer:  I think they should likely have the surgeon look at the wound everyday or at least every other day to make sure it is healing and not getting infected, wish I had more to offer. JG 12.16.07

• Dr. Garcia! Thank you so much for providing such an informative website. I am 1 1/2 weeks post-op for a FTT with muscle repair. I am concerned that I may have ripped my internal stitiches. Last night I was experiencing a great deal of discomfort as I felt very bloated and kept experiencing piercing, periodic pain that felt like I had gas and it was exploding in my stomach. This morning I awoke withouth the tightness in my abdomen that I had been feeling and although there is still a little discomfort when I cough or laugh, it is nothing like it was in the previous days since the surgery. I am also able to walk relatively upright and have been for the past few days. How can I tell if I have ripped my internal abdominal stitches or am I overreacting and this is about the time that the soreness from the tightening should be subsiding? I would think that I would feel some soreness in my abdominal muscles if I had indeed ripped them, but I don`t. I`m not sure what I should be expecting here if I have ripped them. Can you give me an idea?

  Answer:  you are right, ripping the stitches casues a great degree of pain, more likely is that you had some muscle spasms in the muscles because of the sutures and the spasms have gotten better. JG 12.16.07

• Dr Dr Garcia: Thank you for your prompt response regarding my questions post ftt 2 1/2 wks ago. The only other thing I was concerned about were the two scabbed areas along the incision line pretty much directly below the belly button area. I found some pictures showing necrosis and these could be similar but mine are very small. Not larger than a dime. Could they cause some issues. I`ve never smoked, exercise regularly and am 5 ft 3 in and 120 lbs so I didn`t expect any issues with scare healing. I`ve had a few other abdominal surgeries and the scars always healed well. I will ask my ps to aspirate the small fluid collection area when I see him this wk. Thank you.

  Answer:  just put some neopsporin on those spots and let them scab up and then fall off, let the doctor see them too. JG 12.16.07

• Hi Dr Garcia: I had a ftt (no muscle repair) about 2 1/2 wks ago. I wrote last wk about a small amount of fluid in the upper right side yet. Went to ps last wk and he didn`t feel it was enough to stick a needle into me. Still have the same amount and see him again this coming wk on Thursday. Would you suggest just having it removed or is there a risk for more problems? Can it just resolve by itself? I don`t see how the skin will reattach there if there is still fluid. Second, I`m not sure I`m clear on what necrosis would look like. I have some purpleish areas around the scar, but when you push on it the color comes back. I also have one small purple area near the bb that does not change color when pushed on. I also have two areas on the incision with dark scabs, anyways I think they are just scabs. Could all of this be the result of going to tight? My ps did state that he had to go right up to between the breast area to stretch it far enough which I assume was so that I didn`t have a vertical scar from the old bb. One tender stitch also. Would warm or cold compresses help with any of this? I don`t want to seem neurotic when I go back to my ps as I always have alot of questions for him. Sorry for all the questions but this all makes me a little nervous. Thank you.

  Answer:  it can resolve on its own but if you can feel it and see it I feel it is worth aspirating it to let the skin heal flatter. I think the purple areas you have are not necrosis, just some limited bruising that should get better on its own in time. When the undermining is more aggressive, like they did for you, there is more tension and those small areas can arise. At this point I suggest warm for the tender stitchs. All the best. JG 12.14.07

• so are there good chances of the nitro helping the blood flow to come back in that 1 1/2 inch purple area or is the sking mostlikely going to die ? anything else that can be done?

  Answer:  the nitropaste does not bring blood into an area, it allows it to drain out of an area. The purple area, in the worst case scenario, will scab up and eventually fall off, and then depending on the size of the hole, it can close on its own or be cleaned up and sutured closed. JG 12.14.07

• I had a tummy tuck over 3 weeks ago. Please recommend scar products for healing and fading. I have heard of silicone sheets and mederma. What is your suggestion? Thanks

  Answer:  I like Mederma or ScarGuard, I think the effects from silicone sheeting are small to none. JG 12.14.07

• but what is causing the lack of blood supply....and if necrosis is occuring because of too much tension...does this mean the stomach area was stretched (cut) too tightly??? they are treating it with some cream....name starts with nitro.....something. Is this appropriate?

  Answer:  tension is from too muc skin possibly being taken out and the loss of blood supply can be from an inadvertent injury to the blood vessels in the area. The Nitro Pste is to improve venous blood flow out. It is used in cases of dimished venous outflow, yes. JG 12.14.07

• Hope you are doing great! my daughter underwent tummy tuck yesterday a.m. Well, today, there are signs of necrosis , about 2 inches on scar site, looks like a purplish bruise. Can you please explain why this happens, what needs to be done and what could happen. Also, her ps recommended she stays until tuesday, instead of saturday and is charging her for the extra stay, is she responsible for having to stay more days due to this problem???

  Answer:  it is usually due to loss of bloof supply or too much tension, it still might survive though with some care, don`t jump the gun just yet. As to being responsible for charges, that poicy varies frm surgeon to surgeon. Best of luck. JG 12.14.07

• Anesthesia question again. Thanks for your quick response! For someone that doesn`t want general anesthesia what alternatives would you consider? MIA, spinal, epidural? Thanks again.

  Answer:  epidural or spinal but one must be careful because if the level of the anesthesia rises too high you will not be able to breathe. JG 12.13.07

• Sorry, I meant MIA instead of general anesthesia.

  Answer:  I figured. JG 12.13.07

• What are your feelings about using MIA for tummy tuck instead of MIA? I want a tummy tuck but really don`t want general anesthesia.

  Answer:  well, what happens if you are in the middle of it and the pain is unbearable with the MIA, are you going to have the surgeon stop half way through? JG 12.13.07

• Hi Dr. Garcia. I am having a abdominal hysterectomy in February. What are the chances to get a tummy tuck at the same time?

  Answer:  I personally do not like to do them together due to higher risk of complications. JG 12.12.07

• What are the dangers of an inner thigh lift as compared to other plastic surgeries. THANKS!

  Answer:  well the biggest things are the downward migration of the scar that makes it visible in a bathing suit and the potential for the scars to not be thin but thicker scars instead. JG 12.11.07

• My question is on tummy tucks. I do not care much to repair the muscles in my stomach as I do workout quite a bit however I had my daughter at 18 and my pregnancy made me a blimp. Needless to say I have a lot of stretchmarks that I just cant live with anymore. Is there a procedure that can be done by cutting out the front area of skin and then reconnecting it (by moving my belly buttone) without the full muscle repair? I just want the skin to be fixed by taking off the stretchmarks...nothing more. And if so what is it that can be done and what would something like that cost? Thanks a bunch

  Answer:  sure, the muscle does not have to be fixed during a regular tummy tuck, you can opt out of that. JG 12.11.07

• Dr Dr Garcia: I am 9 days post op from tt. Drains were removed 2 days ago. Today when I push on upper R side it seems to be a little wavy. Could that be a seroma? If so can this resolve itself or would it need to be drained. I see my PS on Monday but this makes me a little nervousl Also, how long does it usually take the skin to reattach to the facia?

  Answer:  could be, yes. When small they can go away on their own, if not they need to be aspitrated. They can do it on Monday. The skin cannot reattach until the fluid is gone. JG 12.8.07

• Hi Dr Garcia: 8 mos ago I had a mini tt (my decision, not the Dr`s) with some lower muscle repair. Everything went real well, scar healed great, very smooth, PS was very nice and I had no problems except that the mini did not give me the results I was looking for. I had several stretch marks above the bb, some excess skin and a stretched out bb. I decide to go back for a moderate tt which was skin only (no muscle repair) but to include the skin above the belly button. I am 1 wk post op. I did go to a different PS as the first time I went to the one where I work while off for a different surgery and no one I work with new about it. For confidentiality reasons only I decided to go somewhere other than where I work. I am fully confident with the new PS also. The only question I have is that this scar is a little longer but also there is some pleating as you get closer to the middle. Much more bruising this time also. The PS said he needs to do the pleating so that as the skin stretches back out it will all smooth out nicer and I shouldn`t end up with dog ears on either end of the scar. He says I need to wait at least 4 months for results with that. That is my concern. Right now it`s not looking so good and I realize it`s only been a week but what are your thoughts on that. The first scar never looked like this even at the beginning. Also could he have stretched it to much. He stated he needed to lift the skin to right under the breasts in order to get the stretch marks below the belly button and not to have a vertical scar. Quite tender in that area yet. I also get this constant stinging pain on the left side. I am only 5ft 3in and 120 lbs. so there wasn`t alot of excess skin above the bb just the wrinkled stretch marks. I am wearing my support garment 24/7 which the PS says I need to do for six weeks. I have another Post op visit next week and will discuss with the PS but just wondering your views.

  Answer:  well, all normal in terms of the bruising, in terms of the pleating, it does tend to flatten over time and you see that when there is an attempt to keep the incision as short as possible, so I would agree, give it some time and let it all heal before deciding on anything more. Best of luck. JG 12.7.07

• What are the risk, of a diabetic person who is going to do a tummy tuck?

  Answer:  higher risk of infection and the wound not holding together and splititng open, but I have to say, if the diabetes is well controlled that should not happen, best of luck. JG 12.6.07

• What type of butt implants do you use?

  Answer:  at present I am not doing buttocks implants as I do not like the feel of the ones available here in the US. JG 12.5.07

• I had a seroma after a tummy tuck day 12 which my doctor drained. He wants to see me in another two days to drain me if it happens again. It is happening again. The procedure was not painful as I am still numb in the area but what am I doing wrong? When does this condition subside?

  Answer:  it needs to be aspirated so the skin can re-adhere, it is likely going to have to be done a few times, the more fluid there is the more times it will need to be repeated, wearing a compression garment and limiting activity will help, best of luck. JG 12.5.07

• I had a tummy tuck 11 days ago and now have discovered that I have itchy skin mostly where the incision is. Is it ok to use vaseline around and on the incision?

  Answer:  I would use topical Benadryl cream but not on the incision. JG 12.2.07

• Hi Dr. Garcia, I wrote to you this past winter of 2007 concerning skin necrosis after my tummy tuck - I am the woman that loves riding horses. I have been meaning to write and tell you that I used the KCI vacuum wound pump for about 2 months - what a pain in the butt - however, it worked just great! The hole is barely even noticable since the skin grew back and it is nice and pink and not obvious. However, the main reason I am writing is to thank you so very, very much for your advice and your words of encouragement. I was so discouraged - practically on the crazy side! - and you were kind enough to take time out of your very busy life to write to me several times answering my concerns. You were just wonderful and so very many times I have thought of you with a very warm heart - so, it`s about time that I let you know that. So, again, many, many thanks for your kindness and your encouragement and your time. If I ever get my rural NYS butt to your part of the country, I am going to look you up. You take care, stay in good health, and take time out to play - okay? Mary Dixon

  Answer:  Mary, I am so glad things worked out, the VAC system is a pain, but it does help, I appreciate your kinds words and wish you a healthy holiday season, be well and thanks for getting back here and giving me the progress report. JG 12.1.07

• I had a tummy tuck 10 days ago. When do most patients stand upright? Should I attempt to stand upright or just let it happending naturally?

  Answer:  stand straight when the tension on the wound allows you do to do so. JG 11.30.07

• What exactly is a mini-tummy tuck? thx

  Answer:  a tummy tuck where only the skin below the belly button is tightened, there is no movement of the belly button and wlll likely not tighten any skin above the belly button, nor will it tighten the muscles above the BB. JG 11.28.07

• I had a minnie tummy tuck a month ago and had the scar injected with Fibroquel. I had good results as of now but I feel like the side that I was draining from the scar is raised there. I was wondering if I should have it injected with something again. I know that in the USA fibroquel is not available but is it ok to get a steroid injection or is it too soon. Was it to soon in your opinion to even get the fibroquel? Also I heard about having a laser run over the scar to lighten it is that something I can do now or should I wait, and until when would you suggest. I had my surgery done out of the country and I feel like they move a little faster with procedures and I just want the opinion of a surgeon in the USA. Thank you.

  Answer:  I think a steroid injection is likely OK to do, lasers can also fade the scars too. I have never used the Fibroquel so I am not sure about the timing, I think the results and studies are still lacking on its effectiveness for scars. JG 11.27.07

• I am interested in getting a Tummy Tuck and Bladder Suspension surgery. Is it uncommon for these procedures to be done together? How do I find doctors that will work together to have both procedures done at the same time?

  Answer:  It is not common, but not unheard of to do them together. I think you need to interveiw a specialist in each field of gynecology and plastic surgery and then have them speak together. JG 11.26.07

• I am three months pregnant. I have two children both born by elective c-section within 15 months of each other. The youngest being four years ago. I have had an inch gap between my ab muscles ever since and a protruding lower belly which seems to get bigger as the day goes on. In June I will have another C-section. Is it possible to have a full tummy tuck at the same time in order to avoid a fourth surgery? Has this ever been done?

  Answer:  well, it can be done but there is a little more risk due to the longer surgery. JG 11.23.07

• For a FTT, if i wanted a little frontal thigh lifting, would i need to ask for that to be done at the same time, or does it occur anyway, because of FTT? I am getting a butt lift 3 months later, which i was told would lift the backs of thighs just a bit, and sides of thighs substantially so am hoping for a bit of front lifting with the FTT. Also, i am concerned about shape/healing of belly button. Do you believe in inserting anything in bb to make sure it doesnt heal as a slit, like a foam ear plug or marble? If so, at what point should this be done? Are external bb stiches removeable and internal disolvable? If removable, when do they come out, and when do horizontal come out? Thanks!

  Answer:  it is an additional surgery and you will need to speak to the surgeon about doing them at the same time, it can be a lot of surgery and will prolong the recovery quite a bit. A marble will help the belly button stay open, yes. As to the sutures used, it varies by surgeon preference. Removable sutures are usually taken out at one week. JG 11.23.07

• i would like to know how much it will cost to have a tummy tuck, also i am getting married in vegas in september and is it possible to have the surgery and enjoy my holiday also? thank you

  Answer:  I do not think it is safe to enjoy your holiday after a tummy tuck here, the fees will vary depending on time but it runs about $8200, all inclusive. JG 11.20.07

• Dr. Garcia, Thank you for your advise that a second surgery and drain may be needed to close my wound after circumferential body lift. My surgeon agreed when I suggested it. He said I had a pseudobursa and he ended up removing it from over 1/2 of my incision. Now my question is, how likely is it that this thing is going to return? I have a tiny raised area just past the second incision and it is not getting any larger and fluid could not be aspirated from it. I had a JP drain in for 6 days and was having 30 cc/day from it when it was removed The second incision looks good otherwise. My second question is, if there is still some of the psuedobursa remaining is it possible that it will not cause any problems? Thank You again.

  Answer:  it is possible but it usually does not happen, all the best. JG 11.18.07

• Hi Dr. Garcia, I had a full tummy tuck a few months ago, and after about 5-6 weeks, there was a hole that opened up in the incision with some drainage. I was seeing the associates of my surgeon daily that week, and was told that I had a sterile abcess . When it was my surgeon`s turn to be in the office and I saw him, he cut a 1 opening and found a half-dissolved suture, which he removed. He packed the opening and it took about 8 weeks to completely close. During that time period, lumps developed along the incision line, larger at the center, graduating out to smaller at my hips. They seemed to be at regular intervals, so when I was told that I was reacting to my sutures, that seemed logical. My discomfort was increasing daily, and my surgeon finally said he would see me monthly, but I reached a point of desperation and went elsewhere. Another surgeon opened up the incision, and said he found an old seroma and lots of scar tissue, which he excised. He said that the problem I`d had was from the drains being removed to soon (at 50 cc/day) and that he doesn`t remove them until they get down to 20 cc. I don`t understand the development of the lumps with regard to a seroma, and wonder if I was having a suture reaction also, or if lumpiness is common on a pseudobursa. Some of the central lumps were quarter-size, but at my hip, they were about the size of a pea. My second issue is that when my belly button was moved, it was off center by about a centimeter. Now that I`ve had the revisional surgery, it`s off even more. I wouldn`t care about having a scar next to it, if it was centered. Can it be moved without opening the abdominal incision yet again? Thanks for your help!

  Answer:  it is likely you had a little of both, but the cyst wall of the seroma can feel hard too like a lump. As to shifting the belly button, that would only require incisions around the belly button, the lower incision likely would not need to be opened. JG 11.16.07

• Hi Dr. what advise do you offer patients thinking about cosmetic surgery. With what happened to Kanye West mom?

  Answer:  I think they need to discuss things with their physician, make sure they are certified by the American Board of Plastic Surgery and make sure they perform their surgeries in an accredited surgery center, they can call the state and county medical board and find out if the doctor is in good standing. As to Kanye West`s mother, the autopsy is today but it could have been many things, irregular heart beat, pulmonary embolism, too many thing unknown so far I am afraid. JG 11.13.07

• Hi, You answered my question about my tummy tuck I had 2/2006, could you tell me is there a certain doctor that should do the injection? I really don`t want to go back to the PS.

  Answer:  I think it best to see another plastic surgeon. JG 11.13.07

• Dr. Garcia You recently answered my question about the many surgeries and a tummy tuck. With my past surgeries would you consider working on a person as myself with my previous surgeries? I have endure 14 surgeries in all and am in great belief that cosmetic surgery could be no worse. Maybe a tummy-tuck, breast lift and lipo in hips.

  Answer:  previous non-cosmetic surgeries will not necesarily preclude further surgery. Please send me pictures and a history of the surgeries along with your concerns to drgarcia@lvcosmeticsurgery.com for my review. JG 11.12.07

• I had a tummy tuck 2/2006, I still have alot of stinging feeling in my upper abdomen, feels like someone has stabbed me from the inside out, it just burns so much. I still have alot trouble wearing anything around my stomach that is not elastic or very loose. I thought this should have passed a year ago.Any thoughts would be greatly appreciated.

  Answer:  sounds like some scar tissue wrapped around some nerves, may want to see if an injection of local anesthesia into that spot will help, and if it does it can be injected with alcohol to kill the nerve but then it will be numb. JG 11.12.07

• Doctor hace un mes me realizaron un segundo tummy tuck pero esta vez el lado izq no a querido cerrar todavia continua abierto apesar de q el resto de la herida se ve muy bien como si fuera de meses,la abertura q tengo es como de 5 cms q me recomienda q debo hacer,mi doctor me sugiere q continuemos esperando q sane sola,q me aconseja,gracias.

  Answer:  creo quel lo mejor es seguir lo que le dice su cirujano, estoy deacuerdo con el. JG 11.12.07

• I am nine weeks post op from a tummy tuck with no lipo, as I had no fat. I had two drains in for almost 2 weeks. Now I have a pseudo bursa and have had to have my abdomen drained each week for 7 weeks. Dr. said fluid usually stops in 3-4 weeks, but I am still building. Had 12 ounces taken the first time and 1 plus ounce taken the last time. Can you shed any light on why I am having this problem or is there something I should or could do to rectify this problem? Also will it cause any future problems?

  Answer:  until the pocket of the pseudobursa sticks down there will be fluid, it sometimes takes aspirations done more frequently than once per week to get it to stick down faster. JG 11.12.07

• Dr. Garcia, I am the one that asked about the tummy tuck with the previous stomach surgeries. I forgot to add that I am a 43 year old, African American Female. Thank You

  Answer:  makes no change to the suggestion. JG 11.12.07

• Dr. Garcia, I have had several surgeries which are to include; (2) small bowel obstructures, (1) ovarian cyst removal, (1) ovary removed after cyst was removed, (1) scar tissure removed from stomach, (1) complete hysterectomy and (1) C-section. My question is this, I have tried and tried to reduce the big bulge in my stomach. Would I be a good candidate for a tummy tuck or a mini-tuck? My other surgeries were necessary but I would like to have an elective surgery and this would be it. Any information you could give me would be gratly apreciated. If anyone else has gone through anything similar, please do not hesitate to post for me.

  Answer:  if it is the muscles that has split apart they can be repaired with a tummy tuck, but likely not a mini as the repair will likely need to be done from breast bone all the way to your pubic bone. JG 11.12.07

• Hi Dr. you just answered my question earlier today. You said if it is not fat the muscles would have to be readressed does that mean the TT would have to be re-done? If so is it harder on the PS to redo? I think you have said before if you hold your stomach in, and loss inches it is fat is that so?

  Answer:  essentially yes I am afriad. It is a little harder for the surgeon to do but not that much. As to holding your stomach in, yes, that is correct. JG 11.10.07

• Hi, Dr. Garcia luv your website. I had a TT 5/07 w/Muscle repair. My upper/Mid Abd still looks distended. My PS told me from the start he could not do aggresive lipo w/the TT that I would later need a touch up. But never told me I would still look distended. Last time I saw him he told me I dont need a touch up I need Aggresive lipo.Does that sound right? Or do you think he just didnt tighten my muscles enough? If I suck in by stomach I am flat which those were the results I was looking for.

  Answer:  hard to say without examining you to tell what is causing the bulge, if it is fat, then liposuction is the answer, if it is because the muscles there are not as tight as the lower ones, a common problem, then the muscles need to be readressed. JG 11.10.07

• Hi Dr. I had tt 8 months ago. The scar healed beautifully. Still get a little swelling when I walk a lot. My concern is, it seems like near the second suture, above my belly button, there is a indentation and a lump or scar tissue deep under the skin. I feel that area and it feels really hard or tight. I had a ct done and they said I had a seroma. It just feels like it pulls and the knot bothers. What can that be and how can it be repaired? When I pull my muscle in or bend over it feels like it interfers and bothers? Could it a broken suture? or scar tissue around the suture? Thanks for any help.

  Answer:  well it could be cut out and restitched but it might develop scar tissue again, hard to really say without feeling it I am afraid. JG 11.7.07

• Hi, Dr. I asked about garments and lower muscle repair for a FTT, you didnt answer the part about which you prefer doing first, FTT or butt lift, and why?

  Answer:  I do the part that bothers the patient the most, they decide, I have no preference. JG 11.6.07

• Hi Dr Garcia, I am the one who was scheduled for a butt lift, then 3 months later, FTT. well, i decided to do them in reverse order, since all my paperwork kept having me down for the FTT forst(Dec31). I called and talked to the patient coordinator and asked which she thought made more sense to do first. She said its up to me since the PS wanted to do both together, he doesnt have a prefereence as to which comes first. I know from having had a MTT with MR that a FTT with MR(upper only, i assume) will hurt just as much. I am assuming he will extend the incision as far as he can towards the back, knowing that the butt lift incision will meet up with it. couple questions, do you think he will need to mess with the lower ab muscles at all, since they were done 6 yrs ago with MTT? and which do you prefer doing first, front or butt, and why? also, what type garmet will i wake up in,typically, for a FTT? all i had the whole time for recovery for MTT was an ab binder.

  Answer:  hard to say whether the lower muscles need to be tightened without examining you. I usually use a garment similar to the one used for liposuction for those preocedures. JG 11.6.07

• I was diagnosed after 4 children with diastasis recti. I have had back pain for several years and when I do some core strengthen exercises I experience pain to the point I`m off my back for a period of time again. I have had physical therapy many times and I`m wondering if repairing my stomach muscles via tummy tuck would provide relief from back pain.

  Answer:  it might but I cannot guarantee it. JG 11.6.07

• I had a full Tummy tuck 6 months ago but the upper part of my ab muscle still sticks out like it was not tightend. The Doctor I went to said I would need to have the procedure done again. I will not be going back to him because now I know he is only a D.O. Can this be corrected without being fully cut open again?? Thank you

  Answer:  will need to be all opened again, sorry. JG 11.5.07

• I had a full Tummy tuck 6 months ago but the upper part of my ab muscle still sticks out like it was not tightend. The Doctor I went to said I would need to have the procedure done again. I will not be going back to him because now I know he is only a D.O. Can this be corrected with being fully cut open again?? Thank you

  Answer:  I am afraid it will need to be all opened again to gain access to the muscles in that areas which likely were not tightened enough, sorry. JG 11.5.07

• Dr. Garcia, My age; 47. Great skin, latino woman. I had a FTT w/MR, 11 yrs ago. Great results. Four years ago, I had Tumenscent lipo. Two years later, I had Vaser Lipo on my upper abs. My problem; My upper abs were great, and smooth before Vaser. Now they are lumpy and uneven. I should have left them alone. What are some possible corrections? Is a reverse tummy tuck good for that? I am wanting a Breast lift also, therefore wonder if a reverse TT can possible address this during that same time? or ... fat grafting? which is better? Thank you so very much!!

  Answer:  I think fat grafting after that much surgery will be unreliable, I think some undermining of the skin and further skin removal would help but a reverse tummy tuck will leave a scar that crosses underneath the breast bone between the breast and will not heal as thin as the tummy tuck scar. JG 11.1.07

• Dr. Garcia, I am 5 ft, 100lbs and had twins (6.8 lbs each) four years ago. I had a FTT in Dec 07. I also had an umbillical hernia repair. I am in great shape and can even see my stomach muscles when I contract my abs, but my belly button looks puffy (almost outy-like ). My PS states that he has to repair the hernia again, this time using a mesh. Also, when I stand the top half of my belly button feels hard and the area around my belly button looks bloated. What questions should I ask to insure that I get a belly button that looks as close to my old one as possible? Thanks in advance for your response.

  Answer:  I am sure that is what they are going to try but with a hernia it might not be possible now due to scar tissue. JG 10.30.07

• Dr. Garcia, I had a circumferential body lift and am almost 7 weeks post op. At about 4 weeks post op I had an area break open on my incision line in the back and began draining large amounts of serous fluid. It was left open to drain for about 4 days and then air pockets formed in the front of my incision line. You could actually hear the air making sounds under the tissue when you pushed. My surgeon did try to aspirate the area in the front but no sermoma was there. I then had a wound vac for a few days and the air left the front. After the wound vac was removed I packed the open area in the back with about 2 feet of 1/4 inch nugauze for 2 days. The area in the back has tunneling and undermining. After 2 days my surgeon wanted to see how it would do to leave packing out and keep it compressed with my garment. The air pockets in the front returned. Is it possible that the tunnel from the open wound in the back continues on around to the front and is allowing air to enter? Am I in danger of my tissues not adhering back down at my incision line? Please give me your thoughts on this situation. Thank You.

  Answer:  I am almost certian there is a communication from the back to the front, not unusual. I think the tissues will eventually readhere but it will take along time I fear. Might need a re-operation and drains put back in to get it to close though. JG 10.26.07

• Hi Dr. Garcia, I had a full tummy tuck 9 months ago I still have some drainage in my belly button right side at and am felling a nogle on the right side of my tummy also my pcp adv that it may be a stich or a canal that developed and may continue to drain. Since I had the procedure out of country have not consulted my surgeon but am going to see a surgeon here in the states. What could be wrong and maybe an option on correcting if needed? My pcp took a culture but states that a surgeon may give me some options whether it be to go in and clean it out I am assuming stitches is this an option or what would be suggested?? I am a little worried at this point.

  Answer:  most likely an infected suture or sinus and it will need to be cored out and closed, not a major thing. JG 10.25.07

• I am about 3 months post FTT, I have started working out again at the gym but have been able to find no answers as to how cut I can get my tummy now. Doc, will I have a V? or even defintion after this surgery?

  Answer:  no way I can tell that without seeing you, sorry. JG 10.25.07

• I had a tummy tuck and liposuction in the four flanks 8 weeks ago. The doctor said I am doing great. Said I don`t have to wear the girdle anymore. But is it better to wear the girdle? I forgot to ask how long it takes for the swelling to go down. I love the new look cause I don`t have the flabby skin on the lower tummy anymore. He did a great job. I found your site and thought I would ask you. I kept filling up with fluid in the beginning so had to have the drain on for awhile. Then had to have the saltwater put in to see if that would stop the fluid build up and that worked but now it is hard there but he said that will go soft. Thanks for making this site. Tina

  Answer:  it will take a few months for the rest of the swelling to go down, if you feel more comfortable with the girdle it is OK to use it but you do not have to. The tissues will get soft in time too. Best of luck. JG 10.23.07

• Hi Dr, i am getting a butt lift(no fat transfers) end of Dec and then a FTT 3 months later. Will i be able to stand the first incomplete scar since it will stop probably around the hipbone area until it is finished by the FTT? If it is dog eared, i am assuming it can be fixed during FTT? Will the butt lift address the sides of upper thighs in a good way? The PS said he can only do what he can reach since i will be on my tummy whole time. Also, i like the volume i have in my butt now, lots of muscle and a nice shelf from years of squats. Just have droopy /saggy skin over it now. Will my butt be flat after a lift? I heard from one person who wasnt happy with hers because it was flat after. I have heard of transferring a butt flap to the lower back/upper butt. Do you know what that is ? If som pls explain. I have the option of staying overnite after surgery. Would you recommend this? I have had a MTT with MR, didnt stay, would have liked to but i hear the pain is minumul with a butt lift.

  Answer:  I almost always do my lower body lift in stages and yes the dog ears will be removed during the second surgery. I think you will get some thigh lifting from the buttocks lift and then some more from the tummy tuck. If you have good muscle tone and shape now the skin elevation will not flatten it, that occurs in people with poor muscle tone with overly tightened skin. JG 10.23.07

• Good afternoon, I want to know if a tummy tuck in a good idea for my situation. When I was a small child, I had an apendectimy(?)and after that had two additional surgeries due to infections. So I have a horizontal scar which is fairly small and thin, but the scar from the infections is long and thick. I have 3 children now, a big buldge on one side of the scar and I do have frequent pain. My doctor has diagnosed this as abdominal adhesions. I want to know if it is possible for me to have a tummy tuck or will this not be a good thing for my?

  Answer:  well abdominal adhesions are inside of the abdomen and are not helped with a tummy tuck, but the tethered skin and depressed scar can be helped with a tummy tuck. JG 10.22.07

• acaba de realizarme un segundo t.t y esta herida es mucho mas larga quisiera saber si puedo tatuar la herida y cuanto tiempo debo esperar para realizar el tatto

  Answer:  despues de 6-8 semanas se puede hacer, buena suerte. JG 10.21.07

• I was sent home from my TT SX w/out a compression garment. I was told it was due to concerns about blood flow issues. The issues were treated during my 2 day stay at the hospital w/ nitroglycerin paste. MY concern is the swelling I am experiencing as I also had inner thigh lipo. My question is - is this a normal way to treat blood flow issues and do I need to worry about my recovery being hindered without using a garment? I expect to recieve one at my 1 wk followup.

  Answer:  it is a normal way to treat poor blood flow and it migth take longer for the swelling to resolve but the survival of the skin is more imporatnt than the time for recovery. One week without the garment should not make a big difference though. JG 10.21.07

• I had a tummy tuck 4 monthes ago. I went to get checked by my plastic surgeon a week ago i had 6 big bulges in my stomache she said i was fine to come back in 3 monthes. I had to much pressure in my stomache i went to a surgeon, he told me i had a huge ventral hernia, is this possible to a tummy tuck or lipo? Crystal

  Answer:  if the tightening of the muscles during the tummy tuck gets loose or if it was never tightened it can feel like a ventral herna, might want to see the plastic surgeon again and tell them what the other surgeon thinks is going on. JG 10.20.07

• I had a tummy tuck and breast reduction 5 weeks ago, the doctor said I could take the binder off but every time I do I feel like my stomach swells and I feel a tingling so I put it right back on. Is this normal? I really want to take it off but don`t want to hurt myself either. Also when is it safe to go braless at night after the breast reduction?

  Answer:  all normal, it can take another few weeks to get better. I think it is OK to go braless at night now. JG 10.17.07

• I also wanted to know if you can build muscle to take up the space where loose skin is instead of having surgery? Also is their anything you can do to help the stitches come out, they are causing some soreness. Also is their a place online to look up using Tretinoin for scars from surgery, I had a circumferential tummy tuck done 11 wks ago. Thanks!

  Answer:  it might be possible to build up the muscles, whether it will make a difference depends greatly on how much muscle can be built up. I personally do not think Retin-A does much for scars. JG 10.17.07

• I had a circumferential tummy tuck 11 wks ago, and muscle repair, and I still can`t do stomach exercises and it still hurts to sneeze is this normal? Also my incision is still sore on both sides, do you think the stitches are trying to come out? Also I wanted to know, can you build muscle to fill out loose skin? Thanks!

  Answer:  not usual but not unheard of either. I think the muscles are just tight and there is some scar tissue which is stiff. Start by stretching and in a few weeks move to the exercises. JG 10.16.07

• Have you heard of the combituck, an alternative to the traditional tummy tuck? How is this different from the traditional tuck? Would you recommend it?

  Answer:  lots of hype for a procedure that plastic surgeons have been doing for years, the amount of skin removal is less than in many tradtional tummy tucks and it never tigthens the muscle so I think it might be OK in a small percentage of cases but not for most people. It is basically a liposuction with a minimal skin removal so it is nowhere near a traditional tummy tuck. JG 10.15.07

• Hi Dr. This is a follow up question re: indentation from FTT. You weren`t supportive of lipodisolve, and remarked it was interesting that there was an indentation. Any recommendation as to what I might be able to do to address. My PS isn`t offering alternatives.

  Answer:  well since lipodissolve is for dissolving fat, if you believe it, that is why I thought using it would not help as it would potentially cause a further depression. It might be improved with fat injections to plump up the area where the indentation is. JG 10.14.07

• Dr. Garcia I want to have a tummy tuck and breast lift done how much time off do I need to take from work. I have an adminstrative job, very, very little light lifting and walking around the office and alot of computer work? And can I have both procedures done at the same time? And just a ball park figure (I know you need to see me) but average about how much for each/both? Thank you. I love your web site!

