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• Hi dr Garcia, Is it tru that after abdominoplasty with liposuction from certain areas, pubis, hips and stomach middle line, the body stores fat in other places whithin one year like arms , breasts or back , this even when the weight stays the same. I heard that the body needs a certain amount of fat and that if fat is removed from certain areas it will go to other areas to keep up with the amount that it needs, resulting in deformed body composition. to less fat in some parts and too much in other parts. Can it go to the face as well ? What can be done to prevent or to correct this. thanks for explanation.

  Answer:  the fat removed with liposuction is permanently removed, so if you continue to eat above your minimal daily requirement of calories, then you will store fat, and since the original first places for the fat to go to are gone, the fat will find a new place to be stored. It only happens if you over eat though. Your weight staying the same means you actually gained weight since you lost fat from the liposuction, so there was a fat gain you have that has not been appreciated. The body does not need a certain amount of fat. In some cases, after menopause, the body is low in estrogens and your body can make you can gain intra-abdominal fat in an attempt for that fat to make estrogens, but it will not cause fat gain in other areas. Fat gain in the face is weight controlled, not influenced by liposuction.I think you need to get your body fat tested and then start on a smart eating program and exercise program and lose some fat while gaining muscle. All the best. JG 1.26.12

• dr garcia, i just had a scar revision from a bad abdominoplasty scar. I have the impression that a piece of skin, where there was scar tissue is loose now and my belly seems bigger looser then before, do i have to wear a compression garment again ? is this normal i dont fit in my clothes at the moment. I also had a new breastuplift with replacement of implants, second time, i have less pain, but my breasts have the same size as before although they were replaced by smaller implants. Could this be swelling again, i dont feel that much swelling, why do i have less pain then the first time, is there something wrong, less sensation ??? Thanks for reply.

  Answer:  they likely had to release the surrounding tissue on the tummy to allow the wound edges to come together, so that explains the scenario, but that will all settle down with time. As to the breasts, I think it is likely swelling too, which will also go down in time. All sounds normal for what you went through, just got to hang in there. JG 12.28.11

• I am presently 5 months post-op following a full abdominoplasty w/liposuction, and have two concerns. First, I have had a band of very firm tissue (internally) at the suture line, which has resolved everywhere but at the mons pubis. My surgeon believes it will continue to improve with time, but the mons remains puffy and the firm tissue seems resistant to go away completely. Assuming this firm area will eventually soften, will this relieve some of the puffiness of the mons (which I believe is due to some fluid retention)??? Second, and probably of greater concern is that at approximately 8-9 weeks post-op, I foolishly attempted to lift a 40-lb bag of dog food into a shopping cart, and felt searing pain in the left-midline upper abdominal area. My surgeon had told me that the rectus abdominis was significantly separated to the far lateral sides of my abdomen due to years of obesity and two pregnancies, one of which was a twin gestation, and that he did some “heavy suturing” to reconnect the two sheets of muscle. I discussed my lifting ‘injury’ with my surgeon, and he seems to feel that since there is no bulging or evidence of internal bleeding, that the muscle will heal normally. However, it has been over 3 months since I injured the site, and I continue to have considerable pain with the area very sore with even the slightest pressure. I am unable to sleep on my side without a pillow firmly tucked against my upper abs, or without my abdominal binder in place. Although I trust my surgeon and am overall VERY pleased with the aesthetic results of the surgery, I was hoping you could provide some reassurance that this will heal and will eventually stop causing me pain. Thank you so much for your time.

  Answer:  I believe as the firmness in the mons area softens, it will also shrink in size. Edema of the mons can take a long time to resolve. As to the pain after the lifting, if the fascia where the sutures were placed partially tore, that can take a number of months to feel better due to the constant movement and function of the muscle. I agree with your surgeon`s perspective and that it will likely go away and heal without any significant problem. Hang in there and I wish you the best. JG 12.6.11

• Hello, Dr. Garcia. 2 years ago, I had a circumferential body lift. The scar on my abdomen is wide and red, but the scar on my back is almost invisible and hairlie thin. My surgeon at the time told me she closed the top