  Answer:  time off work is about two weeks and a rough estimate of the fees would be around $16,000, all inclusive with an overnight stay at the hospital. JG 10.12.07

• I am a 37 year old mother of three. I am considering three sureries. I only want to be under once. Can I have three procdures done at once. Being under anastisia is the scary part for me. I want a breast augmentatoin (lift if needed), abdominoplasty, and labiaplasty.

  Answer:  It would be a long surgery but I think those an be done together. JG 10.11.07

• I had my tummy tuck with liposuction to flanks on Thursday, (10/04). I feel as though, pain wise, I could stand up straight, but my muscles feel as though the doctor pulled them too tight. Is this normal and will they eventually loosen to the point where they feel normal again?

  Answer:  all normal and they will relax in time. JG 10.8.07

• Dr. Garcia: I am about 5`10 and 130 lbs .. so I am not overweight. However, my stomach really was sticking out with alot of fat on it and some loose skin from 3 kids. I had a tummy tuck about 4 months ago. What I am concerned about is that after the surgery (about 6 weeks), my stomach was much flatter but lately it is not at all .. I have not gained any weight whatsoever. My stomach looks almost like I had nothing done. I have loose skin again and fat sticking out! What could cause this? Also, at the same time I had a facelift and it look perfect but a few weeks after surgery (most of the swelling is gone) I have loose skin again! This is all very distrubing! I am 52 and in perfect health. What can be causing this? Thanks much

  Answer:  well, hard to say, I will say that some skin relaxation can occur after surgery, might just need a small touch up but I would wait at least 6 months if not more before that. JG 10.7.07

• Hi Dr. Your website rocks! I had a FTT 1 1/2 yrs ago. I have an indentation the size of a quarter, directly above my stitches (which have slight puckering in that area) and approximately 3 inches below my belly button. It`s been there since the surgery. My PS proposes addressing with advanced lipodissolve. Would appreciate your opinion. I was wondering what other alternatives I might have, eg fat injection. Thanks in advance for your advise!

  Answer:  well, first thanks for the kind words, as to lipodissolve, although I am not a believer, I find it really interesting that you have a depression and if, and again I repeat if, the lipodissolve were to work, I think that would cause more of a depression, so I cannot agree. JG 10.7.07

• Dr. Garcia, hace algunos años me hice la lipectomia, pero mi ombligo quedo muy feo, y hace como 8 meses me abrieron por encima del vello pubico y el Dr. dijo que ahora si hiba a quedar bien mi ombligo, pero quedo peor y del ombligo hacia abajo mi estomago esta casi plano, pero hacia arriba me quedo una paza muy grande hasta el busto, y me duele alrededor del ombligo, el Dr, dice que es porque tubo que poner un hilo de la facia al ombligo para sumirlo, y yo quisiera ver si soy candidata para hacerme de nuevo una lipectomia a ver si me hacen un ombligo mas bonito y se me quita el dolor. Gracias

  Answer:  tendrias que hacer un tummy tuck y remover piel para mejorarlo. JG 10.4.07

• I had a FTT in 12/05... I have lost 18lbs since the surgery, so my stomach is not tight any longer but I have a lump above my belly button the is long and hard. I thought it was a hernia because it hurts, and can feel it sitting up, coughing etc but when I lay down, I do not feel the lump. I do not live by my plastic surgeon (I moved 8 hours away, so I have consulted with another plastic surgeon, general surgeon. Anyway one plastic surgeon said it was a encapsulation, another plastic surgeon said it was a pseudo bursa and the general surgeon said that it was a ventral hernia. I did a CT with and without contrast and it did not show anything. What is the differnce between an encapsulation and a pseudo bursa? Thank you in advance, Nicole

  Answer:  a hernia would actually be less palpable when lying down. The encapsulation and pseudobursa are pretty much the same thing, sounds like a ventral hernia to me, as they likely tightened the muscles to where the tissues allowed but now with the weigth loss the muscles are not as tight as they could be. JG 10.2.07

• this was about my belly button question. i weigh 115 lbs and am 5`6, in top shape, my body snaps right back after pregnancy so i never had any loose skin, before during or after my pregnancy the stitch job he did just left a canyon like dent above the button and noone thus far will touch it, is there hope? can fillers pop out the dent temporarilly? idk if it is used in the stomache area. thanks shelly!

  Answer:  could consider fillers or fat injections. JG 10.2.07

• After giving birth to 2 sets of twins, when in a halfway sit up position, my stomach muscle was very pointy near my belly button area. I had a full tummy tuck w/mr on 2/22/07 and it seemed to be gone. About 2 months ago the point is there again. Could my PS not have done the muscle repair correctly or could it have come undone? Thanks.

  Answer:  more likely the sutures broke and came undone. JG 9.28.07

• Is it safe to cover a tummy tuck scar with a tatoo? If so, how long should I wait before having the tatoo done?

  Answer:  yes, I would wait about three months for the scar to soften so the pigment will take better. JG 9.27.07

• I would like to have a full tummy tuck I had to children at an early age and it has left me with stretch marks and baggy skin... But what i need to know is if my type one diabetes will stop doctors from wanting to operate on me ????

  Answer:  if the diabetes is well controlled they can still do it. JG 9.25.07

• Can the sutures they use to do muscle tightening bust? Also are they attached to anything to help prevent this from happening, and how long should you stay swollen from this?

  Answer:  yes, the can break or tear out of the fascia which is what they are attached to. If they break you can be swollen for a couple of weeks. JG 9.25.07

• Hi< I am a 400 plus pound woman with a gigantic pannus and am considering a panniculectomy because I can`t live this way anymore. Tell me about the procedure, the risks, hospital stay and healing time. Am I a candidate? Please help.

  Answer:  well other medical issues need to be worked out, but it can likely be done, the pannus is cut off, but it is not a tummy tuck, the skin is not lifted and tightened and the muscles are not tightened either, it is merely a cut across the pannus and a closure. It would be done as an outpatient with possibly one night stay and an extended care facility. Risks are that the wound would not heal due to poor blood flow, infection in the wound and blood clots in the legs. JG 9.22.07

• I had a circumferential tummy tuck 7 wks ago and I asked you about torn muscles and you said there would be a bulge. I do have a bulge in the middle of my stomach, but how do I know if it`s swelling or torn muscles,and are torn muscles painful, because I have no pain except to sneeze. I also had muscle repair, and should it still hurt to sneeze and sleep on my incision. Also how long should I wait to use Tretinoin on my scars, and about how long should it take to see results?

  Answer:  if it is torn muslces it will get larger when you try to tighten the muscles. Muscle repair can hurt for a number of months. I would wait 4-6 weeks for the Retin-A, all the best. JG 9.21.07

• Dr. Garcia, you performed a ba on me in 99 and I have since had two c-sections, my last 4 weeks ago, and will not be having any more. How long should I wait before I approach you for breast/abdominal repair surgery?

  Answer:  I would wait until your weight normalizes and your breast swelling goes down, somewhere between 3-6 months usually. All the best with the new baby! JG 9.19.07

• of 7989 total threads shelly05 | Users | Log out Search: Return to the Forum IndexBoard view Mix view Belly Button PS..I Know It`s Unusual But..My story NE Help? (General Facial Surgery) posted by shelly05, -- Tuesday, 09/18/07, 03:22 AM ok i was here about a year ago and i know i shared my plight with a body piercing incident i had, but it was a long while ago, so let me briefly fill you in and see if anyone knowof anyone who can help with this. ok my piercing got pulled out somehow during my sleep. we are going back nearly 3 yrs now. i was wearing a heavy piece, which i hate myself for now, but didn`t think then, so it likely migrated out more then ripping, cause i didn`t feel a thing and stayed asleep. when i woke it was simply on the bed and i was in shock. ok, so i went to a plastic surgeon cause the emergency room would not touch it. they recommended me to a PS. here in ny. well i got pregnant right before my procedure, and he couldn`t do it, so i waited until after and went back. almost $2k later for 2 minutes of his stitch time, i was bandaged, and let go and my belly button is 1,000 times worse then it ever was. i have talked to people who have had rips there and were able to repierce, and it looked great except for a minimul scar, which could be covered by a new ring, and wasn`t bad, BUT in my case, the guy said he was putting a few stitches in vertically when he in fact did the exact opposite. a red ugly scar is NOT my problem now, the problem is the area is all caved in, it looks like there is no fat above my navel, so noone will pierce it to cover it, cause it wouldn`t hold they say, and i can see why, but i have tried to contact the office about this surgery, and they have not been helpful in having me come in and look at me, and i went to a PS for my tear throughs and showed him my button, and he said he couldn`t and wouldn`t touch it, it would only make it worse, whatever he would do, and that really upset me, cause i THOUGHT someone could fix this. if they can re-create belly buttons, and even sculpt penises for women, and the opposite for men, how can they not figure this one out? it`s very sad for me, cause i have so many other appearance woes, that my stomache was my #1 asset and i loved having the belly ring, and i loved wearing bikinis and crop tops, and now iam covering it up cause it looks weird and freaky but i sooo want it fixed. the original surgeon had told me, i`d have a small vertical hair line scar but that is not the case, (he went horizontal),and he said i`d be able to re-pierce but that is also not the case. what would you do, and does anyone know of anyone that could possible help me with a belly button job. i don`t know if they could inject fillers in there or what would need doing, but there has to be a way if they can do a face transplant. i was so much better off had i left it alone then got the surgery originally any help would be awesome. i live in ny. many thanks, i know this is sort of our in left feild. this does affect my mood daily to, as well as skin and tear throughs, and it`s something i just had to ask. sorry so long..shell

  Answer:  well it might have been aggravated due to the pregnancy effects on your skin, if there is loose skin now then removing it would leave a longer scar, if there is a small hernia, it could be fixed, sounds like you need to just find a different surgeon for an in person consultation. JG 9.17.07

• I had a tummy tuck 14 months ago and before the surgery I could always feel the definition in my lower and upper abs. I could see and feel the definition in the upper portion but the lower still feels and looks like one big bulge. How long will it take before I can see or at least feel the definition down there? It still feels like it`s swollen. I`m a personal trainer so I know how to work the lower abs as well as keep a healthy diet. Also, what can I do to reduce smile lines or their appearance, I need a quick fix, I`m getting married in 3 weeks! :P Thanks for your help and have a great day. :)

  Answer:  it should be better by now. Not much that can be done and look better in three weeks though. JG 9.16.07

• I had a full TT in May of 2007. Everything seems great except I have an area just above my scar on the left side that indents, like there is tissue missing there, it is more noticable when sitting. Is this normal? I did have a seroma for about 4 weeks after the surgery could this have caused it? Is there anything to correct the appearance. Thanks

  Answer:  might be correctable with a little fat injection. JG 9.16.07

• Hi Dr. I had abdominoplasty done in Oct.2005 but shortly after that my muscles in my stomach seperated again. So in Oct 2006 I had surgery done again to thighten them. Now I went back to my Dr. and he tells me there seperated again. The surgery has to be done again but this time he said he`s going to use a mesh and the mesh he`s going to use is from a cow. Is this safe.

  Answer:  I think it is safe but do not expect a flat abdomen with the mesh, it will still bulge. JG 9.16.07

• I am 8 mo. s/p ftt with chronic severe abdominal wall pain. CT reveals abdominal hernia but I also feel lower left quadrant incisional hernia from repaired colostomy site after colectomy takedown (diverticulitis.) In morning, abdomen is flat and comfortable, becomes painful in minutes after arising and protrudes to appearance of 7mo pregnant daily. I feel a large diastesis rectus but pain is most severe around umbilicus initially then extends to transverse abdominus pattern. I have removed random prolene sutures from previous colectomy & MRSA debridement surgeries. I had no pain or muscle weakness prior to abdominoplasty and now am disabled with the pain during the daily rapid expansion. I wear double abdominal supports trying to make it through my day seeing my own patients. I swim and use treadmill one hour daily; am unable to contract abdominus rectus for sitting up unless I physically retract with my hands myself during the movement (like getting out of bathtub or sports car.) I have had PT for 2 months with TENS units to no avail. I`ve even tried acupuncture, although I don`t believe in it. It also didn`t work. Diagnostically, would ultrasonography or MRI be useful? I think this is related to sutures not holding around umbilicus and fascia after my old history of MRSA fascitis but I think this could be repaired. A general surgeon suggested Kenalog with Marcaine but the problem is too generalized. I take 2400mg of Ibuprofen daily without relief and experience cylical gastritis so I must find another option. I`m desperate to find a way to manage this mechanical complication. Thanks.

  Answer:  I am sorry but I really do not have much more that I can offer to correct the problem, I am sorry. JG 9.16.07

• I just read someones question below about women in their 40s in bathing suits looking good every where else but have saggy dimpply butts. I wonder if she saw me on the beach? I had to chuckle. Your answer was to prevent this, work on toning the glutes to give the butt lift/shape but that most women dont do that. I am 48 and work my glutes with a trainer 4x a week, still have a saggy butt. You siad the only alternative is a butt/thigh lift. I am scheduled for a butt lift end of the year, but what is the difference, if any, between a plain butt lift, and a butt/thigh lift? I am hoping my surgery will help my back/outer thigh area, as my PS said it should, without any additional scars, besides the one at lower back.

  Answer:  essentially very similar but if the thighs need lifting too the dissection and time required is greater but the scars are the same. JG 9.4.07

• Dr Garcia, i recently(2 weeks ago) started Chantix to help me stop smoking. I am scheduled for butt lift late Dec so thought i would get ready early for best results. I think the medicine is just starting to work, downside, i am slightly nausaus all the time and havent been able to sllp well since i have been on it, hate to stop because of these side effects, but yet i am exhausted! I have taken ambien in the past but not lately. Any sleep med you could recommend that would work with the Chantix? The feeling i have at night in bed is just buzzing, wired, between sleep and awake all night. have tried Tylenol PM, no luck. I have a c all in to my doc who prescribed it, waiting to hear back. In the meantime, any suggestions? Also, for the butt liftI was persuaded by many not to do lbl, but separate instead, I am the small one, 122, 5`5 ) how on earth does one avoid sitting down for a week? Is laying on back to sleep ok? Where are the drain tubes coming from, upper or lower butt? What is the minimum time i could go back for FTT? Thanks.

  Answer:  can try some melatonin or valerian root for sleep. One can sit but for limited times. You cannot sleep on yoru back for at least one week and in general the drains are on the sides. I would wait at least 3 months for the FTT. JG 9.4.07

• Dr. Garcia, I had abdominalplasty about 4 weeks ago. I am healing beautifully and the incision is mostly closed. However, there is an area on one side that has come apart and to the size of about 1/2 inch. It is appears to be barely healing and has a white coating on the inside. My doctor said that I probably popped a stitch. He said I have two options - 1) let it heal and do a scar revision if necessary later or 2) he will clean it out and restitch it, but there is a slight chance of infection. I am inclined to let it heal, but I wonder if I allow him to stitch it with it heal faster? My doctor said the area should close is 2-3 weeks, but it has been one week and it appears to be barley healing. Thanks for reading this and your advice is appreciated. I completely trust my doctor, and he seems unconcerned.

  Answer:  I would let it heal on its own, the healing at the begining is slow but it speeds up. JG 9.1.07

• Hi Dr. Garcia. It has been 6 weeks since I had a full tt hip to hip with lipo to flanks. Cut is healing great. I feel great except I have hard somewhat painful lumps on both sides of hips that dont seem to go down. I have seen plastic surgeon about this and he says it is from the lipo and its bruising and not to worry. However, I am because it is painful and my hips look very weird and swollen with a small waist. Can you please tell me what you think about this and what should I do? I am still wearing a girdle on and off whenever my stomach starts to feel swollen.

  Answer:  most likely swelling or sutures underneath the skin that can take a couple of months to dissolve and soften, all normal though. JG 8.29.07

• what is a weekend tummy tuck? I have good stomache muscles and am thin but have alot of loose skin.

  Answer:  just a mini-tummy tuck with less being done, you might be a candidate but I cannot say for sure whether you will back to normal in a weekend, I kind of doubt it. JG 8.29.07

• Hello Again! Thank you for your recent reply to my question regarding my pseudo bursa after a tummy tuck in June 2006 . I just read another question regarding a very similar situation from a TT in Feb. 2006 and would like to about the inections mentioned that could be used used to soften the bursa, and who can give them to me. Also, as I stated earlier, it has gotten smaller, and is much less uncomfortable.Therefore, my next question is; over more time, can this type of thing go totally or almost totally away? It has been 14 months now. Thank you so much for your help and sharing your knowledge with us all! DK

  Answer:  well, it will not go away but it can soften and become more pliable and at times be not bad enough to require surgery, the injections are of either kenalog or 5FU, I use the 5FU. Worth a try before surgery and it should not affect the surgery if you decide to do it in the future. JG 8.28.07

• Hello Dr Garcia. First, thank you for what you do on this site. I had a tt in Feb `06 and just some others on this forum developed the seroma above my belly button, which was tapped about 5 times having less fluid developing each time. However, I developed pseudoburso as well. Would lipo of the area even be a possibility, or is an additional surgery my only option? I have heard they can inject a type of tissue dissolving agent to help soften the capsule. However that was not from a M.D. If my only option is to scrape out the capsule, what are the possibilities of it developing again? And is there any way to decrease my chances of it happening again? Thank you so much for your time. C

  Answer:  liposuction is usually not enough to remove the sac of the pseudobursa I am afriad, it nees to be cut out, so more surgery if it is causing problems, injections can soften it and are certainly warranted before more surgery. The bad part is that it can happen agian, although not commonly, best of luck. JG 8.25.07

• Hello, I had a full tummy tuck June 2006. Within days of the surgery I had developed a large seroma a few inches above my belly button right below the ribcage which has since turned into a pseudo bursa. It was aspirated a few times in the beginning,but persisted. Then we did an ultrasound in Dec. 06 to measure it and see where to go from there as it was painful, uncomfortable and very visable. Around Feb. 2007 we decided to go ahead with an ultrasound guided aspiration,and put in a drain... but when we went to do the procedure, there was no fluid, just the sack, which now measures about 6 x 4 across and is about 2+ cm thick. It is still uncomfortable,and visable, but not as bad in the beginning. It is hard to stretch, and I am always aware of it by the feel and sight of it. My PS has recomended to redo the TT (minus the tightening of the abdominal muscles) and peel away this sack. He said most likely we would have to cut the whole pubic incision again( which has healed beautifully) in order to get all the way up to the area where the sack thing is. My question is, do you think we could just try to lipo it out? It is not fat but cant some sort of lipo scrape most of it out or something? I really dont want to re open the entire incision and have all the skin puled away and go through all that again. Or how about removing it by going in through an area from near the sack and me just dealing with a scar. My PS does not want me to have an unsightly scar, but I dont want to redo the whole TT procedure. Thanks for your opinion! DK

  Answer:  it needs to be surgically excised I am afriad. I think a scar closer to the bursa is possible but will likely not heal as well as the lower scar due to the tension on the upper abdominal skin. I must say that I agree with your surgeon, I think a scar near your ribcage would heal wider than desired and be almost impossible to hide in certain cloting. JG 8.22.07

• hi, I had a full tt 5 months ago. My belly button scar is dark red and looks like a smiley face. Will this ever go away? My Doc says cortisone shots will help. It is such a tell tale sign of my tummy tuck. Got any suggestions? Your help much appreciated!!!! Lisa

  Answer:  I think cortisone shots will help soften scar tissue but I am not sure it will do much for the redness, the cause of the redness needs to be determined and then treated, if it is just wound healing lasers might help, if it is an irritation from a retained suture it needs to be removed. Best of luck. JG 8.22.07

• Hi Dr. Garcia, How long after a full tummy tuck may abdominal exercise resume and is it true that there would be no benefit or improvement to the abdomin after a tummy tuck because the muscles are tightened during the procedure??

  Answer:  there is always a benefit to building strong abdominals and we let patients start it after 4-6 weeks. JG 8.22.07

• Dr, what is your opinion on the stop smoking aid, Chantix and isit safe to take right up until surgery? I am scheduled for lbl late december. The docs office who prescribed it said it usually does its thing within first month or 2, 3 months would be unusual for it not to have worked. Do you agree, it works? I really want to stop smoking before surgery. I am about a 3/4 to pack a day.

  Answer:  I think it does help many people but I think the patient should be off of it for 2-4 weeks before the surgery. Some people take as long as three months to quit. JG 8.21.07

• Dr. Garcia I am 3 weeks post op from a full tummy tuck. My incision on the right side has split open. Will my ps have to stitch me back up or glue my incision back together? Should I be worried about a infection?

  Answer:  I think if it is open the risk of abcess is low and wound dressing will need to be done though to avoid an infection. Most likely the best thting to do is to let it heal on its own and then do a scar revision if needed. JG 8.21.07

• Dr Garcia, In regards to the lbl, whats your opinion question.....I did see many pics of scars this PS has done, and was fortunate to see my patient coordinators in person, who had it done. she is probably 15-20 lbs heavier than me, and younger, and way fairer complected, but her round the world scar was almost invisable at 2 years post. That was almost what convinced me, along with her saying she would do it 200 times over, to go ahead with the surgery. I was wondering about the incisions opening tho. is that just due to tension or too much m ovement(or are they one and the same?) what is the best preventative for that happening? By long recovery, do you mean pain wise or general healing? How amny drains and for how long, usually? Thanks so much for your honest professional opinion.

  Answer:  the wounds opening up are due to that and also poor blood supply. The only thing you can do is follow the instructions after surgery to minimize anything from happening. As to drians, most likely 4, 2 front and 2 back, might be in a couple of weeks, but it varies. All the best. JG 8.21.07

• Dr Garcia, if a female family member close to you was getting a lower body lift, what would your main concerns be? especially if she looked decent as is, with just some loose tummy skin and droopy butt? I am having a hard time convincing my hubby that i will be fine. I have already scheduled but need his support. I have had a MTT with M/R, 3 BAs, and lipo 2x. He is worried because he says it is a bigger surgery than i have ever had. Would like your professional opinion on what the biggest risk would be? I am 48 healthy, on no meds, do fine under anesthesia, and heal/scar well.

  Answer:  well, it is a much bigger surgery, and there might well be improvements but the scars are nowhere near as good as anything you have at present and there is littel that can be done to improve them in the future, the recovery is long, the chances of wound seperation and breakdown with slow healing is high, so although at times it is the only answer to correct certain things, for small problems it really might not be worth it. I strongly advise having the surgeon show you some pictures of the scars so you can decide whether you want to do it. JG 8.21.07

• I am 47 years old and had FTT with lipo to flanks almost 5 weeks ago in Prague, Czech Republic. At 6 days PO I noticed the beginning of a seroma. I live in UK and went to see my GP at 13 days but he did not think it necessary to aspirate. I saw a cosmetic surgeon here in the UK at 17 days by which time the seroma sat above almost the whole length of my scar. The surgeon tried to aspirate but could draw no fluid - he told me the seroma was loculating or organising and explained that this means the fluid was becoming like jelly and cannot now be aspirated. He says I just have to wait, be patient and that it might take 6, or even 12 months to be absorbed. Should I be satisfied with this? I take serrapeptase - will this help? My abdomen feels uncomfortable, often a sensation of spasm, especially when I move after being still. At nearly 5 weeks PO I cannot stand for more than 15 minutes without needing to sit and rest - is this normal or is it related to the seroma? I cannot work at the moment but am due to go back at 6 weeks, though the prospect fill me with horror - I cannot imagine being able to survive a day at work and worry about whether, by doing more than I feel comfortable with, I am delaying my recovery and my chances of a flat tummy at the end of all this. Lots of questions I know. Sorry. I trying not to get depressed about everything and am hoping you`ll tell me there is nothing for me to worry about.

  Answer:  not sure if the serrapase will help, I think some massage and warm packs and then a repeat try to aspirate it is best. Your activity level at this point should be much better than that too but can be limited form the seroma fullness. JG 8.20.07

• I have a question concerning an infection that just sprang up at 9 1/2 weeks out. I had a full TT with vaser to flanks/lovehandles on June 7th. I was completely healed and looking good until last Sat. I noticed some blood spots on panties. Seemed weird since incision had been closed and not spotted for 2 weeks. As weekend went on the blood spots became more. By Tuesday There was alot of drainage and pubic area was swollen and tender to touch. Went to see PS. Took a culture and put me on Keflex and I`ll see him again on Thurs. My question to you is....Why would an infection pop up 9 1/2 weeks out. Could it be necrosis? Staph infection? I`m very worried. Could I have caught an infection from pool? Did wearing my binder in the evening an at night cause too much pressure?

  Answer:  can happen from an infected suture below the skin, not common but not uncommon, sounds like they are doing what I would, just see what happens, usually the antibiotics take care of it. JG 8.15.07

• Is an overnight stay usually required for lbl on normal sized person(no GP surgery). I was told 4 1/2 hr surgery. does that sound right?

  Answer:  in many cases patients do stay overnight. JG 8.12.07

• im having a panniculectomy on 08-17-07 without abdominoplasty. im afraid of how i will look after procedure.will i look deform? what should i expect? please email me back ASAP. THANK YOU

  Answer:  it will remove the saggy skin and in cases where that is pereformed the reason the tummy tuck is not done is because the change would be small due to intrabdominal fat or due to perioperative risks. JG 8.11.07

• I had a mini tummy tuck w/lipo 6/26. I really should have had a full. Now I have a bulge in my lower abdomen that comes out. It was there since right after the surgery but went down significantly. It is hard and does not seem to be going down. Does that go down or do I need another surgery.

  Answer:  sounds like more surgery. JG 8.10.07

• Dr Garcia, Do people ever need to undergo a second tummy tuck?

  Answer:  yes, if they gain weight or especially in cases of massive weight loss. JG 8.10.07

• Hi Dr. Garcis had a full tt dec. 3 2005. no drains. hurt from the start told scar tissue. stayed in bed 80%of time only time didn`t hurt. a few months ago some sutures pulled out. the pain much worse.couldn,t tell when bowels were going to move just whole ab get really hard. been a long hard road in my 60`s need help with hard things that hurt some bunch up and create a ball. no test shows. is there a hospital that will diagnois me? my ab is streached to large weight same.know someone can help me? can the tummy tuck be took out (the part that is left and cleaned out?) thank you very much for your answer. thanks for providing this site it really helps to know we are not alone thanks aganin Linda

  Answer:  I do not know of any hospital that can help, it sounds like maybe the sutures tore through the fascia on the muscle and it has caused the pain, not much that cna be done though if that is the case. Wish I had more. JG 8.9.07

• Doc, you need to add a catagory , lbl or butt lifts. I had another consult today, this time the PS recommended doing FTT and butt lift at same time, prefers it that way, doing the round the world incision(i am the one who is normal weight,5`5`, 125 no GB surgery, just saggy 48 y/o butt and bit of loose ness in upper abs) He said i do need MR in upper abs as they have separated. Had it with MTT. no fun,. but he said that tightening those muscles in a FTT really help bring the waist in? do you agree? I used to have a nice curve in but lost it after first baby. He also said that except for the MR, is easy. do you agree?

  Answer:  yup, I a agree and there are advantages to doing the around the world, I agree there too, just a long surgery. JG 8.9.07

• i just wrote you about the springs.I need to tell you i have been in pain 20 mo. my stomach has gotten so big as if 7mo pregnant.i am 63 years old in pain all time in bed most of time please any hospital will find out what is wrong? as i stated sutures pulled out on bottom about 4mo ago pain much worse can feel large hard ball hard to eat the balls feel like same substance as springs am cut from pelvis nearly to spine filled with these hard long things with circles on the ends. i really need help. can`t lay for pain in cuts starts burning and hurting down legs. any place in usa i can go. im sorry for repeating myself i just forgot to say how large my abdomem has got as far as skin will streach the sides have split contents spring like are falling into hips hurts try to sit. body building scar tissue around them the kind like rolled up tape measure everywhere hard things in the middle of them hurting so bad.please email me or call me please help me. sincerely Linda Edgeworth jledge@bellsouth.net

  Answer:  I wish I could tell you more but I really do not have much advice on how to proceed from here, sorry. JG 8.9.07

• I wrote you about tt some kind of long springs have fallen some left in original place just under ribs. the ones that have fallen have round rough ends feels like cutting me. others have cut down nearly to hip bones others have formed balls of them not exposed until day after MRI so much pain what kind of Dr. can help me. any hospital in us that will find what is wrong with me? can you call or write where i can go? thank you Linda Edgeworth 3120 rome rd.s.w. Plainville,Ga 30733 706-625-2236

  Answer:  I am sorry but I really do not have much I can suggest in terms of trying to figure out what is going on in your case. JG 8.9.07

• Dear Doctor, had a tummy tuck 20mo ago have been in pain ever since. bottom part navel down pulled out 4mo ago. now feels like slim long springs some of them have dropped and cut deep places from front to nearly spine so much pain. so deep don`t show up on test hurts so bad. know what i can do? ps said nothing to do with him too long since operation. don`t know where to go what test to ask for what kind of Dr to go to have been to ER just give something for pain. it now causes my legs to hurt until moving around. have any help for me i feel like no hope. sincerely, Linda Edgeworth 706-625-2236 ps there is some in bottom of ab. can`t get Dr. to feel only goes by test. thank you so much i am 63 and need help badly.

  Answer:  I have to say it is very unusual, I think it could be some nerves trapped in scar tissue but by now that should have gotten much better, maybe it is something in your spine unrelated to the tummy tuck. JG 8.8.07

• have you ever done a reverse abdominoplasty? if so, how does the scar running across the sternum heal?

  Answer:  yes and that scar on the sternum is a little thicker than the lower abdominal scar and can be seen in many low cut dresses and in all bathing suits, the amount of skin that can be removed is also not as much as the lower approach. JG 8.7.07

• Hello Dr. Garcia, I had a ftt 7 months ago with lipo to inner thighs, saddle bags and flanks. My ps did not use drains. PS had to drain fluid weekly with a needle due to fluid buildup. I had 2 holes above pubic area that had to be stuffed with gauze daily. They drained a greenish puss with a foul odor. My ps just kept telling me they would heal. He said I did not have any infection. 8 weeks after surgery I developed blisters on my vagina and inner thighs which my gyno cultured and came back MRSA. Was on 4 different antibiotics before infectious disease dr. cleared up with nasal cream. Holes eventually healed. My ps said MRSA had nothing to do with my surgery. My internal dr. and gyno said MRSA was very likely caused by my surgery. My question is: I am considering a breast reduction and more lipo under the breast area. My ps said this surgery would be much easier. Do you think he was honest in regards to the MRSA and do you think I would have a liklihood of developing MRSA again with breast reduction? Aside from the struggle with recovery I am thrilled with my results. Thank You.

  Answer:  I think the MSRA could be attributed to the tummy tuck with the open wounds that needed to be allowed to close on their own and that needs to be considered. Might need aggressive antibiotics for the next go round. JG 8.3.07

• what are your recomendentations on time to quit smoking before/after a FTT? Do drs ever test you somehow before surgery to make sure you have quit?

  Answer:  at least one month before and after. There are tests to see if you have been smoking, they check for a break down product of nicotine. JG 8.3.07

• Any pros/cons to a floating belly button? Do you prefer doing that over patient having small vertical scar? Is the floating bb just your original not attached to the umbilical stalk? Can small ammount of escess upper ab skin ever be removed by excising the bb and pulling/snipping it from there?

  Answer:  well the pros are no vertical scar, the cons is that it can only be floated once. It is amputated from the stalk, corect. I do not think there can be much upper abdominal skin with that technique alone. JG 8.3.07

• Dear Dr. Garcia, I had a full tummy tuck w/ a muscle repair 2 years ago this June. I had a very rough time...seromas, spitting stitches, etc. After the year and half, however, I thought I was homefree. Well, about 6 months ago, I started getting these red painful abcesses on my abdomen, to the side of my belly button. After many tests, including MRI`s, colonoscopy`s and lost time off of work, and a minor surgery, one of them festered and out popped a double looped stitch. When I took the stitch to my regular doctor, she was amazed. I somehow knew all along that it was related to my abdominoplasty but have not been able to find anything about this anywhere in all of my searching. Since then, I have been back to the surgeon twice to have him remove stitches. I know that my muscle repair has come undone. Have you had any experience with this? Will my stomach muscles become lax again? I have not returned to my ps because, quite frankly, I am scared of him. I feel that he will not do anything to correct it and it would be a waste of time. What was my lifetime dream to have a flat stomach has turned into a 2 year nightmare. Any insight you can provide would be most helpful. Thank you so much!

  Answer:  I have seen and heard of it happening and most likely if the sutures have gotten infected and been removed the muscle might loosen up again unless the scar tissue holds it together. JG 8.3.07

• Dr Garcia, havent been here in a long time. have a question about butt lifts. I am normal sized,(5`5 , 125) always have been, work out often with weights and cardio, am 48 y/o, just have a saggy butt with cellulite dimples.. I have 3 consults lined up. it seems that PS s are hesitant to do these on people who havent lost tons of weight. I have had a MTT, 3 BAs and lipo twice, so i am not new to the world of PS. Also, i want to go for a FTT, since my upper ab skin is not a tight as i would like now(been 6 yrs since MTT). PSs seem hesitant about this too, saying i would have a vertical scar for sure. Does this heal well? Do you think anyone would do it all at once, or butt first, then wait a yr and do front? I dont need any butt implants or fat, just a lift. Is this such a big deal?

  Answer:  some surgeons do front and back at the same time and the vertical incision does heal pretty well. I think their hesitation is due to the visible scars that can be hard to hide at times in bathing suits. As to it being a big deal, it is kind of due to the length of the surgery and the resultant scars, but it might be the only option in your case. JG 8.2.07

• How common is it for a scar from a thigh lift to fall because of gravity and time?

  Answer:  actually very common. JG 7.31.07

• Dear Dr Garcia I got a tummy tuck with lipo one year and 11months ago I still have a little pouch, Can you recamend any exercises I can do to help get rid of this?

  Answer:  I do not think exercise will help in most cases, especially if it is excess skin. JG 7.30.07

• Thanks for such a timely answer to my question. You said If the waist stays the same when you suck your stomach in then there is intra-abdominal fat and tightening the muscles will likely not narrow your waist. The width of my waist stays the same. I am able to `suck` it in, though, as there is a bit of a pooch there and the side view will change. Any luck for me? (I also have an UGLY BB and have a few stretch marks & loose skin to deal w/ so the narrowing would be a plus)

  Answer:  well the tummy tuck might fix the pooch and the belly button but I doubt your waistline will change. JG 7.16.07

• Thank you for providing such an informational website. I have explored the archives and found some info on narrowing a waist. I have addictional questions for you. What is the average space between the ribs and hip bone for most women? Mine is about 3 and I think that might be too small to narrow my waist at all. My waist gained 2 after childbirth. Also, when I suck in my abs, my waist stays the same (little or much intra-ab fat??). I have an athletic build - 5`6 /135lbs. I have narrow hips and no waist. I`m just wondering what kinda chance I`ll have of getting a smaller waist w/ a TT.

  Answer:  I really do not have a reference number for that distanc as it varies greatly, the taller one is the longer the distance. I think in your case that number is small, I agree. If the waist stays the same when you suck your stomach in then there is intra-abdominal fat and tightening the muscles will likely not narrow your waist. If that is what you were considering the tummy tuck for I do not think it is a wise idea. JG 7.16.07

• Could something go wrong 10 or 20 years after a butt implant?

  Answer:  something can go wrong after 10-20 years and after 10-20 days too. JG 7.13.07

• What do you think about mentor implant for the butt?

  Answer:  I am not aware of Mentor making implants for buttocks augmentation. JG 7.13.07

• What type of implants do you use for butt implant?

  Answer:  I am not performimg buttocks implants as the implants available in the US I feel are too hard. JG 7.13.07

• How safe is butt implant and what`s the worst could happen?

  Answer:  worst thing that can happen is they get infected and need to be removed, there are relatively safe. JG 7.11.07

• Two questions for you: 1st - is it possible to have diastis without having a large ridge-perhaps just s-t-r-e-t-c-e-d out? My waist was 2 wider after having my first child, when my other measurements were the same. I have done the test and can feel a separation about 2 fingers wide and 3 or 4 fingers long above my BB, but nothing below. Secondly - if it is only stretched out or no diastis, can the waist be narrowed in a TT anyway? And by how much?

  Answer:  yes, the ridge is not always there. The waist can be narrowwed by tightening the diastasis as long as the abdominal contents will not limit it. JG 7.11.07

• My wife recently underwent a full tt, it left a fair bit of stretch marks from groin to navel. I was wondering if there had been any surgical developments that can get rid of stretch marks. Also, I recently heard of a new proceedure where a tummy tuck can be done without leaving any scarring, as the procedure is carried out pulling the loose skin together into the belly button. Is this something you have heard about.

  Answer:  the belly buttom tummy tuck is a minimal improvement and not applicable for most patients. I am afraid as to the stretch marks that science has not yet come up with a good option, sorry. JG 7.6.07

• Would psuedobursa show up on a CT scan with IV/Oral contrast? Does it cause discomfort?

  Answer:  not with oral contrast and it would only show up if it was full of fluid. JG 7.6.07

• Hi Dr. Garcia I had a full tummy tuck in June of last year and every since then I have a foul smell and drainage from my naval every single day also when i awake in the morning my stomach is flat as a board and as the day wears on it becomes puffy and sticks out and it gets really hard and tightens up my doc says he can`t find anything wrong and gave me some antibiotics for the drainage and it cleared it up for about 4 days and it came right back I am confused and don`t know what to think or do. I really hope you can solve this problem for me do i need to consult another doc as to my doc says he can`t find anything wrong.

  Answer:  sounds like you likely have a retained stitich that is infected and until it is removed it will all continue. JG 7.5.07

• Hello Dr. Garcia: PostOp TT 12/05- lump above belly button was thought to be a ventral hernia now after the general surgeon & plastic surgeon has communicated they are thinking that it is not a ventral hernia but an encapsulation. I thought that encapsulation was the same thing as scar tissue, right? The CT scan did not show scar tissue in the area around the navel only at the incision above my pubic line. Is that possible to have any encapsulation above your navel and is it the same as scar tissue? Does it cause discomfort? How can it be corrected? Thanks! Nicole

  Answer:  that is more likely a pocket of old fluid that has absorbed and left a pocket of scar tissue, called a pseudobursa. Might need to be cut out I am afraid. JG 7.5.07

• How much do you charge to do a full tummy tuck and fat transfer to the butt?

  Answer:  I would not do them together, tummy tucks are about $8200. JG 7.2.07

• How long does a butt implant last and how often do you have to replcae them?

  Answer:  they should be a one time thing. JG 7.2.07

• I`m having a tummy tuck and fat transfer to the butt, done the same time. What is the best way to sleep? What would happen if I sleep on my back?

  Answer:  I would not do them at the same time as the pressure of sleeping on your back might affect the fat injections. JG 7.2.07

• Had mini tt with tightening of lower abs 3 mos ago. All went well. Very satisfied with results on outside but wish had done ftt because of slight contour and stretch marks above bb which wrinkle a little-it`s the wrinkling that I don`t like-was hoping to just have that fixed with umbilicoplasty but ps doesn`t think I would be satisfied with results. Not sure I would want to try surgery again as things went so well the first time but how long do you suggest waiting before having any additional or repeat surgery. PS I amazed at all the problems people are having as I had no problems what so ever. Just a little tender yet at times.

  Answer:  I would give it at least 60-12 months and see, glad all is going well. JG 6.30.07

• HEY DOC.THANKS FOR ANSWERING ME BACK SO QUICKLY.YOUR ADVICE IS GREATLY APPRECIATED.I SAW MY PS TODAY (6-28-07 AND HE SAID THAT THE SPOT I WAS TELLING YOU ABOUT WAS ANOTHER INFECTED AREA.IT WAS A SMALL AREA SO HE TOOK A NEEDLE TO IT AND BUSTED THE SKIN OPEN AND LET SOME OF THE INFECTION OUT.HE THEN CLEANED IT AND GAVE ME ANTIBOTICS (KEFLEX).I HOPE THESE ANTIBOTICS HELP THIS TIME BECAUSE IT DIDN`T PHASE IT THE LAST TIME.I DO NOT UNDERSTAND WHY THIS SPOT CAME ON ME.I CLEAN THE AREA TWO TO THREE TIMES DAILY.COULD THIS BE A STAPH INFECTION AND IF SO HOW LONG WILL IT TAKE FOR IT TO GET BETTER? HE TOOK A CULTURE OF IT THE TIME BEFORE AND HE SAID IT WAS JUST A SKIN INFECTION.I DO NOT BELIEVE HIM,BUT I DID NOT SAY ANYTHING.IF IT TRULY IS A SKIN INFECTION THEN I WOULD LIKE TO KNOW HOW I GOT IT.I THINK HE OWES ME THAT MUCH.WELL NO MATTER WHAT I JUST WANT TO GET BETTER.DO YOU THIMK ANY MORE PLACES WILL OPEN UP ON ME AGAIN? DO YOU HAVE ANY SUGGESTIONS ON WHAT I CAN DO TO GET BETTER? IS THERE ANYTHING I CAN PUT ON THESE PLACES TO GET THEM TO HEAL FASTER, AND PROTECT THEM FROM ANYMORE INFECTION.YOU HELP WOULD BE GREATLY APPRECIATED.I JUST SO TIRED OF BEING SICK.I FOUGHT WITH THIS FOR 4MONTHS NOW AND I AM SICK OF IT.PLEASE HELPL.THANKS VANESSA

  Answer:  no way to tell how long it will take, sorry. Once the area is opened up it is much easier for it to heal and get rid of the infection. I wish there were things you could do to help but there isn`t. JG 6.28.07

• I thank you for your recent response regarding a cyst removal and possible reoccurance following hernia repair. I do have one further question: If left alone, will a pseudobursa continue to grow and can it become a health risk? Or will it become more a nuisance and fixing it be merely for cosmetic reasons? I appreciate your help.

  Answer:  no health risk but it can stay there a long time, usually will not go away on its own if it is of any significant size. JG 6.28.07

• HEY DOC. SORRY TO BOTHER YOU,BUT I HAVE ANOTHER QUESTION. AS YOU KNOW I STILL HAVE TWO SMALL INDENTIONS ON MY STOMACH FROM WHERE THE HOLES WERE THAT HAS INFECTION STILL LYING ON THEM,BUT MY CONCERN IS THAT I HAVE ANOTHER SMALL SPOT ABOVE WHERE THE FIRST HOLE WAS AND IT IS KIND OF PURPLE AND LOOKS LIKE IT IS GETTING A LITTLE RED AROUND IT.I AM STARTING TO WORRY AND I DON`T KNOW WHAT TO DO.COULD THIS BE ANOTHER INFECTION OR NECROTIC SKIN STARTING TO FORM? THE SPOT IS NOT VERY BIG BUT I AM WORRIED.SHOULD I GO TO THE BEACH OR WOULD IT BE BEST TO STAY HOME? SHOULD I CALL MY DOCTOR AND LET HIM KNOW.I ASKED HIM ABOUT IT THE LAST VISIT THAT I HAD AND HE SAID THAT IT WAS NOTHING THAT MY SKIN WAS JUST VERY THIN IN THAT AREA DUE TO THE SURGERY AND COMPLICATIONS THAT I HAVE HAD.ANY SUGGESTIONS? COULD THIS BE A STAPH INFECTION AND IF SO WHAT KIND OF ANTIBOTICS WOULD BE GOOD FOR THIS?REMEMBER HE HAD ME ON KEFLEX BUT IT DID NOT HELP.YOUR HELP WOULD BE GREATLY APPRECIATED.THANKS VANESSA

  Answer:  I think you need to see him to make sure it is nto a new area of skin that is going to break open. JG 6.28.07

• In January, I had a triple hernia repair - 2 inguinal and one incisional across previous c section scar. The doctor repaired the hernias and removed excess skin before closing the incision. I had a lot of fluid removed during the following weeks and the area above the incision became hard. I was told to massage it to break up the scar tissue (which I did) but the incision area appeared to be caving in and the area above it pouched out. It was determined that I had developed a cyst which I ended up having to have surgically removed in May - it ended up being a very large cyst and I was hospitalized with drains in for two days - went home with the drains in for one week until they were leaking and no longer working properly. I had more fluid removed and now (at 5 weeks post op) am developing the same signs (hardening of the area above the incision line and pouching) This area becomes hard with any activity and feels like a bruise. I also have stabbing pains, but understand that is part of the recovery process. My physician once again tells me to massage the area, but I am fearful that another cyst is forming. I don`t want to go through this again. I am a 50 year old thin female who is in good health. I have not received the ok to go back to working out, but have tried to swim, but can`t straighten out enough to do laps. I am very frustrated.

  Answer:  sounds like you need to see a plastic surgeon and have the pseudobursa removed again and the drians replaced with possibly some quilting sutures to close the pocket down. JG 6.27.07

• had ftt 3.14.07 with muscle repair; had drains removed in 8 days and a few aspirations after in office;now have severe abdominal distention mostly mid-line and mostly above bb and cannot straighten up; 2 wks ago ultrasound showed hematoma w/fat;but now my abdomen is larger and experiencing tear-like intermittent shooting pain when trying to straighten out and/or move body in any direction;caught a chill and abdomen went into spasm and i couldnt walk w/o holding belly;i think muscles became unstitched with scar tissue forming and causing the distention and in turn stretching the skin beyond comfortability; my g.i. md sending me for ct scan today; doesn`t like what he sees; would an MRI be better? or what tests can best determine if stitches came out of muscles? and what tests would be best to determine if there is surgical hernia? ps wants to see me in 6wks and advised maybe some lipo then; i have a gut feeling this is not the answer; im very concerned and dont want to 6 more wks b4 doing anything--goin to Mexico in 3 wks(7.22) and am afraid to travel that something might be wrong or go wrong while away; any dangers here? should i go to another ps for 2nd opin? gen`l surgeon for 2nd op? I know i asked a lot of questions, hope you can help.

  Answer:  CT scan or MRI are about the same for what is wrong, I am afraid you will need surgery and a drain to fix the problem. As to determining if the stitches broke, you would need the scan done both in the relaxed and then in the bearing down position, no easy to do. I think you should get it fixed sooner rather than later, and liposuction might remove the hemtoma but will not fix the muslces if the sutures broke I have to say. JG 6.27.07

• Dear Dr Garcia almost two years ago I got a full tummy tuck.Since then I had my doctor redo the liposuction on my stomach, Now I still have a belly it is hard in some spots and squishey in others, And it by no means flat,I do exercises alot of crunches, should I have it re done the lipo part, And is this normal. should it be my abdomin be flat?

  Answer:  hard to say what is going on but it sounds like it could be fat inside your abdomen below the muscles that is only able to be flattened by diet, liposuction and a tummy tuck will not flatten intra-abdominal fat. JG 6.25.07

• HELLO DR. HOPE ALL IS WELL. ITS BEEN SOME TIME SINCE IVE RETURNED WITH ANY QUESTIONS WHICH IS GOOD BECAUSE IT MEANS ALL IS GOING GOOD. WELL MY CONCERN IS THAT LATELY IF BEEN FEELING SOME STABBING PAINS ON ONE PARTICULAR SPOT JUST BELOW MY RIB CAGE. AT ONE POINT IS WOKE ME UP AT THE MIDDLE OF THE NIGHT. IT JUST LASTED FOR A COUPLE OF MINUTES. SO FAR IT HAS HAPPENED A COUPLE OF TIMES. ITS NOT CONSTANT JUST COMES AND GOES. ALSO AROUND MY SCAR IT FEELS LIKE ELECTRICITY SPARKS. IT HAS BEEN 3 MONTHS SINCE MY TUMMY TUCK. THANKS FOR YOUR TIME. GOD BLESS. VIVIAN

  Answer:  most likley a litle scar tissue that with time and stretching will get less and less. JG 6.24.07

• can`t find answer to problem.adhesion loose but cut deep are filling with scar tissue DO said what is she felt round and narrow hip skin is seperating can`t sit. have no plsce to give vitamin shot now has shrunk so much original wuestion wher get help pulled ou tt said need gen/plasiic surgeon

  Answer:  I am sorry but I really do not understand what you are saying or asking. JG 6.25.07

• Hi Dr. Garcia, I had a full tummy tuck done 3 weeks ago. My doctor recommended dermawave treatment to help with the healing process, I went this past wednesday for the treatment and after that I`ve been feeling more swollen more like bloated, is this normal? Also when I wake up in the morning my tummy is fully flat but throughtout the day it gets swollen or bloated again, is this also normal?? please advise

  Answer:  sorry but it is normal. JG 6.15.07

• tt18mo ago hurt since closed 13ct pulled out intense pain ER two days later. went ps did op said too long not my op if in pain in mind. went to two ps in Atlanta they both said pulled out hate to put through again might pull out. I feel sticking and stomach stays in spasm. had adhesion bands grow around hips made deep cuts now filling with scar tissue and hard objects i think clips or something that didn`t dissolve. hurts down legs move knots releaves some knots are all across my hips.went to dr. last week felt said scar tissue in round shapes offerd no help. my ab feel full of soft wire like objects try to push to side to stop spasm last only minuits.I need help said must find surgeon that is gen/plastic surgeon to repair.I`m 63 non smoker non drinker and have to lay down or in pain all time. please help me if you can or foward to help anywhere. please tell me what to do where can i go please. they tried to give me vitamin shot pumped up shot in scar tissue. hips have sink in places where they put shots. feels like skin is seperating and loose and small hard objects is causing it. can furnish references as to mental stability this is really happening. thank you Linda Edgeworth Plainville Ga 706-625-2236

  Answer:  sound slike you do need a repaet surgery. Due to potential legal issues, and some doctors wanting to know why I referred a patient to someone else and not them, I think you are best to go to this website and look for a plastic surgeon in the area you desire. I wish you all the best. JG 6.15.07 http://www.surgery.org/public/findasurgeon.php.

• Hi Dr. Garcia, I will be getting my tummy tuck next Monday. The Pre-op appointment nurse stated that I soak in a tub with 1 cup bleach before the surgery. Is this normal? Have you ever heard of this one? It is not supposed to hurt me, but sounds crazy and I am a bit concerned. -k

  Answer:  it is done to clean the skin, you can use bacteriacidal soap instead. JG 2.2.8.07

• Dear Dr. Garcia, I was reading a question someone else posted and for the first time I read something about Intra Abdominal Fat. I never heard of this. Since I am considering a full tt and lipo of the flanks ( I am about 15 pds over my normal weight) in June I want to be realistic about the results. I have a protruding stomach just like the other person and I also seek a flat stomach and smaller waist as a result of this procedure. How can I tell if if I have this kind of fat? Is there some kind of self exam I can do?

  Answer:  the tummy tuck will remove the fat and skin you can pinch, nothing more. If you try to suck your stomach in and your waist does not get any smaller or narrower, then the amount of intra-abdominal fat you have may be enough that the tummy tuck might not be a dramatic change. JG 2.27.07

• I had a tummy tuck 2 years ago. The surgeon is a friend, she did a great job. However it is still very tight, and very numb. The feeling has not improved at all. Is this normal? There is a place probably 3 inches wide from my incision to above my navel that has absolutely no feeling. It looks great, but sometimes the tightness and numbness bothers me. When I exercise I can tell that there is a feeling, but I can`t tell that its sore. Will this change with time???

  Answer:  I think if it has not gotten better by now it will stay that way. JG 2.27.07

• What is a subcutaneous pseudobursa? Can you explain it to me in layman terms? And how does this problem occur? Is it anything that I did? Because there is no way this surgeon is going to take the blame. Or is it some thing that just occurs and it is no ones fault.

  Answer:  it is a sac that forms around a fluid accumulation and looks like a joint capsule around a joint, in most cases for it to go flat it needs to be surgically removed, it is the result of the fluid reaccumulation and the body trying to wall it off. JG 2.26.07

• Dr. Garcia, I had a tt 1.5 months ago and I`ve developed a small hard lump in my pubis area. What could this be and what should I do?

  Answer:  most likely some scar tisssue that in time will get softer, massage and a little heat should help. JG 2.25.07

• I had a tummy tuck done over a month ago. My stomach is a mess. I developed a hemmatoma and now I have to go for a cat scan because I have a hard lump in my stomach with a severe extending stomach. I looked ten times better before the surgury. I am responsible for all this financial burden of tests and blood work because my ins. will not cover it. Is it his responsibility to repair the damaged he caused. H e says its because I smoke. I smoke about 3 cigarettes a month if I am lucky, because I get extreme nausea and cant smoke when Im like that. I really need your help.

  Answer:  smoking does not cause hematomas and as to the lump, it most likely is a pseudobursa which formed around the area where the hematoma was and needs to be cut out. It is a complication from the surgery, and in most cases the surgeon will do it for little to no surgical fee in my experience. JG 2.25.07

• I had a full tt with hernia surgery 8 wks ago. I have a hard, oval, tennis ball-sized swelling in the middle, but right below my incision. My ps says it`s lymphatic swelling and I should massage it. It feels uncomfortable when I do this. It hasn`t gotten bigger in a month, but it hasn`t gone down either. Could this be permanent? What`s your advice to get the swelling to go down comfortably? Thanks

  Answer:  might be scar tissue too, it might take months to go away, I think warm packs and massage are a must at this point. JG 2.21.07

• Thanks Dr. G, My next question is should my ps drain the fluid from under my lower stomach area from the abdominoplasty, it has been since June 06 and the fluid has not gone away even after the lipo in Dec. My ps keeps looking at it but has not addressed what options there are to get rid of it. I will try to excercise for the puffiness under the bra line.

  Answer:  if there is fluid that can be removed with a needle it should be done to allow the skin to re-adhere. JG 2.21.07

• Hi again Dr Garcia. I think I need to reformulate my question. When I said I had lipo, I meant I had it on my sides not on my tummy. In my tummy I only had the tt. So when I am in front of the mirror my waist looks nice since is narrower from the lipo but when i turn and look at myself sideways I am as wide as I was before just not wrinkled. It is seven weeks already and I am very worried. I was hoping for a so longed flat tummy.

  Answer:  if you had fat inside your abdomen, below the muscle, something they can tell before surgery, then expecting to have a flatter stomach would have never worked. JG 2.21.07

• Hi Dr Garcia. I had a full tt and lipo together Jan 2. Now, seven weeks post op, my scar is pretty normal and my belly button looks good, however, when I look at myself in the mirror I am narrower in my sides but I would say it almost looks the same as before when I`m sideways, except that I don`t have any lines cutting my belly and my belly button is not wrinkled. I steel wear my same clothes, it just feets a little different. When I pull my stomach in, the part under my breast tucks in fine, but under the belly button does not get tucked in. I`m thinking that maybe that lower part might be a little swollen but it seems to me that it is not going to get flat completely. I was about 10-15 lbs over my ideal weight when I had surgery, but its not like I was obese, so my expectations were actually higher. Do you think is too early to think that way or should I talk to my ps about a redo?

  Answer:  way too early, also realize that if you had liposuction and the tunmmy tuck, since tissues were removed, you should weigh less now than before. Also, the 10-15 pounds of overweight and the end result will depend greatly on where the fat was, if it is mostly intra-abdominal, then the tummy tuck will not provide a smaller waist, just a removal of skin, so there are anatomic variances that will affect the end result. JG 2.20.07

• Hi Dr., I am undergoing a tummy tuck procedure in the next month. many of the questions submitted on your site are complaints from patients about their procedures. I was wondering whether their complications are because their surgeon did not perform the surgery correctly. Are your patients pleased with their procedures and how often do they have complications? I`am hoping and praying for no problems

  Answer:  in the vast majority of cases the patients are happy with their surgery. JG 2.20.07

• For a full TT, if the patient was coming in from out of town, how long should I plan to stay in LV and do you have recommended lodging? Also, what kind of follow-up is needed and do I need a PS back home to consult for the follow-ups? Thanks for your time on this great site.

  Answer:  we can assit you with the lodging and I think 10-12 days would be minimum, a plastic surgeon back home might be needed for ideal care so you would need to establish that relationship first, especially if I do not know them personally. JG 2.20.07

• Dr. Garcia, Is it ok to do multiple procedures along with the tummy tuck? I have a Mid Facelift, upper eye lift, breast aug. and Tummy Tuck and minor nose surgery scheduled March 5th. I am 39 and in excellent physical health. Would you say this is too much? How long before you think I would recover from so much? Thanks for any advice... --k

  Answer:  I think that is quite a bit, I personally like to limit my surgical procedures to 5 hours or less, so you may want to speak with your doctor. If you did all of that I think a month at least for recovery. JG 2.20.07

• what does fever and redness mean? when does swelling finally go away after a tummy tuck?

  Answer:  could mean an infection, it can take 6 months or more for all of the swelling to go away. JG 2.20.07

• Dr. Garcia, I had abdominoplasty in July 06, in Dec I had to have lipo for some fat pcokets. I see my ps ever 6 weeks and I am not happy with the results. My close do fit better, however I have noticed and my ps stated during my recent visit that I am still swollen right under my bra line as well as fluid in the lower ab area. My ps stated that it normally takes 3 months for great results, apparently that has not happened with me. Am I at fault with this since I have not dieted or exercised. I have not gained weight, however I have not started a exercise routine yet. Woud that speed up these great results everyone talks about. When I hold my muscles in the visual is great however otherwise I still have a very wide waist area.

  Answer:  well what you are desscribing can be due to swelling below the skin in terms of the lower and upper abdoemn but the fact that your waist is still wide is due to fat inside of your abdomen under the muscles that cannot be removed with surgery, but diet alone. Staying at the same weight is good but after the surgeries you have had you should have lost weight since tissue was removed. I think once cleared by your surgeon you need to get back on a diet and exercise program to make sure you get rid of the fat you have gained since at this point after a tummy tuck and liposuction you should weigh less. JG 2.19.07

• Hello I had a full tummy tuck on Jan 9th 2007. I have since then had drainage from the insision and right above my Pubic area hasn`t healed it`s about 1/2 opened and draining. I had also cleaned my belly button with a Q-tip and that started draining a bunch for a couple of hours it has since stopped. My lower abs are really sore still and right under my belly button is red (pink) and is really hard hard like a hard ball. Is that all normal? The doctor perscribed me antibiotics which i finished i`m just curious if this is all normal? do i have fluid still??

  Answer:  well, not normal but it can happen, I think you need to stay in close contact with your surgeon to make sure an infection is not getting worse. It might take weeks for that draining to stop and the wounds to close. JG 2.19.07

• Dr Garcia, I had a ftt almost 2 weeks ago. The swelling is pretty uncomfortable, and I was wondering if there was anything I could do to help reduce. My PS advised against using ice because it would cut down on the blood flow to the area. Would any kind of soft massage help? Also, the area where my stitches were is itching. Does this mean that it`s healing? Thank you for your time.

  Answer:  masage and warm packs might help. The itching is normal and a good sign. JG 2.19.07

• Dr Garcia, I had a ftt 6 days ago. My stomach is still very swollen. My bb is very large and horizontally oval.Will this shrink down with time? thanks

  Answer:  yes, too early to worry. JG 2.13.07

• Hi Dr. Garcia, I will be having a vertical abdominalplasty (lower abdomen up to the breast bone) performed in March. My doctor suggest this procedure on bariactric patients because of the excessive fat on the upper abdomen. Based on several friends in the past that only received the hip to hip procedure, they had a fat roll that remained on their upper abdomen. Is it possible my Dr. may be right on his findings? What do you think? I frequent this site and find your answers to questions very helpful. Thank you for being their for us.

  Answer:  I do many vertical abdominoplasties, but if there is enough skin there is mostly a vertical incision and a small horizontal one too. Glad you like the site and thanks for visiting. JG 2.12.07

• I have just asked a question but Imade a mistake, I meant to say the plastic surgeons in the city I live in will NOT do corrective surgery on a TT performed by another surgeon Thank you

  Answer:  may need to go to a nearby city I am afraid. JG 2.11.07

• I had a full tummy tuck on 11/01/06, more than a year ago. I am totally not happy. When I bend over, my stomach moves up, when I stand up, it moves down, My doctor told me that I would have a slight bulge just below and in the center of my rib cage. My mons are drooping down, my waistline is 8 1/2 larger that it was before (not at all a slight bulge) I had the tummy tuck and I cannot wear slacks or skirts because they fall down and I have to pull them up every few steps I take. My entire stomach cavity is very tender and sore, my stomach, or whatever it is just moves around depending on how I move. The plastic surgeon told me that the results from the TT are not good because I have a short torso. He did not mention this to me prior to the TT. In the city where I live, it seems that other plastic surgeons aer willing to do any corrective surgery. After I complained to him, he sent me a certified letter stating that I had 30 days to locate another doctor and that he was terminating the patient/doctor relationship because ours was not good. what are my alternatives? that you.

  Answer:  All I can suggest is seeing if someone else is willing to take care of you, if not someone in your area, then someone nearby, sorry to hear about the problems with the doctors. JG 2.11.07

• Hi Dr. Garcia, I had a full TT two months ago and I still have swelling on the lower left side of my abdomin. At least that is what my Doctor said it is the last time I saw him a month ago. The left lower side is very swollan until its hanging over the line that was made during the operation. I have internal burning now and again and soreness just on the left side. The right side is perfect. I was told the swelling will go down but it appears to be getting worse. when I first had the surgery I was sleeping on my left side which I thought was the problem but is not because I stopped a month ago. When I am undressed I look deformed and I still wear a full body girdle. Would this be the problem? Should I be alarmed and call my doctor? Is this normal? Will the swelling go down?

  Answer:  I think it can take time but it might have some fluid that your doctor can suck out, might want to go back and see what they say.JG 2.11.07

• Dr. Garcia, I had a tummy tuck about 8 weeks ago and every thing looks great except my belly button. It is more like a slit instead of round like a navel should be. I read some where on the internet to put a marble in it. I have not tried it. What do you think. Thanks for the help.

  Answer:  well the marble will keep it open but whether it will work depends on how the cut was made. If it was round after the surgery and became a slit the marble might help, if it was a slit to begin with I do not think it will help and you may need a little revision of the belly button. JG 2.10.07

• I had a tt two wks ago, last wk I developed a hard buldge midway between my breast and navel w/some bruising, the area looked like it was swollen. I went to my PS, and he thought it might be possibly a torn stich. That same wk, I had a trouble clearing my throat and coughing due to a sl cold. And that was possibly the reason. Because I have taken good care of my self. My PS says the swelling will go down in time. This wk, the swelling is going down, but still sl swollen, the hard area is still sore. I want to know when the swelling is gone, will my upper abd look flat. He said there are many stiches in that area. I dont care if I dont have a six pack protruding, but at least want it to look right.

  Answer:  should get pretty flat in that area if he put in a number of stitches, yes. It will take some time though. JG 11.29.30

• I am 1 week post tt. I love my results and everthing seems to be coming along. Minimal or no pain, just a little swelling from where my ps removed one of the drains and I`ve been putting ice on this area to assist w/reducing the swelling. Only issue is that the sutures on my right side popped at the corner (hip area) and the my ps said she cannot resuture, and applied more steri tape. Will my scar heal unevenly with this open gap on the scar? I also have drainage through the steri tape...is this normal? Is ice the right remedy for swelling? Thank you in advance. Your web site has been very informative.

  Answer:  some drainage is expected and the area where the sutures popped will close and should heal well, if not it can always be revised down the road. Ice is good. Thanks for visiting. JG 11.29.30

• Hi Dr. Garcia, For people who have tummy tucks or any kind of lift...is there anyway to maintain the elasticity of the newly tightened skin, other than not gaining weight? Because, for people who don`t have lose skin, all they have to do is workout and weightrain and they don`t lose that elasticity...any hope in the same results for post-op patients? Thank you!

  Answer:  unfortunately, no, it is genetically predetermined and affected by what has occured before. Working out and weight training does absolutley nothing for skin elasticity. JG 11.26.06

• I had a FTT on 11/15. On 11/22 I had one drain taken out. I still have one drain in. I have cleaned the tubing by squeezing the gross stuff out into the bulb. However, today it doesn`t seem like my drain is really filling. Instead the fluid is coming out around the drain (out of the hole where the drain is inserted). Is this ok or should I call my doctor ASAP? I`m not scheduled for another appointment until 12/4 (to get my second drain out). I live 5 hours from the doctor so I don`t want to make an unecessary trip. Thanks for your help.

  Answer:  I think call the doctor and you should see them on Monday or Tuesday, no emergency, the drain is most likely clogged and the fluid is coming out around the tubing. I would not wait for the 4th. JG 11.26.06

• Hello, I had a full tummy tuck on 6-5-2006. I have 2 questions.I still have some lower abdoman swelling that gets worse as the day goes on.I used to wear a size 8-9 and now I have to buy an 11-13! When should I expect this to subside? Second and more important ...from the day of surgery I had extreme pain in the upper center abdomen right below the ribcage and moderate pain for about 3 months after the TT with abnormal swelling. The Dr. removed brownish fluid from there 3 or 4 times. The constant pain finally went away, but it is still swollen and hard , and is about 6 wide by 3-4 in diameter. It hurts there when I exert myself or stretch, and gets harder as the day goes on.My Dr. said it will go away, and he is not so worried since it has greatly reduced in size in the past 2 months and the constant pain is gone. What do you think this is? ANd what should I do about it? Thank You!!! Debbie

  Answer:  swelling can take up to 12 months to go away. The pain in the upper abdomen may be from the a small cyst like pocket where the fluid was and it needs to soften and be able to stretch more, all not uncommon. JG 11.24.06

• Sorry - i forgot to add to my question below about reverse TT - other questions on your page have stated that reverve TT may not last long - can you give your view? should permanent lifting sutures be insisted on to make sure the scar stays wihtin the mammary folds?

  Answer:  well, it is true in the sense that the scar can migarte downward and make the scar more visible. The permanent sutures do not mean the results and the location of the incision will be permanent. JG 11.19.06

• HI I came across your site after searcheing endlessly for information about reverse abdominoplasty. I like in the UK, i had a FTT and MR over a year ago. I`m left with HUGE upper ab rolls and a large `ken doll` (large protruding mons) it seems like my body has `dropped` !! After the TT by navel was perfect tear shapped, now it is `hooded`. My PS has offered a reverse TT to help the upper abs roll problem and also offered to take a `rectangle slice` from my pubic area to flatten my `ken doll` I do believe that he has done a fiar job (i had huge overhang (7 children) and my lower tummy is brilliant. Please Dr Garcia, could you give me some information about reverse TT. I`ve been told the scar will be under my breasts in the fold, and will cross the midline in an upward motion. Could you tell me whether i`m likely to be flatter in the upper abs after the Reverse TT and also if the pubic area `slice removal` will work. Many many thanks

  Answer:  the pie slice is a good option for the mons, and I have done the reverse tummy lifts but the scars are not hairline, certaily not as thin as the lower abdominal scar, and in cases where there is a large amount of skin the incisions will wrap around toward the sides of the chest. JG 11.19.06

• Hi. I had a FTT, and liposuction of my entire abdomen, and flanks 4 weeks ago. Am I okay to stop wearing my brace/binder now? I dislike it.

  Answer:  I let my patients stop after 4 weeks. JG 11.17.06

• I had a tummy tuck 10 months ago, and i haven`t lost weight. I weighted 142 when i had the tt and haven`t lost why? If they took all that skin away? I still have a lose skin. What can i do to make my skin hard. I didn`t get the muscle repair. thanks

  Answer:  tummy tucks are not done for weight loss, the amount of skin that is cut off in most cases weighs less than 5 pounds. There are no exercises or creams or treatments that will tighten skin, you might need more skin cut off. JG 11.16.06

• HI, DOCTOR GARCIA. MY NAME IS RAQUEL. I HAD A TUMMY TUCK 7 MONTHS AGO. MY STOMACH LOOKED GREAT, UNTIL LAST WEEK. MY RIBS WERE VERY PRONOUNCED BEFORE THE SURGERY DUE TO 3 PREGNANCIES, AFTER THE TUMMY TUCK, THEY LOOKED GOOD,MEANING NOT THAT PRONOUNCED ANYMORE, UNTIL LAST WEEK. NOW MY RIBS LOOK POPPED OUT AGAIN, AND I HAVE A SWELLING IN THE MIDDLE UPPER SECTION OF MY RIBS. MAYBE MY SUTURES COULDNT HOLD MY RIBS ANYMORE, OR DO A HAVE FLUID IN UPPER MIDDLE SECTION?? IS THIS NORMAL? NOW THAT MY RIBS ARE POPPING OUT AGAIN, IS THERE ANYTHING THE SURGEON COULD DO OR THIS WAS SUPPOSED TO HAPPEN WITH TIME, DUE TO MY LARGE RIBCAGE?? THANK YOU FOR YOUR HELP!!! RAQUEL

  Answer:  unusual this far out, hard to tell what has happened without examining you before and now in order to tell. Ribcages are nearly impossible to change in shape. JG 11.16.06

• fantastic site and most helpful,i`m a 31 m and had a full tummy tuck 2 weeks ago,i;m concerned i have a build up of fuild just above my scar,which stetches from hip to hip like a ring is this normal? thanks phil

  Answer:  can happen, not unusual and at times needs to be drained with a needle a few times. JG 11.14.06

• Hello Dr. Garcia. I am post op 11 months from having a FTT. My scar is actually beautiful however, my left side is flat and my right side looks like an egg and feels like a hard lump on the right side. I still have swelling and still have to wear my garments at night, if I do not the swelling gets totally unbearable. I thought that the most I would have to wear these garments would be 6 months. Also, I am still numb which I expected but I still can not exercise. When I do exercise (which is lightly) I get a tingling sensation (like when your foot goes to sleep)and it feels like the muscle on the right side is burning. I do not think this is normal. I have lost weight since my FTT. I am down to 158 which I was 178 but my stomach looks bigger... it that possible? I have thought about a revision but I am afraid of things getting worse. Can you maybe explain what could be going on? Thank you in advance. Great website.

  Answer:  well the swelling should be going down by now and you stomach being bigger I can only guess is due to the swelling, it is hard for me to tell much without examining you and seeing what is going on with your tissues. The best I can say is to go back and see you surgeon and see what they say. All the best. JG 11.14.06

• I have a consult WEDS. with a plastic surgeon. I really just want a mini tummy tuck with belly button repair but I am afraid that he will say my stomach is too severe but a ftt does not fit into my lifestyle and I am not wanting to wear a bikini or anything I just do not want to look pregnant in my clothes anymore. Also I am all for local anethesia instead of general do you think he will let me choose?

  Answer:  well he might suggest what he believes is best and I cannot tell if he will compromise on how he does it. JG 11.14.06

• Dr.G. I just turned 50, I look much younger thanks to a chin and mini lift you did for me 10 years ago. You are the best there is. Now I want to do a eye lift and lower bag removal, tummy tuck, breast lift, thigh lift and lipo on my buttocks. Now the question is, can you do them all at the same time and if so how long would the recovery time be? I live in LA and have to schedule the time off to come out there etc. Also approx. cost if I did them all at once. Oh do you have a location out here? If not you should! Thanks!

  Answer:  I think that is more than you should do at one tiem. Maybe the eyelids, tummy tuck and buttock lipo, then the thigh lift, followed by the breast lift. I do not have a location out there, sorry. I might be able to give you a price estimate if you email me some pictures to drgarcia@lvcosmeticsurgery. com so I can estimate the time, thanks for remembering us. JG 11.14.06

• Dr. Garcia, I had a full tt about six months ago in California. There seems to be still a lot of fat and cellulite on my upper abdomen and also the vertical scar is very bothersome as I cannot wear a bikini. Do you think the hip to hip scar can be reopened and more skin be pulled down so I have the flat stomach that I had expected. I know it takes time to heal but the fat seems to be getting worse and I work out faithfully. thank you

  Answer:  Hard to say without examining you nad seeing how, much skin looseness has developed, but it migth be possible. JG 11.13.06

• Wow! How do you keep up with the sheer volume of questions on this site? Amazing! Kudos to you. To my real question. I am 3 weeks post op from a FTT. I am still very swollen. I have heard of products on the market that purportedly help flush potentially harmful fluids out of your body after surgery. Is there any merit to these garments, or are they simply a way to make money? Is there anything I can do to get the swelling down quicker so that I may see the flat tummy I am so looking forward to? And lastly, what would happen if I were to stop wearing my binder now, and just switch to a control top panty? I feel as though the binder may be causing the swelling to be worse, and to be quite honest, very tired of it. Much praise to you and your staff. Thank you!

  Answer:  I guess I keep up by typing fast. I think the prodcuts you mention are really a waste of time, it is a matter of patience and time,nothing will speed it up except massage. I think going to a control top panty girdle at this time will not make a big difference and may well be enough. Thanks for visiting and hang in there. JG 11.9.06

• hello I had the open gastric bypass about 5 yrs ago and a full tummy tuck with the hip to hip incision and the up and down incision about 4 yrs ago and i am doing really good keeping it off.But I recently found out I am pregnant not planned, and now I am worried about my stomach and the baby. could you give me any advice or help on this matter. thank you

  Answer:  I think you will be able to carry the pregnancy without a problem to you or the baby but the tummy tuck will need to be done again I am afraid. JG 11.8.06

• Addendum to previous post: Sorry that was so lengthy. THANK YOU again for all your advice and for being so patient with all my questions! :D

  Answer:  you are very welcome. JG 11.4.06

• THANK YOU for answering my previous question I posted a few days ago. However, I do have another question. I had my FTT (with muscle tightening and only a hip to hip incision) on 10/18/06 and came home from the hospital on 10/21/06. For the first 3 nights, I slept in my recliner as this was more comfortable for me. Then, I started sleeping in my bed. I have noticed that some of the questions asked on this site are regarding the reason why we have to sleep on our backs for 2-4 weeks after the TT. Could you please tell me why we have to sleep on our backs for this time period? I have NOT been sleeping on my back as my surgeon did not tell me that I should. I have been sleeping on my right side. Today, I noticed that when I bend over, the skin above my belly button hangs down with the exception of a strip of skin down my midline. When I bend over, it looks like two small breasts above my belly button. My right side (which I have been sleeping on) does not hang down quite as much as my left side. Is this hanging caused from not sleeping on my back for the past 2 weeks and folding my skin together at the midline (hence the skin on both sides of midline not adhering to the abdominal wall)? If so, is it to late to start sleeping on my back for the next several weeks to correct this problem and to get the skin to adhere to my abdominal wall on both sides of my midline? I have also been wearing a tight fitting extra firm support girdle 24/7 religiously with the exception of showering and wound care. I have been through so much, and just want everything to come out nice and tight and flat. I just hope it`s not too late for me. Thank you for taking the time to answer my questions.

  Answer:  sleeping on one`s side just makes the swelling shift and I think that is what is occuring, the skin needs to reattach and it all will do so in time. I do not think you are doing any harm though, it is mostly a comfort thin to sleep on your back to avoid laying on the incisions. I think a little massage and shifting to both sides if you are going to sleep on your side in order to balance things out is a good idea. Not too late, just hang in there. JG 11.4.06

• I am a 30 year old female who is s/p FTT 2.5 weeks ago with a new belly button. I have only the hip to hip incision (like a smiley face). My question is this: The area above my navel still looks saggy (I can pinch it). When I lie down, it disappears. It does look better than pre tummy tuck, but I wanted to know what could cause this and will it go away to the point of where this area will be nice and flat? I have a tight girdle that goes from just under the breast to just above the knees that I wear religiously 24/7 with the exception of dressing changes and showering. I am nervous that my upper abdomen will stay this way and will not smooth out and become flat. I would appreciate any advise that you can give. THANKS

  Answer:  it might be due to the swelling so I would give it time, in most cases it tightens up some more. I think the girdle is a good idea too. JG 11.3.06

• Hello Dr. Garcia, can you please help me? my stomach muscles are still VERY tight 4 months post operation, is this normal? I want my stomach to be flat but it seems the muscles are siezed up. how long does it take for them to relax?

  Answer:  everyone is a little different, I would suggest starting with some stretching exercises, just mildy to get them used to it and then progressing as time goes on. JG 10.30.06

• Hi Dr. Garcia, Thank you for this website. I am a 55 y.o. female. In August of 2005 I had a FTT with lipo. For months, my PS kept telling I was still swollen. I didn`t think so, but I figured he was the doctor. Finally he said maybe he didn`t get enough fat out and he did some lipo free of charge in September 2006. My abdomen is still protruding. I look much better than I did before the surgery but I am still not happy. I am not flat like my friends are post op. I lost 40 pounds before the surgery. I went from 200 to 160, and I have not gained any weight at all since the surgery. What do you think? Do you think he just did not get enough fat out, or do you think he did not repair the fascia? Please give me your opinion as much as you can without seeing me. Thanks so much.

  Answer:  might have had some limitations on the muscle due to intrabdominal fat either too much to tighten the muscles or not tightened enough, hard to say without seeing and examining you. JG 10.30.06

• Hello Doctor Garcia. I`m a 36 year old mother of 2 girls who were both delivered via c-section. I had a full TT on Sep 12th. I am DELIGHTED with the results thus far but have noticed lately that at the days end, my tummy is puffy and swollen. Between the TT and exercise, I have lost 34 pounds and at least 6 inches in my waist and could not be happier with the results. I have had minimal swelling thus far and have really only noticed this new swelling in the last week or so. Is this just a normal part of the healing process and is there anything i can do to minimize this end of the day puffiness?

  Answer:  all normal from the increase in activity and will all stop and go away in time, glad all has gone so well. JG 10.29.06

• Hello Again :-) I forgot to ask a few more questions and thanks again for taking time to answer my questions. After a tummy tuck why do you have to wear your binder for 4 to 6 weeks and what happens if you do not. After the drains are removed how long does it take for the holes to close and the soreness to go away? I am currently using perxiode and neoporin as well as gauze and paper tape to cover it. Why does my stomach feel like it very tight at times especially when I have to use the restroom? How do you know if you have blood clot? After my surgery i did start walking around and i am continuing to move about. Just concerned. May many blessing contiune to come your way as you are a blessing to others. Atanta

  Answer:  we use the binder for 4 weeks to help the skin shrink and for support. Drain holes close in a few days. Your stomach is tight because of the sutures placed in the muslces. Blood clots typically cause pain and swelling in the calf muscle. JG 10.28.06

• Hello Dr. Garcia I had a tummy tuck on oct 13, 2006 and just had my drains removed on October 26,2006. (very painful)where does the rest of the fluid go once the drains are removed and can this cause an infection? How long does it take to stand up straight? I have the self disoving stitches; When is it appropriate to have sex? How long does it take for the swelling to go down and how long does the numbness to go away? I am experencing sharp needles pains which the ps said that is a sign of the sensation coming back but how long do I have to wait. Thank you sooo much for taking the time to answer my questions. You are truly a blessing. Atlanta

  Answer:  rare to cause an infection and your body absorbs the fluid that used to come out of the drains. You should be able to stand straight 3-6 weeks after surgery. Swelling will take months and as to sex our recommendation is waiting 4 weeks. Numbness may take up to one year. JG 10.28.06

• Dr. Garcia, I want start off by letting the women who are worried about swelling and not fitting their jeans, you have to give it time. I was the same way. I had a ftt done 7 months ago and every month my abdomen began to look better. My stomach is still strinking and I just bought a whole new wardrobe. Patience is definietly a virtual hang in there. My question to you doctor is, how long should I wait to pierce my belly button?

  Answer:  I think after 3-6 months is OK, so go for it and thanks for sharing your experience. JG 10.28.06

• I had an abdominoplasty last October. I still have excess skin on my love handles and buttocks. Can you do a buttock lift that includes the flanks? If you are able, please also include a cost estimate of the procedure. Thank you for your help. Ryan Huber

  Answer:  yes, a buttock lift will improve those areas. Hard to give a totally accurate fee quote as it depends on time required but I would say somewhere in the $8200 range. JG 10.27.06

• I had a TT 8 weeks ago. My question is, how do you know if you still have swelling on the lower half of the stomach. I have a lower pouch which is soft when i sit. Is this still swelling, and if not will the pouch go done?

  Answer:  it sure sounds like swelling and it can take up to 6 months to go away in some cases. JG 10.23.06

• I had a TT 8 weeks ago, n now I have developed hyperpigmentation around my scar. I currently apply coco butter to the area 4 times a day, what do you suggest?

  Answer:  hydroquinone cream might help, it is a prescription though, need to get it from your doctor. JG 10.22.06

• Hi again, I posted a question in another section, but I have another. I am interested in getting a tummy tuck/liposuction as well as lipo on my hips, inner and outer thighs. I work as a Police Officer. I am wondering how long to anticipate the recovery to be able to go back to full duty wearing my complete uniform. Also, I keep reading about alot of swelling alot of people experience, am I going to have a problem with my uniform fitting post op? Thanx.

  Answer:  well full activity is not suggested for 4 weeks after that much surgery, light duty maybe after 2 weeks. We have a person wearing a special girdle after surgery and by two weeks you should be smaller than when you started. JG 10.22.06

• Hello Dr. Garcia. I have alot of excess skin from 2 pregnancies. I am considering a tummy tuck to remove this mound I have let. It just feels heavy and hangs there. However, lately, I have been feeling a pain in my left side. The pain actually feels like a tear of some kind in the skin (internal). When I stand up, it feels like a tearing pain and only feels better when I hold my stomach up. I have been trying to find something on the internet that perhaps I can correlate the symptoms, but have found nothing. Do you have suggestions of what I can look up? If it persists and gets worse, I will go to the Dr. but wanted to research it first. Thank you.

  Answer:  might just be the excess skin pulling on the underlying nerves causing pain. If it is then the tummy tuck wil help. JG 10.22.06

• Dr Garcia, one of my friends just had a TT, and she is using Cranberry Seed oil on the scars/wound, i gotta say, her healing has doubled and it`s only been two months since the TT, almost nothing there. Could it be because of this oil? or just a coincidence? thanks

  Answer:  I have never used it but I am glad it has all worked out. I guess we will need to see it used on maybe half the incision and not the other half to compare correctly. JG 10.20.06

• Buenas Noches, muchas gracias por haver contestado a mi anterior pregunta. Estoy un poco preocupada, yo mido 5 3 y peso al rededor 112lbs, hago ejercicios todos los dias, desde que me hice la operacion de Breast Implant replacement y MTT, las cosas no han sido como esperaba en cuanto a recuperacion. Ya tengo 3 semana y 1 dia desde que me operaron y hace 3 dias aparecio un dolor muy intenso en un costado de mi estomago, al lado derecho, cerca de la herida de MTT, acabo de hablar con al enfermera y me recomiendan que vaya a emergencia. No puedo creer por lo que estoy pasando, no tengo fiebre, osea que no es infeccion..en la parte de arriba de donde esta la herida de MTT esta mi estomago duro y muy sensible...que me recomienda? Gracias por todo y por su tiempo.

  Answer:  un poco de calor con una toalla, probablemente es uno de los musculos que esta iritado. Buena suerte. JG 10.20.06

• hi dr garcia , i`m 47 yrs old f , i`m going tt & mr on nov 20 , i`m wondering what do u think of someone wieghing 280 lbs at 5`8 getting this done .i had 6 kids and my belly is big and even when i loss wieght my belly is still there ,

  Answer:  Well, hard to say without seeing you but I think the results are not going to be very dramatic in terms of narrowing your waist with those dimensions but it should remove the skin that might be hanging and causing irritation in your private parts. JG 10.20.06

• Hi Dr. Garcia...I am two weeks post-op from a full tummy tuck....question..my BB is oozing a clear fluid and it seems to have a little teach right below it....I can see some white skin and I am African American....is this normal? I am cleaning it daily with peroxide, but I am unsure of what it come be. Also, right above my pubic hair my incision didn`t close properly it seems open, my PS said it was fine..to wash it gently and apply neosporin..thoughts? Additionally, this may be a crazy question, but how long will I have to sleep on my back?

  Answer:  it is just some areas of slow healing that eventually will close with the treatments you are doing. As to sleeping on your back, just for 2-4 weeks or so. JG 10.20.06

• Hi, I had a full TT with Lipo on back 16 days ago and still have jp drains in, is it possible to feel those move? I`ve been experiencing a sort of grinding type, seems like somethings moving feeling in my lower abdomen for about 1 week when going up stairs or straining for BM, I`m worried about possible hernia at incision or lower pelvic region? What do you make of it? No lumps or anything else unusual going on.

  Answer:  it is possible for you to feel the drains moving around. Nothing to worry about most likely. JG 10.18.06

• Dr Garcia, i have a weird question? can the stomach skin be pulled up from underneath the breast? i have a very small sagging upper stomach, very small and a tad wrinkled as well, if i were to measure it it will be like a small finger in with. i notice that is i stretch my skin upwards towards the breast it goes away right away. I don`t want to have a scar in my stomach, and i`m pretty much flat on the lower stomach as well. thanks

  Answer:  it can but it will leave a scar that crosses over the breast bone and can be seen in certain tops. JG 10.18.06

• Hello Dr. Garcia. I had a FTT 3 weeks ago. I am concerned about the scar. It is starting to hyperpigment. Grrr. I have problems with pigmenting after injury. Would it be OK to put hydroquinone 4% along the scar line to avoid too much pigment from forming. Thanks! Have a great day.

  Answer:  yes, OK to do so, or use ScarGurad. JG 10.18.06

• Acaba de realizarme un MTT pero todavia quedaron muchas estrias quisiera saber si el laser Relume me ayudaria a disminuirlas y cuanto debo esperar para comenzar a usarlo en la herida tambien

  Answer:  no creo que merece la pena. JG 10.18.06

• Cuanto tiempo debo esperar para realizar un segundo MTT.Gracias

  Answer:  por lo menos 6 meses. JG 10.23.06

• De antemano gracias por sacar tiempo a contestar mi inquietud,hace 4 semanas tuve un tummy tuck me tallaron los musculos y me hicieron mi ombligo nuevo,pero a pesar de q mi estomago se vea muy plano mi ombligo quedo muy arriba y eso me hace sentirme muy mal y al lo finales de la herida se han hecho como bolsas quisiera saber si puedo realizar otra operacion para intentar estirar mas la piel patra bajar mas el ombligo y cuanto debo esperar para operarme de nuevo.Muchas gracias.

  Answer:  si, creo que con otra cirugia se puede mejorar, se tiene que cortar mas piel y hallar para abajo. JG 10.17.06

• Como esta Doctor Garcia? Antes que todo quisiera darle las gracias por tomarse el tiempo en contestarme la siguiente pregunta, Hace 3 semanas, tuve Mini TT, mas cambio de protosis ( senos )que ya tenia 10 anos. Desde la operacion no he tenido mi estomago plano, esta muy hinchado, hoy me levante con un dolor en el lado derecho, 2 inches arriba de la insicion pero al lado derecho, se siente como cuando corres y tienes que parar porque un dolor al lado derecho no te deja correr.....no me puedo parar derecha, es un dolor fastidioso, que no se va con tylenol, se siente como una puntada, estoy pasando por un poco de depresion, aparte de eso en la parte de abajo de mi hombligo tengo un protuberancia o una bolita hichada..que puede ser eso? y la protosis de mi seno derecho esta mas abajo que el izquierdo, ( un poco pero se puede notar ) como se puede solucionar esto? Gracias por su tiempo, y cuando voy a poder ver mi estomago flat ??? Que tenga buen dia.

  Answer:  el dolor probablemente es los puntos cual le pusieron en los muscolos y en tiempo se mejora. La bolita puede ser un poco de sangre o liquido que se tiene que absorber. Con la protosis, se puede poner un brasssiere para mantenerlo en posicion, y debe de ver a su cirujano. El estomago alomejor le tarda un par de meses. Buena suerte. JG 10.17.06

• I had a TT on June 7, by the 14th, I had already started running a very high fever. I was prescribed antibiotics. On the 17th, blood and puss started running out by my drain tubes. On the 23rd, the doctor removed my drain tubes. I had beed complaining to the dr. that I was in extreme pain and couldn`t stand up without hurting. All he would do is prescribe me more pain pills and has yet to even take my temperature. On the 30th, I went to the E.R. because my left side was swollen so bad and so sensitive, they done a swab test but wouldn`t touch me (their exact words)and sent me to my dr. He told me everything was fine. July 6th, I went to my regular physician, the E.R. tests were sent to his office and showed staph infection, he gave me antibiotics. The same day I went back to my dr. and he said all was fine and gave me more pain pills. on the 7th, I side busted open ( a 4 inch by 3 1/2 inch hole). On the 11th, I went back to the dr. and he removed the stitches form my b.b. and done a swab on the hole in my side only after I showed him the antibiotics me regular physcian prescribed me and after he argued saying the tests were wrong. On the 13th, the dr. called saying the test results were in and it showed staph infection and gave me another prescription. I finally got all the pain gone and thought I was getting better. Until last week I started hurting again, I went to my physicain again (10-16-06) and he said I am infected again, saying now it is fat necrosis. After all these months, and all the pain, I now wish I would have never had this procedure done. Any advise on what I shouls do now? Please help. I am also trying to find another plasticd surgeon because he sure hasnt impressed me much . thanks!!

  Answer:  sounds like another surgeon is a good idea. You will most likely need some wound exploration and debridement of all dead tissue so the infection can be controlled. Best of luck. JG 10.17.06

• I had a TT 8 weeks ago. I had thought that it had removed a ;lot of stretch marks that I had. I just had my Post op pictures taken and notice that I still had lots of them. My question is can the strtch marks occur from the skin being pulled tight, and then loosing up? It seems that that are rising up from the TT scar,

  Answer:  very unusual for them to form from the surgery, more likely is that they were not able to be seen as easily due to the swelling making them look like they were gone and now that the swelling is down you can see them on the skin that was not able to be removed. JG 10.16.06

• Hello Dr. I had a extended TT 4 weeks ago and I feel great, however I have developed a soft/fatty lump about 1 in. above my Belly Button, what can it be? Should I be concerned?

  Answer:  most likely a little fluid that in time will go away, nothing to worry about. JG 10.15.06

• Yes, the man upstairs will ABSOLUTELY see you as a generous man to give of your time this way. Thanks for your reply. I guess I`ve really got a problem then, my WHOLE abdomen itches from my navel down to my scar almost 2 years post-op. I can scratch and scratch with no sense of relieving the itch. I will try the cream but additional surgery is out of the question due to expense. I am also the one scheduled for the Alloderm graft and facelift. God Bless you Dr. G!

  Answer:  keep me posted, hang in there. JG 10.14.06

• What is the recovery time of a tummy tuck and what does the procedure actually entail?

  Answer:  2-4 weeks down time and it involves removing the excess skin from the front of the abdomen and tightening any loose muscles if they need it. JG 10.13.06

• Is velasmooth treatment effective? Could you explain to me, what it exactly treats?

  Answer:  I think is is effective for the treatment of cellulite, but it is not permanent. JG 10.13.06

• First may I say that you will earn your rewards in heaven. How giving of you to help women such as myself in giving the advice you do. God bless you. Next, I too have a question. Almost 2 years ago I had a full tummy tuck. I love my results I just have obsessive itching. An itch that won`t resolve since the skin is somewhat numb yet the underlying tissues are what itch. Will it resolve? Ever?

  Answer:  well, I hope the Man upstairs is listening, I can always use a little help. As to the second point, the itching you describe is uncommon, it might be due to some small nerves being caught in scar tissues. Assuming nothing you have taken orally has helped, if you could isolate it to a small area it might be able to be injected with a steroid or local anesthesia to see if it will get better. Itching is very common for the fist year or so, but this is past the norm. Repeat surgery might help, in terms of releasing the scar tissue, but it also might do absolutley nothing or make it worse. I would start with trying some Capsacin topical cream, available OTC at pharmacies and see if that helps over time. All the best. JG 10.12.06

• I would like to thank you, you have been so helpful. Also, I have a severe problem with my love handles. I have had lipo on them 6 years ago and find that they are bigger than ever. What can I do other than lipo?

  Answer:  may just need more aggressive liposuction, cutting them out can leave long scars. JG 10.12.06

• What doctor in NYC would you recommend for the velasmooth treatment? Thank you again.

  Answer:  Due to potential legal issues, and some doctors wanting to know why I referred a patient to someone else and not them, I think you are best to go to this website and look for a plastic surgeon in the area you desire. I wish you all the best. JG 10.12.06 www.surgery.org/public/findasurgeon.

• I have had only one kid and my stomach is horrible. I feel so insecure due to it and it affects my personal life severely. I have indents, stretch marks and excess skin. Is there anything you could recommend other than a tummy tuck? Will exercise help me, creams or anything other than a tummy tuck? Also, if a tummy tuck is my only resort, will I be able to have more kids after the fact? Thank you for your help. I really appreciate it.

  Answer:  A tummy tuck is the best option but it will be all torn if you get pregnant again and the tummy tuck will have to be repeated. JG 10.12.06

• Since after a tummy tuck there is lots of swelling and fluid for months afterwards, what happens to the skin when the fluid is gone and the swelling goes down...it seems like there would be loose skin where the fluid was taking up space.

  Answer:  it usually shrinks pretty well. JG 10.12.06

• why does it tAKE SO LONG FOR THE LOWER PART OF YOU STOMACH AFTER A tt TO GO DOWN?

  Answer:  please see adjacent answer

• Hello Dr. Garcia, my question is my stomach is still swollen, I am 8 weeks post op from a TT. The lower area is still swollen and sticks out. I did not have this problem prior, will it go away and if yes how long? Secondly, how long does it take to get the sensation back in your stomach after a tummy tuck? Thanks

  Answer:  please see adjacent answer. JG 10.11.06

• I am 6 weeks post op from a ftummy tuck. The majority of my stomach is flat except for the lower part. I am insecure because I a pouch. It looks really funny. Im not sure if the muscle is still swollen. When I sit down, it looks really bad. Is this normal? If yes, how long does it take for the swelling to go down on the lower part of the stomach. The swelling is in the supra pebic region, as well as above it.

  Answer:  all normal, it talks a long time, at times months, for that area to get flat, hang in there a little longer. JG 10.6.06

• Hi Dr. Garcia First I would like to say what a great site you have. I had a full tummy tuck and a breast aug. I am very happy with my breast but however not so with my tummy tuck. My belly is very flat now and I have 94% less sketch marks which is very good. It will be a week tomorrow since I had these done. I peaked at my belly today because (I have not seen it, I see my doctor tomarrow to have my drains out hopefully)I was so sick when I saw my belly button. I have a ton of stitches around my belly button and my belly button looks like a wrinkle and it is very fluffy around. I always had a cute BB and now I am depressed of ever having this done. Looks like my Belly button is closing. My mother in law had a TT and said hers were inside the BB and she only had two. I got tape on my tummy tuck incision and as well on my breast. I find my belly button horrible. Are all those stitches suppose to be around my belly button?? Why would my doctor do that and why does my belly button look like its closing?? Please reply. I will ask my doctor but I felt I should ask another just in case he might just say its normal. Thank you in advanced, Jessica

  Answer:  thnaks for the kind words. The stitches are not uncommon and they will be out soon so it will not look that way for long, they are there to keep the skin edges together to let it heal well. Sometimes the stitchs below the skin do not oppose the skin edges well enough on their own.If it looks lik$e it is closing your doctor may suggest placing something in the belly button to keep it open until it is done healing. He/she can tell you when they see you. Best of luck. JG 10.5.06

• I had a tt and hernia repair and diastasis recti repair just over 9 weeks ago and developed seroma. (I am extremely happy with the results of the abdominoplasty) I`ve been going in regularly to have it drawn off, the first time was 270 cc, 4 days later another 250 cc`s and then less each additional time. I`ve probably had fluid drawn off 8 times now. He removed about 75 cc`s two weeks ago and I still am having a build up. Another cosmetic surgeon was extremely concerned that this has lasted for more than 2 months and thinks there might be a possible bursa issue. My insurance only covers for complications within the first 3 months. Is this something that sounds odd to you that it`s lasted this long and should I be running back to my dr to get him to remove a bursa before my 3 month mark is up? Also, my mons pubis was very swollen but is still rather large and jiggly, should I ask for a repair of that if they end up having to reopen me?

  Answer:  well a bursa most times will close off in time, I think more frequent aspirations to allow the bursa to close is best, but if you are coming up on a time frame of needing it covered, then it might be wise to go ahead. Understand that although it might sound very easy to go in and remove a bursa, one needs to understand that there are many causes for a seronma to form and removing the bursa can cause bleeding and lymphatic drainiage too that will cause a repeat bursa that may need aspirations again. It is easy to criticize another and suggest other options but I will tell you, removing a bursa is not guarantee that the bursa and seroma will not continue, and thre are the added risks of a repeat anesthetic. As to the mons, that might be able to be tightened at the same time but it depends greatly on the quality of the tissues, those with poor quality skin and tissue with contributing medical problems may not heal as well as others. I think you should be frank with the surgeon, him/her them your concerns, but it is usually not as easy as the second opinion doctor has suggested. Best of luck. JG 10.5.06

• Hey Doc! Do all PS all use external sutures around the navel? It seems the internal stitching makes a much nicer scar. Thanks :)

  Answer:  no, it depends on how the skin edges oppose at the end of surgery, skin sutures when placed are meant to align the skin edges better and when needed will lead to a better scar than when they are needed and not used. JG 10.4.06

• I had a tummy tuck with repair of the rectus muscles and then reinforced with aloderm about 3 1/2 months ago. I am just now experiencing a sharp pain just below my sternum to the left of the repair incision. My doctor told me I tore the fascia but did not have any hernation due to the aloderm. Is this normal and should it heal on it`s own?

  Answer:  well, it is unusual to use alloderm for rectus repair, I think you might have pulled the rectus or torn some of the sutures, and I do agree that herniation is rare but if you tore part of the muslce it will take weeks for it to heal and the pain to go away. JG 10.4.06

• your site is the greatest of all. thank you in advance. If you dont place anything in your navel aftre a tt, will it close all the way? Or will it look like an inny ? I had a tt 6 weeks ago and my hole seem to be closing more and more each day. Thanks again.

  Answer:  no, that is rarely done. If it is closing I think you need to see your surgeon. Thanks for visiting. JG 10.4.06

• I had A belt lipectomy and butt lift with skin and fat grafs 1 week ago. I am still draning a lot and kinda scared. Also right down the middle of my stomach there are stretch marks that i never noticed before. I have always had stretch marks on my belly but these are really big and white. I am wondering if thats just swelling? The operation took 8 1/2 hours.. More than i expected because the doctor and I werent sure if he was going to fix my backside. He ended up doing that. I am just wondering becaue my surgery was so extensive is it okay to be draning DARK red from on of the 4 drains? I am actually standing up straight walking very well up and down stairs.. So other wise i am in good shape.. Also can i use Vitimin E capsules opened up on my arms Like i always have or can that cause a problem? Answer:

  Answer:  all normal for what you had done, I would use a lotion with Vitamin E rather then opening the capsule to avoid getting plugged pores. JG 10.2.06

• Your website and e messeger played such a big role in my tt operation. I was prepared because of these writings.Thank you so much. Anyways, I had a tt done 5 weeks ago in the islands, I had no problems I was walking straight by the 2nd day, no pain, no complications, just swelling which I know is normal but 1 day ago I noticed a bump inside my navel,I was placing a marbel there in order to keep it from closing, today I realize the bump is softwhen you touch it, it looks like puss or something is in it. I am very nervous because,I dont know what this can be. I also look very swollen like before the tt, but early in the morning I am flat. You really cant notice it when I am dressed. Please help me; Im going crazy overthis.

  Answer:  warm packs and massage, might be a small superficial infection, if it pops open and drains just keep it clean with peroxide and neosporin, they usually close on their own, not an unusual problem. Best of luck. JG 9.30.06

• I`m a little concerned about the time line post op for being active again. I noticed ALOT of ladies asking questions about post op popping stitches etc, and problems being active 4-8 weeks post op, and I was told I could go back to the gym to lift, 1 week post op as long as I had support (back rest, machine based lifting). Keep in mind that I am a trainer/ fitness instructor. I am currently 6 weeks post op. My PS said after 3 days I was upright and walking better than most, and at day 5 when he took out stitches and drain tubes by 1 week I could go back to gym. He also said by week 3 I could do whatever I want as long as I feel good and feels okay to do. My question is this normal and can I be doing any damage? My endurance based training IS heavier than most women (Horizontal leg press - 150lbs 40 reps,, 170lbs 18 reps) I have had some fluid drained from my upper rectus region, and the fluid has come back again, but my PS said it is not harmful fluid and my body would eventually absorb it. I am not feeling pain. Am I okay to continue?

  Answer:  Well, every patient is different, I allow full weight lifting without limitations after 4 weeks. JG 9.30.06

• Dr garcia, What do you think about velasmooth? i have some sagging in my stomach and i was thinking of trying that out instead of mini TT. thanks

  Answer:  I think it works in some people, does help smooth cellulite out in some but as to skin tightening, I think the effects are small. JG 10.1.06

• 2 weeks ago I had a tummy tuck, and unfortunately I cannot fit into any jeans, all way too tight in the midsection, I thought having a tummy tuck was was supposed to help this situation, is this all just swelling and when can I expect to fit into my jeans again

  Answer:  well it is hard to tell without examining you and seeing what the surgeon did, it might be swelling, it also might be that the tightening of the muscles pushed the intrabdominal fat out laterally leaving you with no difference in your abdominal width. If someone has a large amount of intra-abdominal fat, a tummy tuck does not always make the waist smaller. That should be able to be seen before the surgery. JG 9.30.06

• how can you tell if some of your sutures can apart from a full tummy tuck?

  Answer:  you can at times feel a depression between your rectus muscle in the center or a bulge when you strain your abdomen while lying down. JG 9.27.06.

• I am 4 weeks post op from TT. Below my belly button is still really hard and the bottom half sticks out like a pouch. Is this normal

  Answer:  all normal but will take a number of weeks to soften and shrink. JG 9.27.06

• Hi Dr. I had a TT & Breast lift w/ 400 cc silicone implant done in early June. It seems like i am heavier after my surgery. Does your metabolism change from having these procedures? Is it now going to be easier to gain weight in the stomach...or will any weight gain (5-9 pounds) just show up more since this surgery? My stomach area and lower areas seem to be gaining alot of weight! Is my body somehow accepting fat in my stomach area to make up for what was removed? i had twins 3 yrs ago and gained 70 pounds. i lost all but about 10ish of those pounds way before the surgery. My sister said she can`t seem to lose weight a yr after her TT surgery too. I`m really scared! is this normal? thanks so much for your reply

  Answer:  well the implants alone weigh almost two pounds, and the inactivity for a while afterwards does tend to allow you to gain some weight but most of it should come off once you get back to your normal routine. Your metabolism does not change after the surgery. JG 9.27.06

• I`ve seen a few people ask about popping the internal stitches from a ftt. Working in a gym, I`m always lifting weight or moving machines around. At times I push and/or pull up to 250lbs at once. I am 10wks PO myself so I am concerned of course. My PS said I could lift as much as I wanted and that the stitches won`t come apart. Does exercise without restrictions include this kind of weight lifting? (I am a woman 113lbs) Yes...I already know this is bad for my back lol. What percentage of ftt stitches do come apart? Am I at a higher risk or is that really determined by my PS`s work? Thanks for your help :)

  Answer:  by 6 weeks they are pretty strong and if you are already doing it without problems I think you can continue. It is affected by both the surgeon, the choice of sutures placed and also the quality of your tissues. JG 9.26.06

• I am 2 1/2 weeks post FTT. My upper abdomen is swollen and hard. I went to the dr because I was concerned. He told me that I tore some of the sutures, and the only way to fix it was surgery. Is surgery the only option?

  Answer:  I am afraid so, sorry. JG 9.26.06

• I thank you so much for answering my question. I am 4 weeks post-op - my surgeon said that my scar is pulled and raised becouse it is inflamed - he is going to give me cortisone shots. is that going to solv the problem...if that doesn`t hoe long should i wait to ask for scar revision...

  Answer:  I think it is a good place to start. JG 9.26.06

• I am 4weeks op op from a tummy tuck and ba can I start walking or riding an exercise bike or is it to soon.

  Answer:  we personally let them begin at 4 weeks if all is OK. JG 9.25.06

• I have never seen a better internet site and so much insites and support to people that have done cosmetic surgery. Thank you ..I had a tummy tuck four weeks ago. My scar is not a strait and the the skinen is pulled so tight that there is a small puffines above it, do the stomak does not look flat with a scar..i am using the topical silicon cream and the scar looks better .My only concern is about puuled scar line - i had a few of my friends with a same procedure, they were all swallen, but their scar did not look so pulled and tight...any suggestions...also i would like to ask you if the abdominal definitions is posibile with lots of abb work after this surgery..thank you for all the honest answers on this web site.

  Answer:  the pulled issue should get better in time as the skin relaxes, that can happen if the skin was aggressively pulled and a lot of skin removed. It is common for swelling to reside right above the scar, I suggest massaging it to the sides to let that fluid go over and around that scar. As to abdominal muscle definition, it needs two things, thin subcutaneous fat, which might be and might not be possible after your tummy tuck, since I have not seen you, along with aggressive muscle development, but if you have both of those, then yes. Thanks for visiting too. JG 9.21.06

• Dr. Garcia I had a tummy tuck 4 weeks ago and a ba my questions is how long will it take for the swelling to go down above and below my scar. My stomach is flat except for the part below my stomach. It fells really hard. Will it soften. Secondly, my PS is going to open the suture on one of my breast to lower my implant. Is this normal? I had old implants removed and the new ones look smaller. My PS said that my implant size is 375 and he filled the implant to 425. I am not happy with the size of the implant. I am thinking about going up to about 500 to 550cc will this be a noticeable difference.

  Answer:  it might take a few months to go down. The swelling makes it feel hard but it will all get better in time. As to relaesing the implant, it is not common but not rare either, it is needed at times. I think going from a 425 to a 550 should be a noticeable difference. JG 9.19.06

• Dr. Garcia, Its been about 7 weeks since I have had my tummy tuck. Every time I ask anybody at my plastic surgeon office about any concerns, i get the same ansewr which is that everyting is normal. Most of the time, I have this hardness around and above my belly button area and sometimes a little pain and bloatiness that i have to rub on the area. It also sticks out, sometimes it looks as if I`m pregnant. The lower part of my abdominal is flat, but now it looks opposite from before i had my tummy tuck, it`s the upper part that is sticking out now. Do you think this will go away? Should I bring this to my surgeons attention? What signs should I be aware of? Do you think I am going to need more work done? Crystal B

  Answer:  it should go away, hard for me to say without examining you but I do think you need to bring it up with your surgeon. There is a possiblity for you to need a little more work, more muscle tightening on the upper abdomen. JG 9.19.06

• Dear Dr. Garcia, I am a 29 yr. old mother of two girls. I was sure two years ago I was finished having babies and finally underwent a full tummy tuck and lipo in the waste area. My husband and I are continplating a third child but I am extreamly scared of what the after math will be. I will be deliverd via c-section gaurenteed. I was always overweight and this is the first time in my life that I have ever had a flat belly, tight and hard. I know by reading the other questions in the blog that you say the tummy will need to be redone because the pregancey will destroy everthing but how bad will it really be. I am intrested in any photos you might have of any patients who have had a pregancy post tummy tuck. I can`t express enough how scared I am about how ugly I will look, I am mostly scared that I will look deformed will that happen?

  Answer:  I do not think it will be any worse than it was before. I must say that I don`t have any photos after a pregnancy and a tummy tuck, I have done a handful of patients but they have not given permission for us to circulate their photos. JG 9.18.06

• I'm 4 weeks post op from ftt and am still quite swollen. My major concern is that I still have my original belly button, despite having a ftt. Is this possible? From everything I've read, a new belly button is necessary when performing a ftt. I have a scar from hip to hip but there is still some loose skin above the belly button and my stomach dips in at the centre below the belly button just like it did before the surgery. My surgeon assures me he performed ftt plus m/r but I can't understand why he didn't take more skin out - he only removed a section about 2 inches long. The whole reason I had the tt was because I hadn't the hanging skin when I bent forward. It looks like it's still there but now it's filled with fluid. Is it possible my surgeon didn't do a ftt after all??? I'm really disappointed as I can't imagine how the skin will contract back in after so much swelling. I looked better before!!! SP. Australia.

  Answer:  I think it is due to swelling at this point, and without examining you it is hard to tell you about the belly button but a new one is not always created with a full tummy tuck, at times it is just moved. JG 5.7.06

• Hi Dr. Garcia, I had a full tummy tuck and muscle repair 6 months ago. Is it normal to still have a red ring around the belly button, as well as a thick red scar across the abdomen? How long does it take to lighten up completely? I've had a stressful time since the surgery. I lost my mother 1 month after surgery, and 2 months ago was diagnosed with breast cancer, for which I'm now receiving 61/2 weeks of radiation therapy. Would this make it heal slower? Is it normal - and will the color eventually fade? The red ring around the belly button is noticeable, although otherwise it looks well shaped, and the belly is flat. Thank You for this site. :-)

  Answer:  not uncommon, patients vary greatly in how they heal and at what speed. It might take a full year to get the end result in terms of the scar fading. The radiation should not affect the healing to any great extent and I am sorry for your loss. JG 5.4.06

• dear dr.g: Is the diastasis repair as involved as the tt/mr I went through 6 months ago?i.e.,drains and will their be additional incisions, if so would they be placed in the old incision area? what are the complications

  Answer:  pretty darn close. They should use the old incisions. Complications are infection, fluid collections and tearing of the sutures allowing the diastasis to recur. JG 5.4.06

• I HAD A TUMMY TUCK 4 WEEKS AGO, MY SCAR FEELS SOFT AND IT LOOKS LIKE IS HEALING VERY WELL. THE PROBLEM IS THAT IM FEELING A ROUND LUMP UNDER THE SKIN RIGHT ON TOP OF THE VAGINA AREA SCAR. IS THIS NORMAL, ALL AROUND THE SCAR IT FEELS FLAT EXCEPT IN THE MIDDLE. THAT SMALL LUMP.RK. THANK YOU.

  Answer:  normal and should flatten out in time. JG 5.4.06

• I had a FTT 10 months ago and still not flat. I still feel some numb at the belly. Is this normal or do I need a Lipo done to have my tummy flat? Please advice. Thanks.

  Answer:  may need a little liposuction done. JG 5.3.06

• I had a tummy tuck 12 weeks ago and am VERY swollen especially in my upper abs. They are puffy 24/7 and when I bend forward my upper and lower abs meet together like two separate large rolls. They are nowhere near being flat. Am I being impatient or is something amiss here? Also can exercise make swelling worse? I am not allowed to do direct abdominal exercises, but I do workout 5-6 times per week now. HELP! Thank you.

  Answer:  well, swelling should be going down by now. I suggest seeing your doctor to see if you have any fluid that can be aspirated. JG 5.2.06

• I have small amounts of stubbon tummy & lovehandle fat. I also have a flat bum. Would fat transferal frm tum to bum be possible? How precise can such bum sculpting be?

  Answer:  it is possible but long term results show it might not survive forever. JG 4.30.06

• Thank You, Dr. Garcia for your fast response, last week I asked you about the infection I had developed after 4 weeks I had had the tummy tuck. This week I was seen by an infection diease doctor and a dermatologist the dermatologist didnt believe I had a cellulitis infection so he prescribed Betomethasone oitement which immediately started working and the redness is almost gone and the infectionist stated it doesnt seem theres any more infection so I dont believe we need to research anything but if theres no more infection why am I still very swollen above my incision it loks like a have a small ball inside. Is it going to go away or not I wasnt like this before the surgery. I am back to my routine with exercise but i dont see improvement . SF

  Answer:  the swelling is common even without the redness and is normal and will go away but it takes time. It might take a few months though, hang in there. JG 4.30.06

• drg: I asked you previously about my pelvic area still swollen/protruding after 6mos ftt - you mentioned check w/PS re MR may not have held up - what is the correction procedure for this thanks so much. vj

  Answer:  it would need the muscle being tightened again, so it an be called a diastasis repair. JG 4.28.06

• Dr, I was the one who asked about the puffy stomach after a tummy tuck. Would I have to undergo surgery again if fluid is accumulating under the skin?

  Answer:  you may just need a needle apsiration to remove the fluid. At times a drain can be placed though the skin if it continues to reform. JG 4.23.06

• I had a FTT 8 weeks ago but 4 weeks after surgery I develop an infection(fever and chills)under my scar(rednessa)my surgeon and primary Dr says its a cellulite infection . I been in an antibiotic for 4 weeks and the redness is not gone . I no longer have a fever or chills but the redness doesnt seems to go . I am still very swollen . my Drs say the infection might take upto 2 months to go away . I would like to know if you had had cases like this or if its common. Thanks SF

  Answer:  it is not common, but can happen, and it sometimes is hard to treat because the fat underneath the skin may not be getting enough blood flow to deliver the antibiotics to cure the infection. Hang in there and give it some more time. JG 4.22.06

• Dr.Garcia How bad is the scaring after a FTT? Thank You.

  Answer:  it depends on how tight the closure is done and how much skin is removed and if you smoke or have diabetes, they typically are not hairline scars but can look pretty good. JG 4.22.06

• i had a mini tt 3.5 weeks ago, my stomach when i laugh gets a really tight feeling and almost pulsates. Can you do any harm to the stitches inside by laughing?

  Answer:  no, it is just the muscles getting used to things, it will all get better in time. JG 4.22.06

• I had a tummy tuck about two weeks ago and my drains were just taken out but I think it was too soon. What can happen if the drains are taken out too soon?

  Answer:  you can develop an accumulation of fluid below the skin. JG 4.22.06

• I had a tummy tucks about two weeks ago and it seems as if my stomach is getting puffy. Is that normal?

  Answer:  yes, it can be swelling or a fluid accumulating below the skin, you should go back and see your doctor though. JG 4.22.06

• I have a hiatal hernia with no current symptoms. My GI doc said a ftt/mr shouldn't be a problem. My ps didn't seem to be concerned. I am very worried that the acid reflux may return with a vengence. I was advised NOT to have surgery for the HERNIA as it often results in other problems. Have you had patients with a hiatal hernia. If so, any complications? What is your opinion - would you do the ftt/mr surgery on a patient with no acid reflux symptoms? Thanks so much!

  Answer:  well, the tighter the muscles are tightened, the greater the chance of the hiatal hernia symptoms coming back. It is just a pressure thing I am afraid. JG 4.22.06

• I am almost 4 weeks post op from a mini tt, I have returned back to work this week, I am on my feet for practically 8 hours, I notice at night my stomach muscles seem to throb and feel very tight. Is it bad that i am on my feet this long? I do try to sit when i can for short periods. I had alot of muscle repair and notice my muscles just feel really tight out of the blue and then it stops, once and a while I also get sharp twinges and a burning feeling. Is this all just normal healing stuff? How long does this all take until it stops and I feel normal again? Also I play softball is it a good idea for me to take this season off or will I be okay to play? Thank you for all your advice, this sight is great!!!!

  Answer:  no,nothing bad but what you are felling is normal, a small girdle at work might help. All of that is normal and wil go away in time but it might take a few months. Softball may be tried in 2 more weeks but you will not be 100% I am afraid. Just stretch before the games. Best of luck. JG 4.22.06

• What can i do if i need m/R after tummy tuck?

  Answer:  it can be fixed but the incisions will not necessarilly be the entire length of the tummy tuck ones. JG 4.21.06

• Hi Doc. Is it possible to develop defined 6 pak abs after having a tummy tuck? All after pics of post tummy tuck patients are just flat tummies with no definition. Thanks.

  Answer:  yes, but you need to have little subcutaneous fat and very well developed muscles. JG 4.19.06

• I have had 2 csections and my abdomen hangs down and is lopsided. I am considering a tt,but am concerned about the risk of general anesthesia. Last year during general anesthesia, my optic nerve was damaged and I lost vision in one eye. Most likely due to low bp and ischemia. I know I have an increased risk of this happening again. I was wondering if tt can be done under sedation and local? thanks, jsw 4/19/06

  Answer:  it would be tough to get the muscle tight but maybe a spinal or epidural could be used. JG 4.19.06

• My skin is loose after my tummy tuck. Why?

  Answer:  skin stretched out from swelling and it should tighten up in time. JG 4.19.06

• Hi Doc. At 8 weeks post FTT op, I continue to swell as the day progresses and remain swollen till following morning. I suspect it will go on for at least several more weeks. I've been supplementing with bromelain (1200mg/day). Is there any point at this time to continue with the bromo? Should I just let nature take its course and forget the bromo?

  Answer:  I think at this point the bromelain can be stopped and I don't think it will do much any longer. Go ahead and stop it. JG 4.18.06

• Hi Doc, thanks for all your help in the past. I am 10 weeks post-op TT and was wondering if I should still be wearing a garment overnight to help w/swelling. I'm so puffy most of the day and it's really annoying. I stopped wearing the garment permanently a few weeks ago but I'm wondering if I stopped too soon. Also can you recommend a good scar product? I've been using silicone strips for 6 weeks with absolutely no change. Thanks, you're the best! 4/18

  Answer:  I like ScarGurad for the scars and you may benefit from a small girdle during the day to help with the swelling. Hang in there. JG 4.18.06

• Hi Doc. I start my 8th wk post FTT, today. Been working out everyday (cardio and weight training) however not as heavy and hard as pre surgery. At the end of this wk I should be training as before. Is there anything I can do to pull or tear those permanent stitches, like weighted reverse crunches, weighted pull ups, rock climbing, heavy squats (at 2-4 reps max range)?

  Answer:  just use common sense, if it hurts, back off. JG 4.18.06

• From what I understand, in the extended abdominoplasty the scar extends around the flanks onto the lower back. Will it be possible to have a modified version of this proceudre in which the belly button is not repositioned, but the loose skin on the flanks (my biggest problem area) can still be addressed? thanks

  Answer:  yes, more of a buttock lift. JG 4.16.06

• It it normal to get swollen after 2 months of tummy tuck?

  Answer:  it can happen depending on the type of activity. JG 4.16.06

• Dear Doctor, After reviewing this page, while full of a lot of useful info...it appears that all tummy tuck patients are plagued with long term swelling, pain and complications! Would I be correct in assuming that this page actually represents a minority of patients who are seeking advise for problems and that most patients are very satisfied and actually do achieve desired results!? Thanks JU

  Answer:  you are corrwct, most people do very well. JG 4.16.06

• Hi Dr. Garcia. I have gone from about 260 lbs to 180 and I am 5'8. This has had an enormous effect on my body and I am considering and arm lift, tummy tuck, breast lift/augmentation and liposuction on my thighs. Will these need to be divided iinto different surgeries or can they all be done at once? If so, how would you divide them? Also, I am only 25 and do not know if I want children, will that effect being able to have a tummy tuck? Also I am still 20 lbs above my goal weight, should I wait until I reach that weight? Thanks.

  Answer:  I strongly suggest they be divided into at least two and maybe three. I would do the liposuction and arm lift, then the breast lift, and then the tummy tuck and augmentation. Children in the future will affect the breast lift and the tummy tuck both. I suggesting being within 10 pounds of your goal weight. Best of luck and congratulations on the weight loss. JG 4.15.06

• Almost 8 wks post FTT w/Lipo and still no changes in my measurements. Although the contouring is more pleasant, I seem to look wider instead of slimmer. IS THIS NORMAL?

  Answer:  well, if there is an appreciable amount of intra-abdominal fat before the surgery and the muscles are tightened, in some cases the waistline can become wider. That is a decision that should be able to be assessed prior to surgery. JG 4.15.06

• dear drG: I had a tt/mr 6 months ago and the pelvic area still seems large as if it is swollen - is this normal and should I do anything about it.vj

  Answer:  I suggets seeing the surgeon and seeing if the muscle repair has held up. JG 4.14.06

• At 2 months of a tummy tuck do thing i am still swollen?

  Answer:  yes, still some swelling. JG 4.14.06

• How long will it take for me to stand stright up after a full tummy tuck. It has only been three days and I am moving around and standing a little straighter than day 1.

  Answer:  next few days should get better. JG 4.14.06

• When someone get a tummy tuck do they also need to get m/r? and why?

  Answer:  only if the muscle is loose. JG 4.12.06

• I had a tummy tuck 8 weeks ago. how long to i have to wear a tight gartment?

  Answer:  we usually stop ours after 4-6 weeks. JG 4.12.06

• I am 9 weeks post tummy tuck. Over the weeks my belly button has become redder. It wasn't really red at all post-op, but within a few weeks it was and now it's not going away. Is this normal for redness to appear where there was none before? It's basically on the perimeter of the BB, not inside. How long can this last? I finally can wear a two piece bathing suit and I don't want a big ol' red belly button! Thanks for your time. 4-12-06

  Answer:  may want to see the surgeon, it can be all normal as the sutures under the skin dissolve. JG 4.12.06

• It's been six months since I had my tummy tuck. I have not been happy with my reuslts. Well it turns out that it was not that I was still swollen from my adboben. I have lost some weight. In my hip area I have skin creases, which I thought were dog ears. Well now I have to go through the procedure again. My PS is recommending that I only get some lipo done on abdomen and cut an extra 2 inches on hips to pull down the skin as well as some more lipo. I still have one side of my hips with a love handle. Do you suggest that this is the best way to get rid of this or fix my problem? Or do you think that doing the whole full tummy tuck again would be the best. I need a second opinion? I am very concerned, I didn't expect for this out come! thank you sj

  Answer:  Hard to say without seeing you but if there is loose skin, it will not be tightened by just liposuction I am afriad. You may need cutting surgery but not as extensive as the tummy tuck was. JG 4.12.06

• Hi Doc. I've started my 7th week post FTT W/Lipo. Have been working out for 3 weeks (moderate cardio & weights). I'd like to start training hard & heavy like I did pre op but I get nervous when training abs, squats, or doing pull ups because it still feels like I'm going to hurt something in there. I feel pulling and pinching in there after working out and by the end of the night I'm swollen. Thanks for any advice.

  Answer:  start slowly and advance as you feel more comfortable, it should be OK to proceed slowly. JG 4.11.06

• RE: previous question. I ask this question becuase most of tummy tucks that I have seen have involoved an incision from 3 o'clock to 9 o'clock or shorter, and I was just wondering if it is common to make a larger incision than this without making the surgery a lot more invasive.

  Answer:  The length of your incision is dependent on the amount of skin redundancy on the front. Making the incision longer in a horizontal aspect will not cause the flanks to tighten. JG 4.10.06

• What are the risks of performing a tt at the same time an abdominal hysterectomy is performed? Is this a procedure commonly performed?

  Answer:  higher infection rate, higher risk of slow return of bowel function, higher amount of abdominal swelling due to the intra-abdominal portion, and higher risk of blood clots in leg. I do not recommend it being done together. JG 4.10.06

• I have heard that numbness around the center of tummy can be permanent with a ftt/mr. Have you had patients experience this? How long does is usually take for feeling to return? Does it return to the belly button area? Thank you!

  Answer:  It can happen and yes some of the patients I have done the surgery on have had it happen. It might be permanent. And it can happen to the belly button too. JG 4.10.06

• I want a ftt with mr, but am frightened of the feeling of suffocation due to the tight mr. Is this a problem for any patients? How long does it last?

  Answer:  I have not seen it be a problem but you can always ask them not to tighten the muscles,although that will compromise the end result. JG 4.10.06

• I am 57 yrs old, petite, good health, non smoker. Considering ftt/mr. What type of results have your older patients experienced? Does it take longer to recover? More complications?

  Answer:  It all depends on your general health, but it might take a little longer than on a younger person, yes. Complications are about the same. JG 4.10.06

• Is it ok to have a body warp 3mo after a FTT.

  Answer:  Yes. JG 4.10.06

• Dr Garcia I had a FTT 3mo ago Iam still swollen is this normel. Can I get in the tanning bed .How long will it take for me to get well all the way. The lower part of my stomach is swollen. Thank you so very much

  Answer:  Should be significantly down by now, but not totally down. All of it should be gone in 6 months. Maybe you should see your doctor. JG 4.9.06

• I am 8 1/2 weeks post tummy tuck. I have recently gotten back into exercise but my PS told me no abdominal workouts until I am 100% back to normal. I still have significant upper ab swelling and I can't imagine going that long without doing ANY kind of ab work. I know each PS has their own way of doing things but if there are that many opinions they can't all be right or wrong! Her general exericse motto post-op is, if it hurts, don't do it which I agree with. She told me pre-op that she could tell I worked out, but I want to SEE my results now, not just know they're hiding! What do you tell your patients? Do I really need to wait until I am completely healed??? Thanks for your time!

  Answer:  I let them start working out, with the if it hurts stop adage, after 4-6 weeks. Best of luck. JG 4.9.06

• HI DR GARCIA. IAM 5,3 AND 136 LBS I HAVE STRECHTMARK FROM MY PREGNANCIES, AND I LEARNED ABOUT MINI TT ??? PLEASE EXPLEIN ME WHATS THIS AND IF THE SAME TAME OF RECUPERATION AND LESS EXPENSIVE??? THANK YOU MV

  Answer:  mini tummy tuck is where the skin of the lower abdomen, below the belly button is pulled down and tightened, it may not remove all of your stretch marks, depending on where on your abdomen they are. JG 4.9.06

• I am pretty flat in lower abs (had lipo about 10 yrs ago). My upper abs & muscles protrude so I have a roll in that area only. My ps said he does not like reverse abdominoplasty because it's going against gravity & doesn't last that long. Would the ftt/mr address my upper ab roll? Thank you for our response.

  Answer:  it should if done aggressively. JG 4.9.06

• Hi Dr. thanks for taking the time to answers everyones questions. I had a full tummy tuck and breast lift/augmentation 4 weeks and 2 days ago.I cant stand up straight and my back is killing me.. My husband took 6 weeks off work to help me with our 2 babies and to take care of me. I have taken it so easy that my scar looks great but I want to try and straiten up. Is it possible that I am having problems because my breasts are much larger and the weight is pulling me down? I am 5'7 140 pounds.. I just started very light walking but I get tired fast.. Do you have any suggestions on how I can stretch out??? Thanks for your time. L.T 4/8/06

  Answer:  All I can suggest is to slowly try to stretch, it will not hurt anything at this point, just go slow. JG 4.9.06

• Would you hesitate to do a ftt/mr on a patient with asymptomatic hiatal hernia? Had sharp pains across diagram 2 months ago, now gone with Protonix med. Otherwise very healthy, at ideal weight, non smoker, need lot of UPPER AB mr work. Thanks!

  Answer:  as long as the symptoms of the hernia are controlled with medication, no, but the symptoms may get worse after the muscle tightening. JG 4.9.06

• I was wondering if vitamin E is a good thing to take to help in the healing time after a mini tummy tuck? Will this benefit me at all, if not is there any vitamins that you would reccommend? Right now I am taking a multi vitamin as well as vitamin C. Thanks.

  Answer:  I think Vit E is a good general supplement. JG 4.9.06

• How can I protect my tummy tuck scar and belly button while I tan? I'd like to have a few tanning sessions for an even tan. I'm 7 weeks post op & I'm going on vacation in a few weeks. I'll be sporting a bikini, something I haven't done in over 20 years!

  Answer:  sunblock is an option. JG 4.9.06

• Almost 7 weeks post FTT. Started running again and weight training. I get swollen after working out and feel pulling, twinging, and even some cramping throughout the day. The pulling and tugging is all over, never in the same spots. When I wake up in the morning, tummy is pretty much flat, but as soon as I start stretching the discomfort begins anew. Any suggestions?

  Answer:  All will be better in time, all normal healing. JG 4.8.06

• I have read on your site that 4 -6 weeks after a mini-tummy tuck it's OK to do abdominal exercises (as I was told also). On an episode of Dr. 90210, I was surprised to hear the Dr. told a girl who had a tummy tuck that she shouldn't do crunches for 6 MONTHS...with what kind of TT surgery is it OK to resume ab exercises after weeks and what kind of TT surgery requires months of no ab exercises? I am a thin person who had lipectomy, correction of diastasis recti, and excision of loose skin. No problems I can detect, but I did go back to the gym full out after 5 or 6 weeks, and was wondering if this could cause long term damage?? Thank you.

  Answer:  every doctor has their own routine but doing abdominal exercises keeps muscle tone and avoids atrophy of the muscle so we like to return the patient to that activity when they are feeling OK. JG 4.8.06

• Great website. I had a full tummy tuck with abdominal repair a little over a year ago. I lift weights and do ab work 2-3 times per week and cardio 2-3 times a weeks. My weight is about 5-8lbs less than when I had the surgery. Lately, my stomach has been protruding a lot and I have been having twinges below the belly button. Do you think I have ripped the stitches of the abdominal repair or do you think this is a hernia. Should I see my PS? RD 4/7/06

  Answer:  I think you should se your surgeon, could be a breaking of the sutures more than likely. JG 4.8.06

• dr garcia - PLEASE help! I had a FTT appr 13 months ago. Ive been experiencing alot of swelling still and my doctor says i just have dominant muscles. It was completely flat initially, but that night after surgery, i got very sick and threw up all night, is it possible i tore stiches in my muscles or something is in my abdomen? I can not even do a single sit up without experiencing pain in my abdomen. What could be wrong? Thank you so much for your time and opinion. Lisa

  Answer:  it is possible that the sutures in the muscle were torn when you threw up, yes. May need to be repaired. JG 4.6.06

• Hi Dr Garcia, I'm from England and very impressed with your website. I had a full tummy tuck on 5 December 2005 and have healed exceptionally well with hardly any swelling or discomfort at all, really pleased with my results. I went to have my navel pierced this week and was told to wait at least eight months after surgery. My surgeon told me three months only. How long would you advise your patients to wait following surgery? Thank you.

  Answer:  usually we say 6 months, all the best with the new jewelry. JG 4.6.06

• I was just diagnosed with a hiatal hernia and would like to have a ftt with muscle repair. Can the hernia be repaired at the same time? Have you done this? If not, will the tt cause problems with the hernia later? Thanks so much for your response.

  Answer:  I would not suggest it as it raises the risks and time of surgery, you should fix the hernia first. If the hiatal hernia is not repaired, then when the muscles of the abdoemn are tightened, the hernia can be worse. JG 4.4.06

• Dear Dr. Garcia, Iam in the procees of losing weight. I've already lost 26 lbs. within 7 wks. and still losing. My question is having c-sections and being 52yrs old, Iam I too old to have a tummy tuck?

  Answer:  no, I have done patients much older than you. JG 4.4.06

• I was just wondering how common it is to have a third, vertical scar from the old belly button hole after a tummy tuck. I am told I don't have enough loose skin to prevent this.

  Answer:  not uncommon if there is not enough skin on the upper abdomen. JG 4.4.06

• Hi Dr. Garcia. I am 8 weeks post full TT with muscle repair. I saw my PS today b/c of what I thought might be excessive upper ab swelling. When I sit my abs protrude out over the top of my pants. It's not like handfuls of skin or rolls like pre-op, but still a concern for me. She told me that when she lifts the skin up she doesn't lift it too far because otherwise the waist will look thick when she's done. I tried really hard to grasp this concept but failed! Since I am just 8 weeks we both know that it's too early to definitively decide it's one thing or another. But she seemed to think most of her patients by this point weren't complaining of swelling of this nature (either that or they just don't tell her!) She did say that by six months it should subside enough to determine if it's truly swelling or not, but she said a redo of the MR might be a possibility in the future. Have you EVER redone someone's MR??? She told me way back that I had quite a bit of MR in my upper abs, but we both noted today that the upper abs are soft and the lower are much harder. She said lipo is not an option b/c I don't have enough fat. I'm pretty average/thin to begin with, I'm 5'6 and about 142 lbs. Do you have ANY thoughts on this? Sorry if the info is limited, I'm having a hard time remembering everything! Thanks for your time. 4-3-06

  Answer:  I have done muscle tightening on a redo basis, yes. The muscles are very difficult to tighten up near the ribs due to being limited by the ribcage, so it just may take time and if not a little more suturing of the muscles hopefully will take care of the problem. I will say that it is excessive tightening of the muscles that can widen the waist in individuals that have intrabdominal fat, but not the skin. All the best. JG 4.3.06

• I heard about abdominal etching. is this just another word for tummy tuck? Does it work for everyone no matter what weight? I am a male 38yrs 205lbs. PS

  Answer:  it is a technique employed at times during liposuction in order to make a person who has minimal subcutaneous fat and thick abdominal muscles easier to show their abdominal muscles. It works only in thin individuals. JG 4.3.06

• I just had a mini tt 6 days ago. I am still pretty sore, but am walking around the best I can, Still not walking straight up. How long does that usually take? Also my belly button looks really weird. It doesn't look round. I had alot of stretch marks so my belly button was positioned a little lower than before, but it looks like it is in the middle of stretch marks and is long and you cant really see my belly button. It looks like a mess. I can't really explain it. I know I have alot of swelling still, will my belly button look more normal when swelling goes down?

  Answer:  it all depends on your pain threshold and how much muscle work they did. When the belly button is not moved but only pulled it can be distorted some. May get better when the skin relaxes a bit. JG 4.3.06

• At 6 weeks post op from FTT w/Lipo of flanks, is there any continued benefit from massage, and if there is, how many times/day and for how long?

  Answer:  not much, just tincture of time for now. JG 4.2.06

• had ftt w/lipo of flanks. haven't lost any inches. Still swollen 5 weeks post op. Will i see any changes in measurements?

  Answer:  may take another few weeks to show through. JG 3.31.06

• Doc, I had a FTT w/ Lipo of flanks 5 1/2 weeks ago, but my measurements remain the same. How could this be? I also had a visible 4-pack, but now the abs are just flat, no muscles show. I'm a triathelete and try to keep body fat at 18% or less. What gives?

  Answer:  just due to the swelling and it will take time for the skin to re-attach to show your abs, give it some time. JG 3.31.06

• I had a tummy tuck 6weeks ago. i am still swollen. do you think i can take water pills to reduce the swollen?

  Answer:  will not work that way. JG 3.28.06

• Hi, i had a tt 6 weeks a ago, and i am not flat,am I swollen?

  Answer:  yes, still swollen. JG 3.27.06

• Dr Garcia, I had a FTT 11weeks ago I still have swelling and my bb is still swollen in side will this go away. I still wear my binder at night and girdle during the day. I am still sore on both sides of my bb.it also hurts a little to sneeze. My bb has not gone a the way back in will it. Thank you so very much.

  Answer:  not unusual, if nothing changes by 6 months you may benefit from a little touch up. JG 3.26.06

• dear drG. I wrote prev about lipo/tt of 7 months ago. the area below my bb and pubic area are still not flat,you mentioned I might need add lipo - do u think I might also need additional skin removal? if so, what will those scars be like, and also would you do corrective surgery?

  Answer:  it all depends on how much fat is taken out but many times no further skin needs to be removed. The scars should be where the present scars are already. I do perform corrective surgery when needed, yes. JG 3.26.06

• Hi. i lost 140lbs and recently had a FTT. i stil have a lot of loose skin that causes there to be verticle crease on my stomach. i can still grab a lot of skin. i read somewhere that alot of massive weight loss patients need a procedure where you have to be cut vertically as well as hortizontally. Im wondering if my doctor just didnt do a good job, or if i needed this other cross type incision. i dont know the clinical name so its hard to research and find pictures of other patients. i am so depressed. i feel like i didnt even have a tummy tuck. i bend over and stuff just hangs. why me??

  Answer:  Massive weight loss patients are high risks pateints and their skin does not respond as well as other people and many times a second procedure to corect skin excess is common. I would give it at least 6 months and then proceed wth a revision. JG 3.25.06

• I was wondering if having my period will affect anything durring a mini tt? I am bloated right now and am scheduled to have my surgery next week, I am due to have my period anytime,will it effect anything? Also this web site is great. I have learned quite a bit about my up coming sergery from this site alone. At the same time it is making me a little nervous about all the swelling, the leaking etc, etc...I hope everything will be o.k. I'm 5'2 118LBS, I'm not overweight just looking to remove stretchmarks and tighten my lower abs. They split after having my children and exercise wont help. My doctor recommended the mini TT. I am a little nervous as it gets closer. Are chances pretty low that I will have complications? Or is that hard to say?Thank you for answering my questions. 3/24/06

  Answer:  Many doctors prefer not to do surgery when on the menstrual flow for fear that there will be more than normal bleeding but it has not been well documented and I do proceed when women are on their flow. Complication rates are low but it is nice to know these things happen so you don't worry to much afterwards. Good luck. JG 3.25.06

• Hi,Dr. Garcia... I had a TT on 12-14-05. [After loosing 182 lbs. from Gastric Bypass.] I was cut at the Bikini line as well as upward. I just told my PS that I feel uneven. My left side looks great. [except a slight buldge toward the top] My rt side feels & looks alittle droopy. I also have about 3-4 inches of extra skin under my breast, at the top of my incision. That area of the incision is very tender. My PS said sometimes with Gastric Bypass patients with major weight loss, a reverse Abdominoplasty is needed. I have faith in my Dr. but am reading that this surgery is not done too often. Will you please give me your input? After all this, one more scare doesn't concern me. Do you find it common with G/Bypass? THANK YOU, SB 3/24/06

  Answer:  The reverse tummy tuck usually is only done if the traditional one offers no benefit. In your case, as is common in gastric bypass patients, a re-do at least partially of what you have had done is very common, and what you may need is just a little more pulling on the surgery that has already been done, but you should wait at least 6-12 months after the original surgery to see how the skin shrinks and swelling balances out. All the best. JG 3.25.06

• Why are there days that i am more swollen, i am 5 week op of a tummy tuck?

  Answer:  activity, what you ate,salt consumption, if you lifted or strained, many reasons,really. JG 3.22.06

• Dr Garcia...Thank you for your time. I am considering having a TT. I had 3 C-sections in 3 years. Is the TT just like a C-section? or it is more dangerous amd more painful? Is it safe for me to have a TT after 3 C-sections? Is the anestesia the same? what is the difference between a C-section and TT besides that one is for beauty and the other to deliver a baby? thank you.

  Answer:  It is similar, in certain ways easier and in certain ways a little more. Pain is similar to a little less. The previous C-sections will not affect the tummy tuck. Anesthesia is similar. The C-section does not remove skin and does not tighten the muscle underneath. JG 3.21.06

• Hello Dr Garcia, I'm currently 8 weeks post op from my tummy tuck, rec'd 01/19/06. However, I did not receive any drains. When I asked my PS, he stated he has a way working around needing to insert drains. Well, within my 7 day check up my PS had to aspirate fluid and dark black/red blood was removed. He anticipated me having to be aspirated several more times but no additional fluid came out. My concern is swelling. I wear my binder during the day,a body girdle in the evening and bedtime. I swell when I try to do light excerises or doing nothing at all. My swelling is within my thighs, hips and tail bone. When I put on my jeans I have these saddle bags hanging over my jeans. Plus, at various times my lower stomach will get big and hard for no reason. Almost like a contraction. Then other times, above my belly button it gets sore and I can feel something sharp like the stitches or staples. I have had 3 MLD therapy sessions within the past month but haven't really seen rave results yet. The therapist did said my lymph nodes were definitely clogged. Plus, I've been constipated for the last month now. Could I have a deep hemotoma or is this all normal? Could I be feeling staples or stitches? Could my post op swelling issues be the result of not having drains inserted in the first place? I'm currently 5'5 at 124 lbs and my PS said he didn't do any lip because I didn't have any fat to remove during my tummy tuck. My PS is great and doesn't seen to concerned. Therefore, your opinion and any advise is greatly appreciated. Thanks so much. MG 03.22.06

  Answer:  It appears more likely that you are having an old hematoma or recurrent seroma causing the swelling and the pain. If it continues this far out you may need a small surgical procedure to place a drain in the area. It could have happened even if a drain had been placed and then it could develop after the drain is removed. JG 3.21.06

• I'm considering a tummy tuck with lipo of the flanks, which extend somewhat to my back. However, I'm worried that once the suregon takes out the fat from my flanks, the skin in that area will sag. Will the tummy tuck help to minimise any sag at my sides? Thanks

  Answer:  fat removal if done properly in the flanks does pretty well and does not leave loose skin typically. the tummy tuck will really not do much to tighten that skin though. JG 3.21.06

• Hi Dr.Garcia, I have stretch marks that go about 2inches above my belly button, what surgery would be best? And would it help if I lost as much weight as possible before surgery to loosen the skin up as much as possible? Thank you AH

  Answer:  there is no surgery that removes stretch marks alone, if the skin with the stretch marks is removed with a tummy tuck, then the only stretch marks that would remain are the ones in the skin that was not cut off. Weight loss before a tummy tuck would yield more skin that could be cut off so I would suggets that. JG 3.21.06

• i had a tummy tuck 5 weeks ago, and i am not flat. Why?

  Answer:  swelling most likely at this point. JG 3.21.06

• Dr. Garcia, Does a full tt always involve getting a new belly button? Thank you! 3.21.06

  Answer:  it always involves moving the old hole, yes. JG 3.21.06

• Is it ok to get lipo of the flanks at the same time as a Tummy Tuck. Why is it that few doctors won't do this but most of them will?

  Answer:  I do it routinely. JG 3.20.06

• I would like to get a tummy tuck can you refer me to a plastic surgeon in Eugene, OR?

  Answer:  Due to potential legal issues, and some doctors wanting to know why I referred a patient to someone else and not them, I think you are best to go to this website and look for a plastic surgeon in the area you desire. I wish you all the best. JG 3.20.06 www.surgery.org/public/findasurgeon

• Hello I am 38 yrs. old and 16 days postop of a ftt. I am a non-smoker and have never been a smoker and to my knowledge am not diabetic, however I have developed necrosis and have a whole and discoloration to my incision. I am very freak out about it and my PS gave me some cream to put over it with guaze and anitibiotics. He says it should heal on it's own. But I am so confused because I am not a smoker or diabetic so what could have happened to me? I am trying to be patient and let it take it's course but I am also concerned. AG 3-19-06

  Answer:  those things can happen to normal people, there is just a higher chance in smokers and in diabetics. It should all heal and the scar can always be revised later. JG 3.20.06

• Dr. Garcia, I had a tummy tuck and lipo of the hip and thighs and around the knees, several years ago. During my post-ops I questioned the long thick strips of fluid buildup on the outer thighs and was told it would go away, to this day it has not. I also have lumps of fat at the hip bones. The doctor said he could do a second lipo to remove but I was scared because of how I felt after awakening and a few days later. I did heal with no problems. I was wondering can I now re-do the lipo to get the thick fluid strips from my outter thighs and remove the lumps of fat left previously? Or can these areas be corrected?

  Answer:  I do not think it is fluid, but residual fat left there from the first liposuction and should be able to be improved with more liposuction. JG 3.18.06

• I am 5.5 weeks post TT w/MR. My upper/central abdomen is very puffy still, pretty much all day. I have stopped wearing my binder during the day so I am wondering if this is contributing to the puffiness and if I should keep wearing it. The upper abdomen actually protrudes over my pants when I sit. Not a roll exactly, but I don't know if it's skin/fat or swelling. When I view my side profile in the mirror I'm basically concave. What are your thoughts on this? When should I get concerned? Thanks much!!!!! 3/17 (p.s. Happy St. Patrick's Day!) :)

  Answer:  mostly just swelling and not uncommon at this point after surgery. Erin go Braugh! JG 3.17.06

• Dr. After 2-1/2 month post a tummy tuck, when i sneeze, cough or strech still hurts (not that much) is this normal? how long more will this go?can i work out now??thank you.excelent web site...

  Answer:  yes, just the muscles that were tightened are trying to let loose and they will get used to their new position in time. It might take up to one year for the final result to be felt. I think you can work out at this point in time though. Remember to stretch those muscles.Thanks for the compliment too. JG 3.16.06

• I had a tummy tuck january 25th 2005 i got a bad navel infection i also had alot of liposuction and ended up wearing the drainage tube for over 20 days. from that time i have had discomfort around the navel area it hurts and its hard from the navel area to a little below it its like a egg shape area. it swells and it feels like im laying on a ball i can not lay flat and get up on my own or i have to turn to the side when i turn over in bed to my stomach or vise versa it feels like something is haning if i wear tight clothes i swell and it feels like somebody has there hand pulling and squezing my navel area and some times around my waist thank you for any information i had a ct scan they said they couldn't see anything?

  Answer:  sounds like a seroma cavity that has created a collapsed cyst and surrouding scarring. May be able to be surgically removed but there are risks of the fluid forming again and the scar tissue which is causing the discomfort may just grow back, tough problem. JG 3.16.06

• fluid retention. how can you solve the problem after 1 month after tummy tuck

  Answer:  all depends on what is causing it, it might take an aspiration with a needle though. JG 3.17.06

• Hello Dr. Garcia, I received a TT and Lipo on 1-16-06. I still have swelling in my lower section and swells more when I have to go to the restroom, is this normal. Also, How long after the surgery can I get my belly button peirced? Thank you for your time. MN

  Answer:  I think yoru belly button can be pierced now as to the sewelling, it can happen but is unusual this far out. I suggest you see your surgeon to make sure all is OK. JG 3.17.06

• Dr. Garcia, Does the reverse abdominoplasty scar differ from the traditional breast reduction scar? If so, how? I have cleavage so my current scar is well hidden, even in bikini tops. Thank you so much for taking the time to answer questions! 3.14.06

  Answer:  yes, it crosses the middle over the breast bone. It will be seen in a bikini. All the best. JG 3.17.06

• Dr. Garcia, Thank you for your answer regarding reverse abdominoplasty. I have already had a breast reduction so my PS and I discussed this option. I had written to you a few weeks ago about fixing lumps and bumps after abdominal liposuction. I am about 7 months out. I have good skin tone and firmness, but a few problem areas. My PS is going to see me again in a few months to re-evaluate and discuss options. Do you like the reverse abdominoplasty? Thank you.

  Answer:  the scar may be seen in certain dresses and bathing suits though. JG 3.16.06

• Dr. Garcia, Thank you for your answer regarding reverse abdominoplasty. I have already had a breast reduction so my PS and I discussed this option. I had written to you a few weeks ago about fixing lumps and bumps after abdominal liposuction. I am about 7 months out. I have good skin tone and firmness, but a few problem areas. My PS is going to see me again in a few months to re-evaluate and discuss options. Do you like the reverse abdominoplasty? Thank you.

  Answer:  I like it for certain people. It just will leave a scar that at times can be seen in certain dresses with low cleavage and in bathing suits. JG 3.16.06

• Hi, Dr. Garcia i had a full tummy tuck, and i have lots of fluid in me, its been a month. It doesn't seem like i had a tummy tuck. What can i do? I am getting depressed. Can i take something like a pill or does it have to drained.

  Answer:  I think it might need to geet drained so I would suggest going back to see the surgeon and have them evaluate you. JG 3.16.06

• Dr. Garcia, Have you ever performed a reverse abdominoplasty? Thank you. 3.13.06

  Answer:  yes I have, just need to be aware of the scar placement. JG 3.16.06

• I had a tummy tuck and thigh liposuction and lift 2 years ago. From the beginning of my post surgery recuperation, the area between my lower ribs and navel has and does still protrude. Additionally, my pubic mound is now very pronounced to the point that I cannot wear a swimsuit without embarrassment. The whole area looks as if I was just 'scooped out in the mid section. Additionally, the scars from the thigh lift have 'drifted down as they sometimes do , according to the surgeon. I am in desperate need to have this corrected, as I now feel I look worse than I did prior to surgery. I am afraid to go back to the same surgeon for fear that if he attempts to fix the pubic mound, he'll damage nerves that will interfere with sexual enjoyment. Any suggestions you could give me would be greatly appreciated.

  Answer:  The nerves in that area should be OK with a little liposuction there and it sounds like the thigh lift scars will need to be re-cut and advanced higher, like a mini thigh lift. JG 3.16.06

• I had a tummy tuck in may of 2005 and on oct 30 05 i had to get lipo of my flangs both sides. And now there is still fat i am giong for more lipo of my flangs on march 27 is that to soon to soon to have lipo done. What are my risks it has only been like 5 months i am also having lipo of my hips. Thank you Kg 03/07/06

  Answer:  no, I think that amount of time is appropriate for the selling to go down and evaluate the residual amount of fat. Best of luck. JG 3.7.06

• Hello Dr.garcia ,I had a full tummy tuck about 6 months ago.On one of my routine checkups,I had a dr's assistant remove stiches from my new belly button & it felt like she accidentally cut one side of it.It looks like it healed pretty good after treating it with peroxide & neosporin,but to this day I still get drainage coming out from it .It's clear liquid,not infected or anything.This can't be normal,I have to wear a band-aid everyday cause i just don't know when I will leak !Could it be that the belly button has not closed all the way ? or could it be from that little cut?they're willing to fix this, but will it leak again ?I am soo confused,scared & frustraded. Please help me get some answers,,, Thank you for taking time to answer my question.

  Answer:  Most likely a small infection in one of the sutures way below the skin and not related to what happened superficially. I think you should let them do what they need to do. JG 3.7.06

• i am scheduled for a mini tt in 3 weeks. I enjoy working out and have been doing alot of pilates. Should I continue doing them until the sergery or will it affect my stomach muscles? Iam having the sergery to get rid of most of my stretch marks and to tighten my lower abs. How long after surgery can I get back to working out? 3/7/06

  Answer:  yes, up to the surgery date is OK.Starting back up after surgeru wil be 3-4 weeks or so, all depends on how you heal. JG 3.7.06

• I am scheduled for a mini tummy tuck in 3 weeks. I am active and enjoy doing pilates. I'm wondering if I should stop doing pilates that have to do with exercising my stomach muscles until the surgery. Will it affect anything? Or am I o.k? How long after surgery do I have to wait to continue with my workouts?

  Answer:  No, I think you need to continue them as you will not be able to do them for a while afterwards and you want your muscles as strong as you can. As to when you can go back, it varies but somewhere between 3-6 weeks. JG 3.6.06

• Dear Dr. Garcia, I am one month post-op TT with muscle repair. Over the past few days my upper ab region (right in the middle) has suddenly become very tight when I try to stand or stretch more. It isn't painful but it feels like a giant section of muscle, not wanting to give. It's sort of unnerving. Is this a normal part of the recovery process? Are the muscles slowly loosening or are they fighting me? Thanks for your help. 3/6

  Answer:  all normal as the tissue heals and tightens as the swelling goes down. The muscles are getting used to their new location, it will get better in time. JG 3.6.06

• I'm getting a full tummy tuck with lipo and would like to know if i can pierce my belly button.

  Answer:  I would suggest you wait until all is healed. JG 3.6.06

• I had a FTT 12/14/05 and today I feel like the muscles on my left side have been cut. I am having discomfort and sort of burning in the muscle areas and of course swelling. Is that normal for healing or did I maybe do something to the muscle in that area? ND 3/5/06

  Answer:  could be some of the sutures in the muscle tore and that is what has caused the pain. JG 3.5.06

• Dear Dr. Garcia, I had a full tt a year ago. I don't like the shape of my belly button( it's unnatural looking), and there is alot of scarring on the outside of it. Could I get it redone, or would the skin around it be too tight to work with. If so how much money does that cost?

  Answer:  hard to say without examining you but you would need to have loose skin around it to allow the scar tisssue to be cut out and a new shape formed. Costs will vary from surgeon to surgeon so you would need to be examined by the surgeon you choose to get an accurate fee quote. JG 3.5.06

• After having a FTT does the stitches in your abdominal muscles dissolve? If the do, how does your muscles stay in the new position? Thanks, ND 3/5/06

  Answer:  typically the sutures are permanent. JG 3.5.06

• I've asked you previously about my TT that I had 3 1/2 weeks ago. I appreciate your help and have another question. Last night I was lying on the couch, then pulled myself to a sitting position. Within a minute I felt a sharp pain in my upper ab region, about an inch or two below where my rib sticks out. It went away shortly, but is tender to the touch. My PS said it could be muscle strain or a torn stitch, but either way there's nothing that can be done. A torn stitch really freaks me out because I'm afraid if I tear one from sitting up, what will happen when I start to exercise again? Is this really a dangerous thing? How many stitches are in there? Any advice would help, I'm sort of freaked out. Thanks in advance for all of your help, it's very appreciated. 3-3-06

  Answer:  As time goes on the tissue heals and they get sronger so those things will not happen as much if ever, in the future with activity. As to the number of stitches, it is many , all depends on the doctor and how loose your muscles were. Not a dangerous thing to occur though. Just be careul in the future and use your arms to help you get up. JG 3.3.06

• I had a TT a few weeks ago and am currently wearing this garment: http://designveronique.com/cgi-bin/ic/dv2/1650.html I have to wear this for one month post-op and then my PS said I could wear anything else afterwards but didn't give me any ideas. I was wondering if you could recommend something that will still give me good enough coverage (esp. upper abs) but a little less like a second skin. I also would prefer something without the shoulder straps as they chafe quite a bit. Thanks!

  Answer:  I am sorry but I do not have a manufacturer that makes something like you are aksing for. JG 3.2.06

• HI, DR. GARCIA I HAD A TUMMY TUCK 6 MONTHS AGO NOW. MOST OF THE SWELLING HAS GONE AWAY. BUT I NOTICED THAT WHEN I PICK UP MY THREE OLD SON, THAT THE LOWER PART OF MY STOMACH GETS SWOLLEN. IT ALSO SLIGHLTY HURTS IF I TRY TO MASSAGE IT. I HAVE FEELING NOW. I DON'T FEEL ANY NUMBNESS. WHAT CAN I DO HELP THIS?

  Answer:  I think it is just a matter of time, sorry. JG 3.1.06

• Dr. Garcia, I had a mini TT and lipo on my inner/outer thighs and flanks. I know the swelling will continue for a few more months, but I seem to have swelling in my pubic region and slight numbness. Will this take a few months to go away as well? I'm just worried about the way I look in clingy clothes, I think it's noticable. Also, what type of massage would you reccommend for my lipo areas?

  Answer:  the pubic region can take a long time to go away I am afraid. As to the massage, just a light Swedish type massage is all. JG 2.28.06

• I had a full tummy tuck three weeks ago w/muscle repair. I have two questions. First, how long do most patients experience swelling? I know it's normal but when is the average amount of time that swelling subsides and you can finally see your new shape? Second, my scar is a handlebar shape and the top portion is going to poke through any pants I'd wear. I have some silicone strips that I will start using ASAP. But what other scar reducing/removal techniques are there in case I need something else? I am not worried about the entire scar, just the top 2 on either side. Thank you! 2-28

  Answer:  swelling will take weeks to months, and you new shape will start to be seen after about 6 weeks but final results take much longer. As to the scars, I use ScarGurad or Mederma on them. JG 2.28.06

• Dr. Garcia, I am 52 years old and eight months ago I had a full TT and muscles tightened and a breast lift w/ augmentation after losing 122 pounds. At first my tummy was nice and flat but have experienced swelling especially after doing too much and lifting two grandbabies ages 2 and 3 all day. For the past couple of months my tummy under the BB looks very puffy and rounded and it does not come and go like the swelling does. It looks like my tummy is fat but I have not gained any weight, in fact I have lost several more pounds. Could I still be experiencing swelling after eight months post op? Will the swelling ever completely go away?

  Answer:  could be swelling and also could be the sutures in the muscle on the lower abdomen broke, or that with the additional weight loss the muscles now are not as tight. JG 2.28.06

• Dr Garcia hace dos meses me hize el tummy tuck en otro pais, despues de 10 dias de la operacion note que me salio en la parte de arriba del ombligo como una inflamacion como una montañita como de 2 a 3 pulgadas, le pregunte a mi doctor y me dijo que me pusiera como una toalla debajo de la faja para presionar, cuando me la quito queda plano por un rato luego se infla de nuevo. el doctor me dijo que si no bajaba me hiciera mesoterapia. queria saber que opina al respecto y que piensa es lo que tengo, tambien porque lo tenia plano al principio y luego se inflo. y que puedo hacer al respecto.le agradezco mucho su opinion.

  Answer:  lo que tienes alli es una coleccion de liquido, no grasa, haci que la mesoterapia no le va a ayudar. Le tienen que aspirar el liquido. JG 2.27.06

• As a pre-teen I under went an abdominal surgery that left me with a 4inch vertical scar above my belly button. I have seen a surgery done where a man had implants inserted under is skin and slowly filled over a period of time in order to stretch it and give him some extra skin to work with. Could a surgery like this or any other aid in maybe relocating my abdominal scar to allow me wear the bikini I have always longed for?

  Answer:  It could but it would take an enormous tissue expander in for a very long period of time for that to be possible I am afraid. JG 2.27.06

• I had a full TT on 2/8/06. I have a handlebar shaped scar. The scar section on the lowest point, just above my pubic hair, as well as the verticle BB incision just above it, are very scabbed. I have been applying Neosporin and gauze for the past 2 days but today noticed tiny spots of blood on the gauze. Is this normal and at what point, if any, should I be concerned? Should I buy steri strips and use those, or continue with the gauze and Neosporin? Any suggestions would be helpful. Thanks. NH 2/24/06

  Answer:  normal, would let your doctor know, may want to clean them with a little half strength peroxide. I would just apply Neopsorin and avoid the steristrips as they may keep the wound moist and wet, not something we want right now. JG 2.24.06

• Is it possible to donate my tissues from an abdominoplasty to cancer victims that may otherwise require a transflap? Do you have any info on such a procedure or website I can research this type of thing on? Thanks

  Answer:  sorry, won't work, their body will reject it. JG 2.24.06

• Hello, I would like to know if there is anywhere that I could get help with getting a tummy tuck for free. I am a single mother of 3, unemployed and going through severe depression due to my rather large, ugly deformed stomach. I am at times suicidal because of this. People make fun of me all the time, it makes me very upset. I have discussed this with my family doctor who basically says theres nothing he can do about it. I dont have good credit to get medical financing and if I had the money for a tummy tuck, I'd most definetly have to use it to feed my children and pay rent expenses. Im sure I will never have the funds to pay for such a surgery but I cant keep looking like this! Sasha S...

  Answer:  I am sorry but I am not aware of any universities doing pro bono cosmetic surgery. JG 2.22.06

• What is the cost range of a tummy tuck?

  Answer:  I could quote you fees but that varies greatly form doctor to doctor. I suggest you get a fee quote from the doctor you are considering perform the procedure. I can only quote fees for people that are going to have me do their surgery. If you desire that fee quote, contact us via email at drgarcia@lvcosmeticsurgery.com rather than the message board. Thank you. JG 2.21.06

• I had a tummy tuck 5 months ago. Instead of loosing weight I have gained weight. I have been watching what I eat. I also have started to excercise. I was originally waring a size 7 in pants. I still am wearing a size 7 pants. I have not lost any weight. My pants are more fitted than they were before I had my surgery done. What am I doing wrong. HELP!!! thanks

  Answer:  hard to say without seeing you and seeing how much weight you have gained and in what areas, you may want to speak with your doctor. JG 2.21.06

• Dr Garcia Ihad a FTT 7 weeksago I still have swelling above the incision sometimes its not as bad I still wear the binder and girdle will this help. My BB still hurts when I snezz. How long should this last. When will all the swelling go away. How long should I wear the binder or girdle and does it have to be tight. Does it take longer for your BB to heal. Thank You so much.

  Answer:  Yes, it is normal and massage and the girdle will help. Not unusual for the tenderness at the belly button this soon after the surgery too. It should get better in a month or so. As to the swelling, that may take close to 6 months for it all to go away. We have patients wear the girdle for one month and then they can continue for as long as they feel they need the support. The belly button can take a long time to feel better as the muscles around it are tightened during the tummy tuck. All should get better in time. JG 2.20.06

• I heard there is a two for one procedure-meaning tummy tuck and a breast augmentation for the price of 3,000.00. Is this true? I am from Los Angeles and will consider going over to your office regardless. My email is ingridlperez21@hotmail.com Hope to hear from you soon! Gracias! Ingrid Perez 323-898-9914

  Answer:  I am not sure where you have gotten that fee quote and am not sure the procedure they may have meant. Maybe in Mexico. JG 2.20.06

• Have you ever done a full lower body lift on normal sized pateint who hasnt had substantial weight loss(Gastric by pass surgery) and what are the requirements, if any besides little back side sag and little loose belly skin? Recovery?

  Answer:  It can be done if there is enough tissue laxity. If the tissues are tight then the scars are not very thin. Recovery is 3-4 weeks. JG 2.18.06

• Dr. Garcia, Thank you for taking the time to answer so many peoples questions. I know I appreciate reading your repsonses and getting myself educated. I am still in research phase but am going to get a FTT with lipo and a BL very soon. I have loose skin and fat in the pubic area and would like to know, can that be remove w/ lipo and also tightened with the FTT or is that a different surgery? Thank you in advance for your response.

  Answer:  Yes, that is usually part of the tummy tuck, we lipo it a little and then lift the skin up. All the best and thanks for visiting. JG 2.18.06

• Dr. Garcia, I am very unhappy with the placement of my belly button after a recent tummy tuck. It is about 1 too high and it is not centered. Is there anything I can have done? KC 2/19/06

  Answer:  well, if it is too high, it can be moved lower but you will have a scar where the belly button is now as that hole will have to be closed. JG 2.17.06

• Dear Dr. Garcia, Hi! About 15 months ago, I had a full tummy tuck with liposuction done. I had complications and developed a blood clot in my lungs. I was hospitalized for a week and was sent home. Since then, everything has been alright and I was put on Coumadin for a year. My Hematologist discovered that I have a genetic tendency to form blood clots quicker than your usual patient due to a gene mutation, but that I am alright to revise any problems as long as I take medication before my surgery. I am only 28 years old and in good condition. I am 5'1 and weigh 110 pounds and exercise frequently. I have had no children but for some reason, I had loose skin in my abdominal region. So I had a tummy tuck. I am very glad that I had the procedure done, but I am unhappy with the results that my surgeon has left me with. Most of the loose skin is gone but there seems to be extra skin still on the sides of my stomach that make me look like I have love handles. Also, the lower part of my abdomen where the incision scar is located, is uneven. It looks full with a depression and a bump in the middle. When I addressed my concerns to my surgeon, he pretty much dismissed them and told me that it was the best he could get it. He said that the bump was my old belly button and there was nothing he could do for me. Since then, I have been very depressed and don't know what to do. I feel like I have traded one abnormality for a few others. On top of that, my new belly button closed up and he has worked on it, but it still looks unacceptable. There is lots of scarring and it just doesn't look normal. Again when I talked to him about it, he just smiled and said it looks great and natural. I can promise you that it does not! I have since then decided to get some second opinions because I do not feel like I should accept these things as my final results. I know not to expect perfection but I have also been told that tummy tuck revisions are not uncommon. I payed a lot of money and went through a lot with this procedure and I don't feel like he did all he could to help me out. So with all that in mind, Do you think that I have reasonable concerns? With what I have told you, Do you believe that there is anything that could be corrected? I do not want to discredit my surgeon. I just want to find someone who is going to help me out and listen. I'm embarrassed by the results I am left with and I still long for the confidence that I expected to gain with this procedure. I appreciate any words of wisdom you can offer me. Thank You! M.T.

  Answer:  It sounds like your concerns are reasonable and are ones that not uncommonly have to be revised in some small number of patients. I think a different surgeon would probably be the best option, the original surgeon may be concerned about the clotting problem and may be apprehensive about any touch ups. It might take a surgery to open the belly button , excise a little more skin laterally and then remove some scar tisse from the lumpy area. Due to potential legal issues, and some doctors wanting to know why I referred a patient to someone else and not them, I think you are best to go to this website and look for a plastic surgeon in the area you desire. I wish you all the best. JG 2.16.06 www.surgery.org/public/findasurgeon.

• I had a TT Nov 30, 2005 since then I developed MRSA 3 times and now I have a mass on my lower stomach and my doctor doesn't think she need to do anything more than give my more Zyvox. I'm worried that this infection will never go away, should she be running soem kind of tests on me?

  Answer:  well, wound cultures are a good idea to make sure of the bacterial sensitivities I think, as to the mass, I think you need to let everything heal and settle down and then see. If the lump on your abdomen gets bigger or gets red then a CAT scan to evaluate it for an abcess may be required. JG 2.15.06

• In a standard abdominoplasty if the incision is 1 1/2 inches above the pubic line does the muscle tightening stop at the incision line or can you go all the way down to the pubic line?

  Answer:  it can be done further down onto the pubic region though that incision. JG 2.14.06

• I know that you are urged to move around as soon as possible after a tummy tuck. Do you recommend straightening yourself up immediately afterwards even though it is painful to do so? Or will standing up too soon compromise healing? Thanks!

  Answer:  no, just walk around, no need to straighten up until you feel you can do so. JG 2.14.06

• Dr. Garcia, I had posted yesterday about lipo and TT. I don't want to rush into surgery that may not be necessary. How long should a person wait after liposuction to see the best results before considering a TT? Thank you so much for providing this forum!

  Answer:  3-6 months is what we suggest. Good luck. JG 2.14.06

• I had full TT 6 weeks ago can I get in the tanning bed. Do I need to cover the incision. and my bb. Thank You

  Answer:  I would avoid the tanning bed until all the bruising is gone and I would cover the incisions for at least the first 6 months. JG 2.13.06

• I had a full TT Jan 5th 2006 I still have a lot swelling cane you put ice packs on the swelling. Also my BB in side has three little white pieces of skin that looks swelling is this ok will it look ok after I heal all the way. Thank you

  Answer:  I think at this point ice will not help much, maybe heat a massage may help a little. Hard to give you advice on the belly button though without seeing what is going on, sorry. JG 2.10.06

• Hello Dr, I am a 50yrs old lady and lost 40 ponds by doing sits and working out everyday.I have achieved my goal but my skin on my tummy is very loose and i can grab it.I feel so bad.Is there anything could be done to firm and tone my belly skin??It is not getting better with exercise.please advice.

  Answer:  exercise will not tighten skin, you may need to have the skin removed via a tummy tuck or abdominoplasty as it is called. Congrats on the weight loss and dedication though. JG 2.10.06

• Hi, Dr. Garcia, I had a tummy tuck about 5 montha ago now. my doctor gave the okay to start exercsing, which I have. since I have started my adbs do not seem to be completely flat. I have also been gettting swollen by the end of the night.Am I over doing it? What can I do to help the swolling down? Instead of loosing weight it seems like I'm gaining weight. Please help me! What is going on? thanks sj

  Answer:  the swelling is normal when exercise is restarted and will settle down in time. As to the abdomen being totally flat, it will take time for all of it to go down, so give it a little more time and watch your diet. JG 2.10.06

• This might be a silly question. But i had a full TT last sept. Since then Ive gained about 5 lbs and recently started a diet. My goal is to lose 20 lbs. I saw on one of the posts that the more u lose, the more loose you are. Well..my TT left no stretch marks..etc..or loose skin. Wont exercise STILL help to tighten even tho u had a TT? and wont i be able to develop my abdominal muscles even though i had a FTT? I mean, what i have now isnt 'it', right. I can improve through exercise/?? and possibly not get 'loose' after weight loss. ?? thanks in advance

  Answer:  exercise does nothing to tighten skin. You will be able to develop your abdominal muscles, yes, but they will not affect the skin. Any weight loss may help you have less intra-abdominal fat but it will be up to you to keep those muscles tight. JG 2.10.06

• Dr.Garcia ,thank you for the info on the tummy tuck i had a hystorectomy at 23 and i'm now 57 years old however i have asthma that is the only thing i can think of that would interfere with my tummy tuck .

  Answer:  one precaution with asthma is that they may not tighten your muscles as much as possible as that can restrict your breathing, otherwise it should be OK to proceed. JG 2.9.06

• Dr Garcia, so for the circumferential body lift, are you saying it is an easier recovery to do a FTT(skin only) first and have the butt lift at another time? What sort of recovery is a butt/thigh lift? Is the butt/thigh lift harder recovery than FTT because of with FTT you can hunch forwward to protect tummy incisions but what do you do for a back incision, and is the incision at back panty line?

  Answer:  yes, it is easier.The recovery from the butt lift is about the same as a tummy tuck, 3-4 weeks. The buttock lift is more difficult due to positioning while sleeping and sitting and the blood flow at times is less robust, leading to poor healing and wounds breaking open. The buttock incision is usually in the bathing suit line, yes. JG 2.9.06

• HI Dr. i had a hystorectomy when i was 23 years old i'm 57 is it safe at this time of my life to still do a tt/ ?i have a large apron it look s terrible >>

  Answer:  If you do not have any medical problems that would complicate matters it should be OK to proceed with the tummy tuck. JG 2.9.06

• What exactly is a torsoplasty and does it always hace to be preformed on someone who has lost a bunch of weight. I am guessing it is like a round the world lower body lift. When i pull op on my lower back, my butt and thighs look so much better. Am considering a skin only FTT in the near future, can this lbl be done at same time? what is the recovery? drains? Incisions? I am 5 6 125, never been overweight. 46 y/o.

  Answer:  yes it is a circumferential body lift, and can be done on someone who has lost support and tissue and the skin is lax. It all can be done at the smae time but will have some serious healing time and also a long surgery. JG 2.9.06

• Thank you for this website. I had a full tummy tuck with muscle repair 3 months ago. I was 5'5 , 125 lbs with little excess skin/fat, but had had 3 kids and weakened ab muscles/fascia. The results were good, initially, with normal swelling (which had been gradually reducing) but an immediately flatter tummy. Last week I started exercising (jogging 20 min. on two separate days). A couple of days later, I went to an hour-long work-out class at my gym ( body sculpting for every muscle group). I tried to go easy on my abs, but still, the overall workout was very exhausting for me. Since then, my tummy looks as big as it did before, and has not gone down (5 days now). Around the same time I started working out was also when I stopped wearing my binder. Thinking that the workouts were making me swell more, I started wearing my binder again, but my size has not gone down. Also, it seems like my flat shape is gone now, replaced by a more round tummy. This is different than the original swelling looked. I did not feel any pain or popping sensations during any of my workouts. What do you think is causing this?

  Answer:  most likely some tearing of the scar tissue below the skin and above the muscle. It happens not unfrequently. Time massage and pressure should make it all go away. JG 2.6.06

• Dr. Garcia, I'm 5 weeks post-op from a full Tummy Tuck, I still have a pouch, My PS suggest I wear the binder very tight an purchase a corset. Do you think this will help, I'm a little disappointed. I expected to be flat by now. He suggested that I come back to see him in two months.

  Answer:  it could be swelling, a very common problem. Do as he says and give it some more time. JG 2.3.06

• i had a ftt 0n 12/20 and as of today i am almost 6 weeks. the other day i snezzed really hard and it hurted so bad and now the top part of my abs are sticky out i am scared i messed up my mr is this possible. i normally swell in the upper abs above bb all the time but soon as i laid down and add binder for extra pressure it goes back flat but this time it is not i had binder on and girdle and it is not going down. i dont go to doctor till 2/22 what should i do.

  Answer:  you may have torn the sutures in the muscle. Not much to do right now, just see your doc and see what they say. JG 2.2.06

• I have excess skin on my side, in my arms, and on my breasts after a 170lbs weight loss. I am need of an arm lift and breast lift. I also have what some people sometimes refer to as back boobs ... the fat overlaps my bra in the back (near the armpit) and slightly on the side (it appears to only be excess skin, not so much fat); I wear a loose fitting bra so I know that the overlapping is not due to a tight bra . I also will be getting a circumferential achor-cut abdominoplasty. With the combination of the abdominoplasty, breast and arm lift, will the skin on the side and back fat be eliminated?

  Answer:  no, that will take a different surgery I am afraid. JG 2.2.06

• I am considering Titan for my abs, still unsure because of lack of info and more importantly, lack of info about good results. IF i do decide to do it, would it affect the underlying tissue if i decide to go with a skin only FTT down the road, as far as the scar tissue that would be under the skin form the Titan machine? I am considering it for mild loose skin in upper belly after MTT 3 yrs ago.

  Answer:  It should not affect any of the underlying tissue to any degree and would not preclude any surgery in the future. JG 2.1.06.

• Dr. Garcia, in 1996 I gained 80lbs during pregnancy (5'5 from 103lbs to 183lbs). At 35, I now weigh 135lbs. Do I need to wait until I am certain I will not have more children before I have a TT? Can a TT and tubal ligation be done at the same time.

  Answer:  I think you could proceed and many doctors will do the procedures together, best of luck. JG 2.1.06

• Dr Garcia I had a full TT with lipo 1 year ago. as a combination of the TT and losing 25 pounds I have gone from a size 16 to a size 10 but I still have a bulge under the scar line that extends to a fat pubic area. My PS first said he needed to do a bit more lipo to that area (and did) but it did not help. He then said it might be scar tissue to wait a couple of months and come back. I did and he said I needed to lose weight. I am so confused. I am not fat and have very good skin (never had stretch marks even with pregnancy). Is this common after TT and what do I need to do to have it corrected. I still can't tuck in a shirt because of my pouch. Thanks LB

  Answer:  It is not uncommon after a tunmmy tuck and may need excision of the tissue rather than just liposuction to alleviate the appearance. The need to correct it is all cosmetic though, no medical need. All the best. JG 1.31.06

• Dr. Garcia I'm 40 years old and I had an abdominalplasty two years ago with great results. What would be the risks of having more children at this point?

  Answer:  it might require another tummy tuck after the baby, otherwise no problems. JG 1.29.06

• puede usted hacer varias cirugias juntas tales como buttock/mentiplasty/tummy tuck/breast aumentation

  Answer:  si pero no creo que todo eso se debe de hacer junto, seria muy largo. JG 1.25.06

• Thank you for the answer about floating bb. If one does get the floating bb, is there then no vertical scar? Also, when does PS determine what needs to/can be done as far as floater or vertical scar during surgery or is it somethiong they can determine before during consult? My PS only said it could be done (hesitantly) but didnt mention where v scar would be or floater, etc, just that horizontal incision could still be as low or lower than existing MTT scar. What should i ask him specifically next time i go in and if he tells me something is it generally hard for a PS to stick by what they say will happen, since things could change once they get in there?

  Answer:  Correct, no vertical scar with the floater. Usually the surgeon should be able to tell before the surgery. I think you need to ask him the questions you have presented here and wait for an answer to them. JG 1.25.06

• hi i had ftt on 12/20 and i developed a seroma had it drained twice but my doctor says he really dont like doing it more than once cause he dont want to cause an infection . my concern is it look like it might be starting back but is real small what can i do besides wearing a tight girdle to keep it from coming back. and what causes the fluid to build back up once its been drained.

  Answer:  The fluid comes from the small vessels that were cut to do the surgery and they all heal back. If the fluid is small, just let it absorb on its own, if it is a good amount, I suggest draining it as the skin cannot shrink if it is too swollen. JG 1.25.06

• Dr Garcia, can you explain the pros and cons of a floater bb and what happens to the umbical stalk when covered with skin? doesnt that look weird, a little bump under the skin? why would someone get a floater instead of fashioning new one at stalk? Also, why would 2 people who appear to have same amount of skin(very little) have their vertical scar in such different locations, like one just under new bb and other one all the way in panty line? All this stuff worries me about FTT(no MR), i am tentatively scheduled for one but all this research is giving me second thoughts. Had a mini 3 yrs ago, dont like upper ab skin, PS said he could do it but now i am not so sure. Is there such a thing as TOO MUCH knowledge???

  Answer:  in a float, the stalk is totally cut so the blood supply to the belly button is from the surrounding skin and nowhere else. They do a float if the amount that the belly button needs to be moved is small, and to leave the natural bb floating looks more natural than fashioning a new one. Where the vertical line ends up depends on skin elasticity as well as the amount of skin removed and also how high up the lower incision is made. There is no such thing as too much knowledge, just to much confusion. JG 1.25.06

• Dr. Garcia, have you ever preformed a reverse abdominoplasty? Was in in conjuction to a BL? Is it possible to have a good result with the incision not going across the sternum, just under each breast extending towards back? I was told by my PS that the incision needed to go across the sternum to be an effective lift/result and i think i asked you once and you said same thing, i thought. just saw pics of gal who had it and her incisions(s) didnt go across sternum but she had a BL with it, the big kind with incisins running from nipple to crease. Thanks you for your time.

  Answer:  I have but not in combination with a breast lift. I think if the incision does not go across the sternum the results are compromised and not as good since the loosest skin is in the middle and that is where you are trying to avoid having the scar. JG 1.24.06.

• Dr Garcia, how long for new bb and vertical scar from FTT to heal? Am scheduled for a ski n only FTT for early April, hoping to be bikini ready bu mid July. Also, if bb isnt opened much due to swelling, have you any tips on having it heal opened, like cotton ball taped in there, marble, soft ear plug? (after all scabs are gone, of course) I have seen some really weird almost closed looking bb s after FTT, want to make sure that doesnt happen to me.

  Answer:  about 4-6 weeks and they should look pretty good. You can use any of those suggetsions to keep the belly button open. JG 1.24.06

• Thanks again for your replies. I had on and off swelling after a mini tt, it seemed like after menustration it would be swollen until I wore tight garment. You mentioned that I could have intra abdominal swelling from the uterus. What causes this? Is this bad? Can it be corrected? Thanks again-rachel

  Answer:  it is not bad and it may be difficult to correct as it is a normal occurance. JG 1.23.06

• Hi Dr.G!! I had Br. Augm. + what was supposed to be a FTT. In the Op Rm. my Dr. decided I didn't need the FTT, so I got an almost hip to hip scar but didn't move my BB. Now I'm 10 weeks and I have loose skin on the upper Ab. I got a capsulotomy on one Br. and I'm going back to the Op Rm. for implant change... My Dr. says he will pull the extra skin from the Upper Ab (no cost)but maybe I will get the vertical scar (he's not sure). I'm afraid now I don't have enough skin to make the old BB site reach all the way down...I don't want to end up uncomfortably tight! Would a Float be better?? Does it look strange? Why is there no way back with it? Recup time of Float? Thanks a million! I'm very scared! LRM, Feb 23th '06

  Answer:  It sounds like the vertical scar is almost a for sure unless the lower incision is fairly high on your abdoemn. This would have happened though if they had done the full tummy tuck the first go round. A float is possible but the belly button may end up too low and will not be able to be moved up again. Re Coup time is the same with a float or a belly button relocation. Best of luck. JG 1.23.06

• What is the most common complication of a FTT(skin only) if there is not alot of skin to work with? If necrocis is going to happen, where is it likely to show up? And when? How is it fixed/treated? How common is poor healing with tummy tucks? If i have had a successfully healed MTT, are my chances of having good healing results while going to the full good, or is it the luck of the draw? Every surgery i have had i have healed very well.

  Answer:  If necrosis happens it is usually early. As to complications, it is usually a thick scar. If necrosis happens it needs to be allowed to heal on its own and then the scar can be revised at a later date. Complications are not common though. If you had good results before, you should have good ones again. JG 1.22.06

• Hello Dr. Garcia. :) I had a full tummy tuck three weeks ago and my belly button is presently flush with my skin. The doctor cookie cuttered my old stretched out belly button and stitched it lower on my abdomnen. I understand it will eventually sink but I am wondering how long this can take. Thank you for your time and have a great day! jd 1-21-06

  Answer:  It might take a number of months, maybe 6. JG 1.212.06

• When getting a FTT, skin only if there is not much skin, does there alway have to be a vertical scar or does it depend on how high the horizontal incision is? Is there a way of not having to have a vertical by perhaps pulling up more from pubic area? If so, how freaky does this make the pubic mound and does this settle down in time? If necessary to have a v scar, is it usually just as long as the old bb hole was or can it be longer sometimes? If longer, what is reason for this? Was ready about a gal on the tummy tuck board who had about same amount of skin i have and had FTT skin only and to her horror, has ended up with a v scar inch or 2 below bb and it is 2 and a half inches long! this has me kind of freaked. PS said more than likely i will have a v scar but he didnt go into much more detail than that.

  Answer:  if there is not enough skin that is the usual issue. The only way to avoid it is to make the incision higher and then the scar will be seen above your pant line. Usually the vertical line is longer then the original belly button in order to close it as a straight line. If closed correctly it should be flat and straight. JG 1.21.06

• I had a full tummy tuck a year and a half ago. I do a lot of hard core yoga 3 times a week. Two months ago I noticed an oval shaped light red mark two inches from my belly button. I also started to have pain an hour or two after a yoga class. I went to a doctor and they believe I have a hernia. Here are my symptoms:My belly swells by the end of the day. If I do too much it gets irritated and my belly will get a constant dull pain. The area it affects are around my belly button and about three inches under my belly button. Does this sound like a hernia or could I have torn something? Is it common to get a hernia after having a tummy tuck? ML 1-19-06

  Answer:  most likely a small hernia. Hernias can happen with or without the tummy tuck. JG 1.20.06

• I had a full tummy tuck three weeks ago. I'm not completely flat, I still have that pouch. Why is this?

  Answer:  normal postoperative swelling most likely. JG 1.17.06

• With a low bikini like TT the muscles are ordinarily tightened the whole way up the stomach stopping at the area between the ribcage. My question is if the incision is put higher about 2 inches away from the pubic area will the muscles lower than the incision be left untightened?

  Answer:  yes. JG 1.16.06

• I had a full tummy tuck 8 weeks ago and since then have had quite bad indigestion and have been able to eat only small amounts of food ( which is NOT a bad thing!). I was wondering if this is caused by the abdominal muscles being tightned and the g/i tract feeling it too? I think I have a small hiatus hernia also. Many thanks for your time and endless patience.

  Answer:  yes, but it will get better. Tightening the muscles during the tummy tuck can also aggravate the hiatal hernia. JG 1.16.06

• Are anchoring sutures the entire length of the scar standard abdominoplasty procedure?

  Answer:  no, I don't think so. JG 1.16.06

• DR. Garcia I had a mini tummy tuck and lipo 6 weeks ago. The lowe ab seems improved but the upper seems worse. Is this normal? One thing that concerns me now is that the area just above the incision, like an inch and 1/2 along the incision, is very hard. I asked, and although they said without looking at it that is normal, I am wondering how long will this last and if it is in fact normal since I haven't really read anything like that in most cases and web sites that I am now looking for answers. Please tell me your opinion. What could this hardening of the skin is, and if there could still be swollen present mainly in the upper ab or is it going to remain like that. Thanks a million. Patricia

  Answer:  the firmness may last a few months and as to the upper, maybe you needed a full tummy tuck instead. Hard to say without examining you, sorry. JG 1.16.06

• Hi Dr. Garcia, I would like to have a full tummy tuck, face lift and lipo to upper leg/lower buttock done at the same time since I only have 2 weeks vacation each year. Is that possible to do that combination at the same time? Would that much done at one time jepordize anything? Thanks KL 1.15.06

  Answer:  I think that would be a very long surgery and would suggest you divide them up. JG 1.15.06

• I realize that there is a fine line when doing tummy tucks between taking too much skin and maybe not taking enough and also possibly being too aggressive and tightening things too much using too much tension. What would be the the problems that may result from too much tension when closing the incision up?

  Answer:  if there is too much tension then the incision may open up or it may lead to a thick wide scar. JG 1.15.06

• Do you recommend doing small amounts of lipo with a tummy tuck procedure or is it always best to do lipo first. I'm talking about 50-100cc's?

  Answer:  If it is that small of an amount it can be done at the same time. JG 1.15.06

• If there are stretch marks that can't be removed in the lower abdomen and the incision goes across them ... will they heal poorly due to the thin skin ?

  Answer:  yes. JG 1.15.06

• Is it standard Tummy Tuck procedure to place suture's into the facia to anchor the incision? Is this normally done the whole length of the incision or just in the middle?

  Answer:  I usually do anchoring sutures the entire length of the scar. JG 1.15.06

• With a standard Tummy Tuck incision going hip to hip.. does the incision have to be more on top of the hip bone?

  Answer:  it can be placed lower at times. JG 1.15.06

• Dr Garcia, with a FTT with no muscle repair, does it address side skin, if so, is there an obvious demarkation, for lack of better word, where the lifting stopped? if that makes sense. To get side skin, does the incision have to go beyond hipbones(towards back) or can it still be hip to hip? Also, does it affect the surgery to have had a MTT in the past, with MR?

  Answer:  The incison should be carried out laterally as far as the skin is in excess. Limiting the incision can leave excess skin. A previous mini tummy tuck should not have any negative effects. JG 1.15.06

• Hi Dr. Garcia: You are wonderful. Recently, you answered a question about a post mini tuck procedure. I had scar tissue and you suggested kenalog shots. They worked thanks. Two more questions. I am a dark skinned african american female and the area of injection has a dark spot. IT's been over four months, is there anything that can lighten this spot? Also, directly after my mini tuck, I had extreme soreness in my upper back thigh below my buttocks. It was painful for about a month and then it left. However, in the process of massaging scar tissue, in my lower abdomen, I noticed the next morning that my right thigh below the buttock had this same sore uncomfortable feeling. Periodically, I notice this soreness, what do you think that is? Directly after the surgery, it was to the point that sitting on the toilet hurt tremendously. IS that nerve damage or something of the sort from the abdominoplasty? Thanks again. Rachel

  Answer:  Maybe Retin-A mixed with hydroquinone. I think the soreness is muscles that are tight and out of balance. Not nerve damage I believe. All my best. JG 1.14.06

• what is the difference between a level 1 and a level 2 skin only FTT? I had a mini 3 yrs ago and now want a skin only full to address loose upper ab skin. I only have about an inch i can grab but PS says i am considered a level 2 and that surgery will be 3 hours? seems like a long time for skin only. His fee, 3850, reasonable? and the time of 3 hrs? your opinion please. thanks!

  Answer:  time seems a little long but not by much, fee if for surgery only seems about average, as to the level 1 versus 2, that is something he uses, it is not referred to commonly in terms of levels. He may use it in terms of keeping his fees for differnt complexities straight. JG 1.12.06

• I am having a US Transvaginal becuase of my abdominal bloating and the chance that there may be a cyst on my left ovary. Unlike the reg sonogram will this show my bladder and other organs? Since these other organs may be the reason for my bloating.

  Answer:  nope, only the organs in your pelvis. JG 1.10.06

• What is a floating belly button and why would it be done during FTT?

  Answer:  it is when the belly button stalk is cut and just pulled down connected to the normal skin, it is done when there is not a long distance to move it but it also prevents it from being maintained in a higher or normal position in the future and will move the belly button to a lower position. JG 1.8.06

• I have had a FTT recently and would like to lose a little weight ( approx 10lbs). Do you think this will affect the results of surgery: how much weight( approximately) could an overweight patient lose before it affects the results and necessitates a further TT due to excess skin etc., Thank you v.much 1/8/05

  Answer:  I think 10 pounds should have little efect, but much more then that may leave you a little looser. The more you lose, the looser you will be. JG 1.8.06

• Dear Dr. Garcia, It has been 4 months sice my full tummy tuck/hernia procedure. I have recently started going to the gym and using the elliptical machine, weights for my inner thigh and arms. I notice that when I do these excercises I feel it in my tummy and I am worried that a stitch will come loose. Is this something I should be woried about and how soon can I do sit ups. My upper abdomen is a little swollen?

  Answer:  I think you are healed well enough that you should not worry. You can start the sit ups now. Yes, most likely the upper abdomen is still a little swollen and may get a little worse for a while when you start exercising but it will go down in time. JG 1.5.06

• What are the risks of necrosis with a skin only FTT on a slender person with not much excess skin, needing a small vertical where old bb was, i am a smoker, less than pack a day for 50 yrs, really need motivation to quit. Does quitting 3 months before surgery for good help lessen the risks? If necrosis is going to happen, is it usually in the area of old bb hole or if T incision, there? Why would it happen in non smokers? Does being around second hand smoke increase risks(bars on weekends)? thank you for your time!

  Answer:  yes, quiting before does help improve the risk of necrosis. If it is going to happen it happens in the skin between the old belly button and the lower incision. It can happen in non-smokers if there is excessive tension or injury to the blood vesssels that is not recognized. Second hand smoke has little effect. JG 1.4.06

• Dr. Garcia, I had an abdominalplasty 8 months ago and I am still having problems with tightness and bulging. Can you tell me why this would still be happening? I really think I am sewn to tight. Have you seen patients with this problem? I would like your honest opinion. Also I get really tight for reason throughout the day. dew 4Jan06

  Answer:  well, although the sutures that tightened your muscle can be cut and removed but then you may bulge more as the muscle will not be as tight then. I have seen pateints that have a sensation of feeling tight for up to a year, but that is part of what they wanted with the tummy tuck, is a tighter abdomen and it at times cannto look tight without feeling tight. JG 1.4.06

• Dr. Garcia, what are the signs/symptoms one would have if they had an adominalplasty, and the muscle was sewn to tight? Also how would it be corrected? WDW 02Jan06

  Answer:  It can be corrected by cutting the stitiches, it would feel tight but it normally does feel tight for a few months but eventually does feel looser. JG 1.3.06

• If you go 36hours and dont smoke will you be ok to have a tummy tuck. Thanks

  Answer:  no, ideally you should have not smoked for one month before and one month after. JG 1.3.06

• I have had 2 children. My youngest is 18 months old. My eldest is 7 yrs. I am 36 with good health and weigh 117 pounds. I have saggy skin as a result of both births and developed a umbilical hernia during my second pregnancy. I have had 2 hernia repairs both unsuccessful. My question is: I heard I would be a good candidate to get a MTT as it would help repair the separated fascia and also having recurrent hernias..is this a myth? Toronto 1/3/06

  Answer:  no, it might be a good option for what ails you. JG 1.3.06

• I am having a tummy tuck on Jan 5th 2006 but I have not quit smoking, but I have cut back from 1pack a day to about 4 a day If I dont smoke any more for the next 2 days will I be ok.I need to know what you think. Thanks so much Kaye

  Answer:  The risks of poor healing are still fairly significant. JG 1.2.06

• Hi, I am 6wks post-op full TT and I am keen to return to the gym. When would you suggest gentle cardio and then very light weights? Also, when would you suppose I could be back doing 3 times a week sessions ( 40 mins cardio and moderate weights)?Thank you Dr.Garcia and a Happy New Year. Jane 1/2/06

  Answer:  I think after 6 weeks you are OK to do so. Full activity in another one to two weeks I feel. JG 1.2.06

• How easy is it to get a natural looking belly button after a full tummy tuck? If the patient starts out with an inny , will it remain that way after surgery? Thank you. CT

  Answer:  It should remain an inny afterwards, yes. JG 1.2.06

• When is the best period of time to quit smoking before a FTT for optimal healing and lowereing the risk of necrosis? I hear smoking is the number one reason necrosis happen in TTs. Is this your opinion? Is the most crucial time before or after surgery?

  Answer:  One month. One month before and one month after. I think smoking is a big influence but it also depends on the amount of tension placed on the closure of the wound, how traumatic the discection is, how extensive it is, if there are any signs of diabetes, thickness of the flap, many other things you see. JG 12.31.05

• Dr, Garcia, I am considering a FTT, skin only. Had a mini 3 years ago and have issues with grabbable upper ab skin. Would a FTT address the skin that runs from hip bone to ribcage, if the incision goes from hip bone to hip bone?

  Answer:  Yes, I think it would. JG 12.30.05

• The procedure I had was called modified abdominoplasty - my own original navel is still there but was moved down a little - it included correction of diastasis recti, liposuction, then skin stretched down and excess trimmed. In classification terms, is this kind of procedure a full, partial, or mini TT? Thanks. CS

  Answer:  closer to a mini but it all depends what they did with the belly button, at times they float it down and you need to know that in case you have another one done in the future. In a float, the belly button is detached from the stalk and left attached to the skin so it cannot be moved reliabely in the future. JG 12.28.05

• Dear Doc, I have a lot of stretch marks below my belly button. However, the skin in my abdomen is not loose but it does contain too much subcutaneous fat. I have heard that a tummy tuck can remove the majority of my stretch marks. I am also considering liposuction on my abdomen. Here's my question: Can a tummy tuck only be done if the skin is loose? Thank you so much. Best wishes for the new year.

  Answer:  A tummy tuck may and may not be able to remove most of the stretch marks. It all depends on how much loose skin you have and where the marks are. If they are above the belly button, they will not be removed, just moved downward. If the skin is not loose it may not be worth doing the tummy tuck. Liposuction may actuially make the stretch marks look worse if the skin gets looser after the fat is removed too. JG 12.27.05

• dear dr.g. I had a tt 2months ago w/lipo hips, thighs. the scars are from hip to hip w/bunching at the corners. dr says adjustments at a year he will do - what will that entail and what to do about scars? Will I also be able to do additional lipo at that time as it seems the back area may need some work., Also, my pelvic area seems to be swollen constantly, is this normal? should I be doing something to relieve this?

  Answer:  That will entail opening the areas where it is bunched up, removing a little more skin and the re-stitiching the skin, not unusual and a lot of it may shrink in the mean time making it a smaller procedure. Liposuction can be doen at the same time, yes. Swelling in the pubic region can last for a while after a tummy tuck. JG 12.27.05

• Dear Dr. Garcia, Thank you for having this website – it is very helpful and informative. One question I am not clear on is the following: I read repeatedly that if one has loose skin above the belly button, a mini TT will not correct that. Would you say this is true even in the case of a thin person whose only problem is this area – and if so, why? And what would you think the solution would be for a thin person with above-the-belly-button loose skin? The full TT resulting in a scar from hip to hip? Thank you. CS

  Answer:  unfortunately yes becasue a mini-tummy tuck only tightens the skin below the belly button. For the skin above the belly button to be tightened, the dissection of the skin must go above it and that means the belly button will need to be repositioned and that makes it a full tummy tuck, no longer a mini. The old belly button site at times leaves a vertical scar on the lower abdomen where the old site is moved down lower. In terms of the length of the scar, some mini tummy tucks can end up with a scar from hip to hip if there is loose skin all the way out to the side, it is not the length of the scar that makes it a mini, it is how far up towards your ribs the tissue is lifted and tightenend. JG 12.26.05

• Dear Dr. Garcia: My 23-year old daughter had gastric by-pass surgery last November. This was her last resort after learning that she had polycystic ovarian syndrome and there was no other alternative. She weighed 376 pounds at the time. She now weighs 200 pounds, needs to lose about 30 more, and presently has approximately 30 lbs. of skin that needs to be removed. Her insurance carrier, which assured her that they would cover the skin removal surgery earlier has changed their policy and no longer will cover this surgery. Financially, the cost of the surgery is way our of her reach and even further beyond what I can afford, since I am on Social Security Disability. Do you know of any foundations, plastic surgeons or anyone else that could help her obtain this surgery? Maybe a teaching facility? Any help you could offer would be greatly appreciated. Thank you so very much. Mary Denley. mdenley@bellsouth.net

  Answer:  I am sorry but I do not know of anyone that does that work pro bono. All my best. JG 12.22.05

• What is the best scar remedy for TT scar?

  Answer:  ScarGurad or Mederma. JG 12.21.05

• Dr, Garcia, I had a tummy tuck and removal of my apron i look better, however, i have a protrusion on fat or skin on the right side and flat on the other. I work out and do cardio, im in good shape. I would like to get lipo done if it will help the situation. It kinda looks like a roll on 1 side. what is the aveg. cost to do UAL? I do not think I will use the Surgeon I had the tummy tuck with. Ann

  Answer:  I would need to have a consultation in person for me to determine the fee as it depends on the time involved. JG 12.16.05

• Hi, I am 3wks post-op full tt and doing great except for a seroma. I have had drainage twice now, quite large amounts each time. Is there any way this could have been prevented, did I do anything wrong? At what stage does a surgeon take alternative action? Will the seroma formation affect the ultimate result of the tt? One last question...!when do you recommend starting driving after surgery, my surgeon ( in the UK) is saying 6 wks. Thank you so much for your time.J12/16/05

  Answer:  Usually aspirations are what is done, repeat surgery with drain placement can be done but I would wait at least 6 weeks to decide. It is not uncommon for it to happen and does not mean you did anything wrong, it is from the lifting of the tissues form the muscles below. The seromas as long as they are aspirated should not affect the final results. We allow driving after 3-4 weeks, all depends on how the patient is doing. JG 12.16.05

• dear dr.g. 3 questions 1.It is 7wks tt. I have a horizontal incision along w/a short vertical under bb. where the 2 incisions meet in the middle forming a T has been oozing. I went tothe Ps 3wks ago and he said to put peroxide on it. It is still oozing and the scab has fallen off and seems to keep trying to reform but doesn't. the area is white and seems to have string like coming from it. What to do? 2. do you suggest putting anything on the incisions both horiz/vertical to help in healing and scaring?i.e.,mederma? - 3. at what point should someone start ab/crunch exercises. thanks much, j.

  Answer:  As to the oozing area I think you need to see the surgeon to see if any ointment or debridement needs to be done of the area. As to the normal healing areas I like Mederma and Scarguard both. I think you should not do any abdominal exercises until the wound has healed. JG 12.12.05

• Dr. Garcia I had an abdominalplasty(FTT)7 months ago. The problem I'm having is swelling in the upper abdomin with tightness, and also the feeling of being pinched in the upper /lower abs. I was told the pinching feeling is my nerves trying to get back to normal, it really is uncomfortable. Are these symtoms normal. Also it feels like the pain/pinching runs up/down the incisional line were the muscles were sewn. WDW 4Dec2005

  Answer:  Those symptoms are normal and should all go away in time. It most likely is from the stitches in the muscle to tighen them. JG 12.5.05

• I would like to know the difference from a mini tummy tuck and the half tummy tuck I would liks to know the price from you for both sergeries

  Answer:  never heard of half tummy tuck. Probably the same as a mini tummy tuck. JG 12.4.05

• HELLO, I WOULD LIKE INFO ON RECOVERY TIME FROM A TUMMY TUCK AND LIPO TO THE HIPS,THIGHS AND BUTTOCKS? CAN YOU GIVE ME A COST ESTIMATE AND RECOVERY TIME. THANK YOU

  Answer:  Recovery time is 2 weeks light activity and one month before full activity. As to the price, I think you need to consult with the doctor you choose as prices vary from surgeon to surgeon and an in person exam is good to have to estimate the amount of time required as that affects the price. JG 12.4.05

• I'm considering having a tummy tuck or liposuction, and a breast lift and possible reduction. I'm 31 with 3 kids and about 144lbs but I have backaches b/c of my breasts and my stomach has a lot of flab that I can't seem to exercise off. What are your suggestions and when can I get a consultation and is it free? Karen,Las Vegas, Hurricane Katrina Victim

  Answer:  My nurses can see you for a consultation free of charge and they can usually get you in pretty soon. Welcome to Las Vegas and hope to see you soon. JG 12.01.05

• Dear Dr. Garcia, I had a full tummy tuck with muscle repair, Breast lift with breast implants on 11-11-2005. I have healed great except since the first day I noticed a small swollen area right about my belly button shaped like a football. It is about two inches by three inches wide. I still have one drain in and it should be removed on tomorrow. My question is will this area get larger once the tube is removed? I will begin wearing binder after tomorrow, will this bring the swelling down? I am swollen all over but am most concerned with this area, because when pressure applied it is very uncomfortable.

  Answer:  The binder will help and it probably will not get any bigger after the drain comes out tomorrow. It may have some fluid that they can aspirate out with a small needle. JG 11.30.05

• I had tt October 14 of '05. I had drain tubes in for approximately a week. After a week of removal of the drain tubes, I had a collection of seroma that developed. I've had it aspirated four times with nearly every time of approximately 75 cc's. The PS put a drain tube back in for a week absent any antibiotics and then I developed a severe infection from the drain tube. The drain tube backed up creating the seroma to fill to about 100 cc's. The place on my abdomen where the seroma and tube was inserted has now become hard as if severe scar tissue has now set in. Seroma is still collecting only now becoming bigger as the days continue on. I am scheduled to be injected with a tetrocycline mixture to help break up the scar tissue. Does this method tend to correct the problem without having to be re-opened for the bursa sac to be closed? I was not overweight when I underwent the surgery. The tt was just the result of two c-sections. I am healthy and was expecting good results and a faster recovery. It seems now that I'm experiencing more problems and more out-of-pocket expenses. Any professional second opinions would be greatly appreciated. I also had a breast reduction, lift and implants at the same time with the tt. The breasts are great and have had no problems whatsoever. I am just trying to avoid additional surgery to correct the problem. I have total feeling back in my abdomen, which the doc says is highly unusual in such a short period of time.

  Answer:  It sounds like you may need to be opened up if this does not work. JG 11.29.05

• Hello Doc thank you for your time and your website. It is wonderful. I had a TT Nov. the 14th and I have read comments about massages but I do not know what you mean by that. Also I read about a week to stand straight after surgery and I still can not stand straight or feel comfortable sleeping in my bed. Thankyou for your help. Sherrie 11-27-05

  Answer:  At times some doctors pull the skin very tight and that can make it harder to stand up straight, as to the massages you need to clear them with your doctor first but they are simple Swedish type massages to help the fluid absorb more quickly. JG 11.27.05

• I had a tummy tuck a year and a half ago... At about six months po I noticed a small lump at my belly button site. I was told by both my PS and a couple of other doctors that it was a small hernia.. and that I shouldn't worry about it. Two months ago... my swelling and hardness got bigger and extended about two inches above my belly button. I went in for hernia surgery but there was no hernia to repair. The doctor told me that other then some fascia seperating.. he didn't see anything wrong. Could this be that my tummy tuck failed? I did gain about 20 pounds in this past 1.5 years, could the weight gain cause this? I am miserable and no one seems to know what this is. CT scan was normal . My belly feels like I did when I was about 9 months pregnant and I constantly wear a girdle just so I can move without too much discomfort. I am at my wits end!! Do you have any suggestions? I am not even sure where to go at this point. Thanks in advance. Rachel

  Answer:  The weight gain can cause the fascia too spread apart and look like a hernia. I think your best bet is to lose the weight and see if that helps relieve the pressure. JG 11.27.05

• how can you tell if you hav developed a bursa ? I am 4 months post ftt and the abdominal area above my umbilicus is huge and has intermittent swelling

  Answer:  hard to say from the outside, sometimes an ultrasound can see the sac. JG 11.27.05

• Dr, Garcia, i was reading about the poor gal with the ugly upside down T scar from a FTT. Is this really a possibility??? I was told if the old bb hole isnt cut off(which would probably be my case) it is just a small, nice healing vertical incision. I am considering going to a full from a mini. This scar issue really freaks me out. I generally scar really well.

  Answer:  It is possibly but should not happen and can be improved with scar revision. It all depends on how much tension is on the wound. JG 11.26.05

• I had a full TT in april of this year. It was only supposed to me a mini but awoke to a full. I nval looks disformed. Doc keeps saying it will go it.. it is still the same after 8 months. I did not have enough skin to remove where old navel was so I have a upside down T scar and the line going up is really thick and nasty looking. Lip is uneven and very noticeable. You can see fat pockets under skin and nice and flat in center but sides are real bad. I keep getting it takes a year wait but I have not seen any after pic like mine. I am only 5'2 120lbs. I looked better before surg now I look disfigured. What should I do? I don't want him touching me again but I don't have to money to have it fixed.

  Answer:  You may need to have the scar revised but I would wait the full year. JG 11.26.05

• How likely is it that upper abs muscles would need repair when going from a MTT with MR to a fullTT? What are the benefits of doing upper MR? I am hoping for skin only FTT. Can the PS tell just by looking pre-op? I have had 4 pregnancies.

  Answer:  if it was not required before it should not be required now. If the muscles of the upper abdomen are loose then the area will look tighter and flatter if they are repaired. If you lay down and then raise your chest up just a little and then feel the midline of the abdomen you can tell if the muscles are split. JG 11.23.05

• Dear Dr Garcia, I am considering a tummy tuck in the near future. I am a male with a very hairy abdomen. Would this affect my surgery for better or worse in any way? Thanks

  Answer:  No effect either way. JG 11.22.05

• Dr Garcia, you say healing is a little longer to go from a mini TT to a full skin only TT. why is that? Is it the incision that takes longer or because of the uplifting the skin? My mini TT(2 yrs ago) was painfull with MR for about a full 5 days. I would think skin only would be a quicker recovery.

  Answer:  Because the amount of tissue that is lifted is more extensive so more swelling. If the skin only is tightened and the muscle does not need to be tightened again the pain is not bad. JG 11.21.05

• Dr. Garcia, i am having a consult soon to go from a MTT to a full. I can grab over an inch of upper belly skin now, am wondering how low my old bb hole will be and does this scar heal well? Will it be really thin and small? Also, are there drains for skin only FTT and how many and for how long? I only had 1 with mini for 5 days. Do they usually do lipo under the belly skin when it is lifted, if necessary?

  Answer:  whatever the excess skin is above the belly button, that is approximately how much the old belly button hole will move. Drains are in for about 5-10 days and healing is a little longer than before. Conservative liposuction may be done, but not always. JG 11.21.05

• I have a question for the doctor. My friend thinks you can have a c-section and a tummy tuck at the same time!!! She actually says it's true because she saw it on tv! I disagree with her and was wondering if that is possible or not. Thank you

  Answer:  It is possible but not typically recommended as there is a higher infection rate and harder to gauge how much skin to remove as it is so stretched out. I do not recommend it. JG 11.16.05

• I hear about dog ears at the incision sites of tt what should i be looking for I am 4weeks po tksj

  Answer:  it looks like a small area of tissue that is folded up ,looks like a lump or a folded dog's ear, but they tend to flatten in time so 4 weeks is too soon to worry. JG 11.15.05

• I had a tummy tuck on 10-31-05 in Houston, TX, I accidentally rolled over the drainage pump and removed the stitch that held the tube in place and it came out five days after the surgery. My doctor has had to use a needle to drain the fluid. He has done this twice. I am wearing a super tight belt/girdle but I still feel fluid. Do you think that I will be OK?

  Answer:  I think he may need to needle you a few times but it should all be fine in the long run. JG 11.15.05

• Dear Dr. G., I have a couple of questions. I am wondering if I would be a candidate for a TT mini or full. I have several factors to consider. Dues to an electral shock in childhood I have a vertical scar from sternum to belly button also I am on an ace inhibitor. I would like to have a full as I have had 2 large children and my skin and muscles never bounced back. I would like to say that I need to loose weight 5'3 and 150#, but every time I do I come back right to this weight. I have been a single home bound for quite some time with caring for a grandmother with alzheimers full time and raising daughter with disabilities, but I do work out about an hour a day. Daughter just moved into adult assisted living apartments and grandmother is to a point a home is seriously being considered. I think it is time to find out if I may reinvent myself, then I will find out if I can afford it :). Your opinion would be greatly appreciated. V.M 11/10/05

  Answer:  ACE inhibitor is not a problem, nor the upper abdominal scar. A full tummy tuck is needed whan there is loose skin above the belly button. I invite you to come in and see one of our patient consultants and they can give you some options. JG 11.11.05

• When going from a MTT w/ MR to a FTT, is it always necessary to do MR in upper abs? i have no bulge of fat there, actually good muscle definition, just loose skin. Had 4 children. Is it something the PS determines ahead of time at consult or during surgery when he gets in there? I know the pain of MR from TT is what is so painful,had lowers done w/MTT. I am considering a b/l with implants at same time(2nd redo). what would pain be like if staying below muscle, going with smaller implant with lift and TT with and without mr and possible lipo of fronts of thighs(just had outers hips/flanks/bananaroll 2 months ago.) Have consult on Dec8 but any ball park price you could give me? I live in Indianapolis. Sorry so many questions.

  Answer:  no, it is not always needed. It is usually determined at the time of surgery if seen and felt. If you are leaving the implants in the same location that pain should not be too bad.I could quote you fees but that varies greatly form doctor to doctor. I suggest you get a fee quote from the doctor you are considering perform the procedure. I can only quote fees for people that are going to have me do their surgery. If you desire that fee quote, contact us via email at drgarcia@lvcosmeticsurgery.com rather than the message board. Thank you. JG 11.09.05

• I have asked about this before, the reverse abdominoplasty. I was told by one PS that the incision would run under breasts across bottem of sternum. Someone on the tummy tuck site said her PS said it could be done with 2 incisions, one under each breast. I am considering yet another breast redo and possible lift and if incisions to lift upper belly can be done just under each breat with a decent result( i can only grab less than an inch) i would have it done at the same time. Hubby wont allow me to have scar running across my chest. I had a MTT few yrs ago, dont like upper belly skin, belly button droops and could stand to be more open Thank you.

  Answer:  I think since the desire for the most tightening is in the center, if there is no incision there, it will limit your ability to achieve the desired look. You may be better off converting into a full tummy tuck. JG 11.08.05

• Hello Dr.G. I just had a midfacelift and full tt/mr w/lipo of hips, flanks thank God I am feeling well, standing straight no drains. I was wondering how long before i am able to exercise. I've been walking more each day pacing myself but wonder when should i start working on my abs. I realize itwill probably be awhile but will the muscles start to weaken again? also when will I be able to sun, swim and although I haven't seen this asked yet, resume sex w/husband. tks

  Answer:  I would say four weeks. The muscles will weaken in that time but they will come back with exercise when you can do it again. Sun and swim after 4-6 weeks, same for intercourse with that much being done. JG 11.07.05

• If i go from a MTT to a full, and dont have enough extra skin to cut off old belly button, approximately where would it be and do they sew it up nice and thin where it heals almost invisibly? I scar very well, flat and fades to white pretty quickly. Thant you! Also, how do they fashion the new bb and how long for that to heal?

  Answer:  It will be between the belly button and the incision, the more loose skin you have above the belly button to begin with, the lower on your abdomen closer to the lower incision it will be. It heals well but will be visible if some looks carefully. The new belly button shape is up to you and the surgeon and it takes a few weeks to heal. JG 11.07.05

• Would Titan help slightly loose skin above belly button as far as tightening it after 3 sessions a month apart? I had a MTT 2 yrs ago, upper belly skin is not as tight as i would like. Also, can one go from a MTT to a FTT keeping the scar really low like i have or would not a whole lot of skin mean incision needs to be higher. I am aware of the hip to hip with a full. What happens to old belley button hole if it doesnt get cut of because of not enough skin, do the sew if up and you have a scar where it was? if so, does it fade well?

  Answer:  I seriously doubt it. The conversion from mini to full tummy tuck can be done leaving the incision in the same location but you may end up having a vertcal incision where the belly button hole got moved down. That scar will fade as well in time. JG 11.04.05

• I wrote the following and you'll find your reply as well. I do have one question about this? If he did that and it helped would I have to continue that for relief or would time heal either situation and that would just be a temporary? Also, I am wanting to have lipo on my inner and outer thigh area and feel that I would have loose flabby sink especially on the inner thigh where the skin is so thin. Would you recommend a minor tuck in the inner thigh area and if so where would you do it. At the crease in the groin area or mid inner thigh area? I had a full tummy tuck 8 weeks ago and I have a stabbing/burning pain on my lower left scar area that feels like something is stabbing me. I do not have a low tolerance to pain and don't image things. I feel great other than unless I am wearing tight slacks I hurt. I can place my hand on that area and hold it in for relief or simply sit and it helps considerably. Could there be a problem that won't heal itself in time. I am being told to let mother nature takes its course but is hard to believe it will get better being that it is so isolated to that one spot and really burns. lying flat I feel great. standing for any length of time hurts. The wrap does help. Answer: It could be some scar tissue that needs to soften, most likely, or a small nerve caught in scar tissue. You can have your surgeon inject a little local anesthesia into the area to see if that helps. JG 10.28.05

  Answer:  If the shot helps then it could potentially but cut out or the nerve being buried in tissue to alleviate the pain. Repeated shots of local anesthetic are not the way to go. As to the loose skin after lipo, it is possible. Usually the inner thigh tuck is done with a grin crease incision but it depends on how the skin sags, at times we place it vertically. JG 11.03.05

• In 2002 I had a FTT with M/R. My PS at the time stated that she left a little roundness in my lower abdomen so that it may look natural. I have since moved to another state. In 2004 I had lipo done to that same area together with my upper abs because I was not pleased with the little bulge. It seemed to have been flat right after the lipo, but now the bulge is back and I'm even more dissatisfied. I recently visited my PS who did the lipo and he states that although it doesn't look bad and only if I wanted to, he would suggest doing a MTT because the bulge is not from fat, it is from loose skin. Do you think that I will have better results coming from a FTT to a MTT? Also, I do want to note that my abs still seem to swell by afternoon and down more in the am but not much. I did mention this to my PS as well. Thanks MJ

  Answer:  A times after a full tummy tuck, a revision is needed and that usually is just a mini tummy tuck type of thing. JG 11.01.05

• Thanks for your earlier answer regardimg tummy tucks. Does a mini tuck also pull laterally AND downward, or just downward?

  Answer:  a little laterally but mostly downward. JG 10.31.05

• I have vertical stretch marks on either side of my belly. When I pull the skin along the vertical axis, the stretch marks become thinner but much deeper, which makes them look worse. On the other hand, when I pull the skin horzontally, perpendicular to the direction of the strtech marks, they look a lot better. Given this information, do you think that my stretch marks would look better or worse after a traditional tummy tuck? Thanks

  Answer:  well, a tummy tuck pulls both laterally and downward so it is hard to say, most likely they will look about the same. JG 10.31.05

• Hello Dr Garcia, I had a tummy tuck, with correction of a diastasis and liposuction 4 years ago. Just under the xiphoid I have a knot of scar tissue and the placement of my belly button is just off to the left. The scar is just above my pubic region and when I sit I have jowels that hang over ht escar area. Is there anything that can correct this. It looks fine as long as I lay on my back or stand but if I move it looks wierd.

  Answer:  I am afraid the only thing to correct it is more surgery. JG 10.28.05

• I had a full tummy tuck 8 weeks ago and I have a stabbing/burning pain on my lower left scar area that feels like something is stabbing me. I do not have a low tolerance to pain and don't image things. I feel great other than unless I am wearing tight slacks I hurt. I can place my hand on that area and hold it in for relief or simply sit and it helps considerably. Could there be a problem that won't heal itself in time. I am being told to let mother nature takes its course but is hard to believe it will get better being that it is so isolated to that one spot and really burns. lying flat I feel great. standing for any length of time hurts. The wrap does help.

  Answer:  It could be some scar tissue that needs to soften, most likely, or a small nerve caught in scar tissue. You can have your surgeon inject a little local anesthesia into the area to see if that helps. JG 10.28.05

• Could the incision of a tummy tuck be placed in such a way so that it is masked by the hair in the pubic region?

  Answer:  It would be very difficult as it would man that a very small amount of skin was taken and that is very rare. JG 10.23.05

• Hi Dr. Garcia, I had a total body lift, abdominoplasty, and my underarms cut and lifted plus liposuction. During the surgery a total of 18 lbs of tissue/fat was removed. I didn't eat anything while I was in the hospital because I felt so bad. When I got home I weighed my self and I am 2 pounds HEAVIER than the day before I had surgery. I have a lot of edema around my ankles, legs, flank, abdominal area but it's been 2 weeks and I'm still caring around all this fluid and my heart rate is 100 at rest when normally it is about 64. Im really not getting any healp from the Dr that originally did this prodedure, he just tells me to wait, but it seems like this weight/fluid that is accumulating is never going away. Alot of bruising is present and hard lumps.

  Answer:  You should be wearing some garments to manage the swelling and also we recommend massages to help with the swelling. If you had that all at one time that is fairly extreme and will take a long time to get better I am afraid. JG 10.21.05

• I have a full TT in October, 2004. I healed great anf the results are wonderful. But I do have one problem. After my surgery I did go back for dog ear revision and also the shape of my belly button was a little odd. The result of the dog ears are fine, but where my Dr. tried to fix my belly button, he was hopeing that the cuts would roll down into my bell button crater. Well a year later and this didn't happen as a matter of fact my belly button now looks almost flat, very little of a crater shape. My skin is very very tight to my stomach muscles. I went to him to see about getting a Umbilicoplasty to reshape it. He said that because my skin is so tight, This can't be done. He is thinking about trying to make a small cut at the bottom and try to pull the top inward and sew to shut, to make is more of a crater, but he said that the previous scars will not roll inward, becasue of my tight skin. I suggested to him to inject fat around my belly button to loosen the skin up so it can roll inward. Do you aggree that I could not have a Umbilicoplasty because of my tight skin? Have you ever heard of injection fat in that area? I need to get some direction what to do. Thanks

  Answer:  I agree with the surgeon because of the tight skin. I don't think fat injections will work but you can talk to him about placing a tissue expander that will stretch the skin over a few months. JG 10.19.05

• Hello. I had lipo while having a full tummy tuck and breast lift. This was done about two months ago. My left lower side of my stomach is bigger and sticking out more than my flat right side. The plastic surgeon said he could go back in and do lipo again on the left side. He did not say when this could be done. My question is, do you think I will have to pay again and will the healing time be so long again?

  Answer:  The healing time wil be less, but I cannot tell you if he is going to make you pay again, you will need to ask him. JG 10.18.05

• Dr Garcia, you explained to me the reverse abdominoplasty but that i could actually go from a MTT to a full and get a better result, more lasting. could you please explain to me more about the small vertical scar i would have from this? I have very little skin left and am skeptical of going to a full safely, without putting too much pressure on the new incision. Where would this vertical scar be located, why, and how big? Thanks.

  Answer:  A full tummy tuck is possible after the mini but it might leave you with a small vertical incision between the lower scar and the belly button, it is the old belly button hole that has moved. The scar certainly will be easier to hide. JG 10.18.05

• Dear Dr. Garcia: I had a full tummy tuck and lipo on 9/7/2005. My tummy tuck incision has not closed up still. I have a two-inch hole in the middle of the incision and it oozes out brown fluids. I had dissolvable stitches. Is this normal and when should this close up? I want to swim laps, but my plastic surgeon won't let me until it closes completely, which seems it won't! I am putting on silver sulfadiazine cream in the morning and ziox ointment in the evening. Nothing is working. Should I get a second opinion? thanks

  Answer:  It is not normal but can happen,. It may takes a few months to close. You should not swim in a pool until it is closed. You may need to get the wound surgically cleaned out too, best to go back to the original surgeon I feel. JG 10.18.05

• Dr. Garcia mi nonmbre amanda Lee en diciembre del 2005 me realize un tummy tuck completo y liposuccion de la cintura,mi peso 140 lbs y mido 5'7 el problema es que me la realize en mexico y el cirujano que me atendio se cambio de ciudad y no lo encuentro despues de 4 meses de endermologie y mucho dolor el resultado sigue siendo el mismo no baje ni medidas ni se quito la bolsa debajo de mi abdomen,en su lugar solo aparece una horrible cicatriz,me gustaria consultarlo y saber si se pueden repetir los 2 procedimientos de nuevo o solo la liposuccion?hay alguna tecnica de anestesia local? espero su respuesta gracias mil.

  Answer:  puede llamar al (702)87-0058 y ellos le pueden dar una cita. No creo que seria posible con anestesia local. JG 10.17.05

• ive just had a tummy tuck and have been advised by friends to use bromelin to reduce the swelling... could u advise me correctly on this matter

  Answer:  I feel it is a good idea. JG 10.17.05

• Hi, I'm considering a tummy tuck in the future and was wondering whether a cut from hip to hip will also tighten the skin on the sides of my torso as well as on my stomach. Thanks

  Answer:  It will only tighten the skin on the front of your abdomen. JG 10.16.05

• Hi, it's me again. The TT that ended up high. Thanks so much for all of your answers. I guess I still don't understand why out of hundreds of TT's this surgeon does he chose to put a high incision on me to avoid healing problems, (if that is the only reason why an incision is placed high) His cosmetic consultant says to me, All of his other TT's have low incisions so why would he place yours high? (She believes his contracting and migrating up theory) I wouldn't expect anything different. It's her job to back him up. Anyway........what makes the blood supply better and wound healing better when the incision is higher? Why don't low C-section incisions have wound healing problems? I just don't get it. I want so badly to understand this all. Wouldn't a doctor realize that when the incision is placed so high it leaves an unnatural indentation and causes a bulge above the incision and a more unfavorable position than if it was a lower abdominal incision.......not too mention the scar being visible. If he felt that the incision had to be place higher wouldn't he just come out and say......you might not be a good candidate for this surgery because your incision will be highly visible?? I think I may try lipo to smooth things out but I don't know how much loose skin will remain to lower the incision. I am only 110lbs and there is just not that much fat there (except on the sides and going towards my back )but the incision is indented in so much that it is noticeably odd in a one piece bathing suit or any form fitting clothes. As much as I've tried to give this surgeon another chance at making things better I just can't seem to trust him again. Do you think I should ask him for a refund to have another surgeon do the revisions or should I give him a chance to make things better? I'm afraid if I ask him for a refund it will just make him mad and he will decide not to refund my money and also not to do the revisions. I guess I should look at it like the damage is done. I can't change the placement of the incision much now. Would there be that much of a diffence in skill and technique when it comes down to lipo and fixing dog ears or is that pretty cut and dry???? I'm sorry that I ramble on so much. Thank you for your opinions. I wish that I could consult with you ......your credentials seem extraordinary and you seem like a real honest straight shooter telling things like they are. Thanks.

  Answer:  Well, he may do it all the time, or he possibly just made the marking on you wrong before the surgery started. I would have assumed that his nurse would agree with his statements too. The blood vessels that heal the edges of the wound come from blood vessels that start near the rib cage, the longer the distance from the rib cage to the edge of skin the potentially the less the blood supply. I agree with your comments and asking him to help you with the fees form another surgeon I am afraid will fall on deaf ears. I probably would not have him do the revisions anyway. I think the additional surgery is pretty straightforward. JG 10.15.05

• Hello, After my 4th pregnancy,my stomach muscles seem to pouch out ALOT.(never did before) Crunches make my stomach look worse.I look pregnant afterwards. Its right in the middle,from right above my belly button, all the way down. Is it possible just to get my muscles tightened,without having a mini TT? I can get the fat off myself.(Ive done it before) Thank you! D.T. 8-14-05

  Answer:  it is but there will stil be scars on the lower abdomen and a small one in your belly button to achieve this. JG 10.14.05

• Dr.Garcia,can you tell me about reverse abdominoplasty? I had a MTT a few years ago, have since never liked my upper ab skin, a little loose. My PS suggested pulling skin up with incision going across chest, under breast creases(have implants, crease incision but it is not actually in crease, about1/2 inch above) He says he would use internat stitches, leaving a very thin scar going across chest between breasts. I scar very well, fades quickly. I am thinking about getting my implats replaced someday with smaller silicon, They are 550 saline unders now. could these 2 surgeries be easily combined? PS says iit would be skin only reverse TT, no relocating of belly button. Scar running across chest concerns me. Please let me know your opinion on this. Or, is it possible to go from a mini TT to a full? Relocating belly button makes me nervous, have heard of messed up bb s.

  Answer:  the surgeries can be combined and I do perform them but the scar over the bottom of the sternum is not a thin scar and will need to be hidden or covered with make up.A full TT can be done after a mini tummy tuck but it could leave you with a small vertical scar where the old belly button hole is moved downwards. JG 10.14.05

• Hi Dr. Garcia, I am 51 (almost 52) years old and am having a full tummy tuck and lipo on my hips and upper thighs on November 1st (after 5 pregnancies, a hysterectomy, and gall bladder removal). I am also a 35 year (one pack a day) smoker. I have been told to stop smoking and quite frankly, am having a hard time with it, but realize I must do it. I am working on it. Will it help to at least cut back on the cigarettes (say to 4 or 5 a day) instead of the usual 20 a day? I am scheduled for an EKG , Blood Test (complete profile and CBC), as well as a physical with a doctor next week. Am I too old for this procedure? I stand 5'3 and weigh about 120 pounds and my BMI is good, except for the lower stomach, which is flabby and extends out. I am looking forward to the results, but am a little nervous, too. I imagine this is normal. Thank You so much and I look forward to a reply. I've been searching the internet and am so happy to find this site. dj

  Answer:  Any decrease will help you heal better from the tummy tuck, especialy the lower middle of the scar. I do nto think you are too old for the surgery if you are otherwise healthy. I wish you the best. JG 10.13.05

• Hi Dr. Garcia, I had a TT 1 year ago and ended up with a very high scar. I consulted with 2 doctors initially. One said I may need a vertical incision in order to keep the horizontal low and the other said that he's never had to do the vertical incision and that he would try to keep it low so that I could wear low rise pants. I went with the one that said he'd keep it low enough for low rise pants. I am far from wearing those. When I asked him why it was so high and indented in he said my tissues were contracting and that the scar had migrated upwards. He said he's never seen this happen but that is the way I healed. He told me to massage it and stretch and it should come down. He told me he cut me low and drew a low line just above the pubic area (like the incision that is shown on brochures), on a picture I brought in to his office a month after surgery. I told him it was high from the day I came home from surgery but he insists he cut me low and it migrated up. He wants to revise it for me and bring the sides in the front more in line with the bottom section which is lower and acceptable but still a good inch -1 1/2 inch above the pubic area. I don't know why the incision is up so high in the front straight down from my oblique's lie a birds wingspan instead of a smiley face incision. It is frustrating when you can't get what I believe to be an honest answer. Anyway he wants me to be happy and wants to redo the whole incision, (except the very center part where the belly button was moved down. He said in his opinion that section is fine and that he'd like to use that as an anchor so that is doesn't migrate up more) cutting out the scar tissue and moving it downwards more in line with the center. I can live with the height of the middle section but it is by far the widest part of the scar and is indented in which gives it that butt cheek look if you know what I mean. I've got to believe that if he leaves that section I am still not going to have a smooth appearance. What is your take on all this?????? I am struggling with making a decision on where to go from here. I did get a second opinion from another surgeon who thought she could move the lower portion down an inch but wasn't sure how much she could lower the sides. She also suggested maybe lipo suction above and below the incision and on the flank area to smooth things out if I could live with the height of the scar and just wanted the overhang on the sides and bulginess above the incision taken care of. I realize it's hard for you to comment on something you haven't seen but any words of wisdom would be appreciated. Thanks!

  Answer:  the end result of where the scar is due to surgical planning and is due to where he made the incision, not due to unequal skin contraction. I agree with your assesment of the incision too. Lipo will thin the tissues out too. I think it wil be very hard to move the scar down until you have a lot of excess skin that can be moved. Sorry. JG 10.13.05

• Dr. Garcia, I had an abdominoplasty almost 7 weeks ago and two days ago I discovered a lump a size of a pea near my navel. I have been trying to research the possibility of what it might be and I think it might be an umbilical necrosis. It is somewhat hard and pointy and it also brings sharp pain in that area which sometimes is also felt in my abdomin. Do I really need to worry or does it go away on its own. I appreciate your time. L

  Answer:  most likely it is the end of the suture they used to tightent the muscles and in time should be less of a problem. JG 10.12.05

• Dr. Garcia, I am 5'8 and weigh 120. I am slim, but after 2 big babies my tummy bulges, mostly below the belly button. My OB told me that the pregnancies streched my abdominal muscles considerably. My PS is suggesting a mini Tummy Tuck since there is not much loose skin above the belly button. My question is will the PS be able to tighten the lower abdominal muscles or will only loose skin and muscle fascia be improved during a mini TT. Thank you CG 10/7/05

  Answer:  The muscles can be tightened in the mini tummy tuck, yes. JG 10.7.05

• Hi Dr. Garcia: Thanks again for all your wisdom. YOu helped me tremendously. I am the person who had a mini tt, then a fat extraction, then finally removal of scar tissue. Later there was scar tissue and with your suggestion, I had kenalog shots which softeneded the scar tisuue and gave me the look I was finally looking for. New question, I am a 37year old, african american, nonsmoker, no drinking, no drugs,very healthy, however the area looks like old skin. It's flat but it's not a pretty stomach. Prior to any surgeries it was fat but youthful. My body is very youthful. Why is this so, and can anything be done about it? Finally, before the wonderful kenalog shots I had a small bubble right above the pubic area above the incision, that would remind me of a fluid buildup. My plastic surgeon said it wasn't fluid. WHen I wear a tight garment, it shrinks and had done so, but I noticed during my menustration cycle, it rose again, and after it flattened back out. Does that sound strange? Do you know what that is? After the first mini tuck, and fat extraction, I had a big seroma, after about three aspiration, it dissipated. Thanks Rachel

  Answer:  could be intrabadominal swelling from the uterus. I am sorry but there is not much to offer to improve the quality of abdominal skin I am afraid. JG 10.4.05

• Dr. Garcia - It has been three weeks since my mini tummy tuck and lipo of the thighs. I was ok'd to begin my treadmill, walking only, today. I wanted to know if there is some kind of exercise/stretch/kegals?/tightening with breathing - that I can begin to help strengthen and/or help the healing process along on my abs. Or should I not do anything and avoid the ab area all together? Thank you for your advice.

  Answer:  I would hold off for another 1-3 weeks or so, then crunches would be good. JG 10.3.05

• What is the difference between a mini-abdominoplasty and an abdominoplasty? Will a mini make you flat as a board without liposuction? I don't have any loose skin but weak stomach muscles and a basketball buldge below the bellybutton that grows when I eat a good meal. I am 5'4 /145 lb and in fairly good shape, work out 5 days a week, with good skin tone. Thanks KAA 9-29-05

  Answer:  a mini abdominoplasy involves moving the belly button whereas a mini is really the lower half only of the full tummy tuck. What the mini will do varies from patient to patient. If you have only loose muscle below the belly button then a mini may be all you need. JG 9.30.05

• Hello I had lipo done on June 3, 2005 and a full tummy tuck on Aug. 3 ( I had healed wonderfully) My problem is that my stitches and two drain tubes were removed after three weeks.Two days later I developed a fever. I had to return to surgery have 350 cc of fluid removed and a tube reinserted. I wore it for two or three weeks and then it was removed. Yesterday I had to go back to the doctor and he removed 5 tubes of fluid from a pocket above my bellybutton. He put me in a band to restrict the fluid in that area. I just removed the band to shower and the pocket appears to have returned.. What am I doing to cause this and do you know of any procedure that might stop the fluid from returning. I teach school and I can not afford to miss this much work. Thank you in advance for your help. I love my doctor I just want to arm myself with as much info as possible. TB 9/27/05

  Answer:  well the drain may need to be placed again, he may need to use some fibrin glue made from your own body to help the problem, or inject some sclerosing agents like doxycycline to get the space to collapse. JG 9.28.05

• I want to get a tummy tuck and I would like to know can I get one without losing weight. I am 5'5 and I weigh 204lbs. I like my shape but I dont like the way the weight is centered around my stomach area is it possible to get a tt at this size? If I had to lose weight what would be my target goal.

  Answer:  I think the probelm lies where the weight is. If you have a large amount of fat inside your abdomen, around your organs, below the muscle, then a tummy tuck will not look good. That would prevent us from tightening the muscle and your improvement would be limited. I think the best thing is to get to a weight that you think you can maintain long term and then be examined so someone can tell you what the limitations will be in your case. Best of luck. JG 9.26.05

• I would like to know how much you charge for a tummy tuck? and if there are any other charges that I need to know about such as body garment, medication and hospital stay? Due to my credit, I would also want to know if you have any type of payment plane such as prepaid surgery or if you guys can work something out as a payment plane? Please feel free to contact me by phone or email. Thank You Monica

  Answer:  I think the best way is to see one of my patient consultants in the office at no charge as they can give you the finance company info we use, they can give you a quote, and also determine whether you need a full or a mini tummy tuck. If it is a full tuck, we include one night stay in the hospital in the fee. They both include all of the garments,lab work, anesthesia, actually everything, except your medications and your massages. JG 9.25.05

• My daughter had implants through her belly button today! I noticed that after she threw up, her stitches tore out of her belly button and I see a little blood and creasing. I also notice in the very center a little yellow tissue. I called the Dr and he said No big deal and not to worry but I am afraid for her to take her first shower if the stitches have fallen out and couldn't she get an infection? Please inform sg

  Answer:  I would wait until you see the doctor before showering. In the mean time, just sponge bathe. JG 9.24.05

• Th;ankyou for your answer, and in response to regarding the possible popped suture, or swelling that I may have accidently done to my 1,1/2 month mini-tt., can you tell me if I would need to have it opened & re-sutured from the inside?, and as for the swelling, will it subside on its own if I wear my garments tight?, or will this need to be drained? or, will they both heal themselves over time, provided ofcourse that I am extra carefull not to re-injure the lower part of my abdomen. Lastly, will my stomach be Flat agian like it was? Thanks agian for your answer.:)

  Answer:  No, it will just heal on its own. The swelling will go down in time also. No need to wear garments or have it drained. I think in time the flatness will return. JG 9.23.05

• Hi Dr. Garcia, I had a mini-tummy tuck & Lipo to the sides of my abdomen, about 1 1/2 Months ago, yesturday at work I had to help lift 75lbs. of boxes for about 10 mints. later at home I noticed a little tingly pain in the area of the insert to the Lipo, upon checking It looked like my stomach had gotten puffy towards the bottom. Do you think something has come undone?, How much can make the inner stiches in my mid-Abs. come apart? should I contact my Dr. DO you think I may have ripped or torn out the inner stiches? Thanks in Advance for you answer.

  Answer:  A suture may have poped or you may just have some swelling. I think the best thing is to see your surgeon and have them check you out. JG 9.22.05

• Hi Dr. Garcia You recently helped me a great deal. I had a lot of scar tissue after a mini tt.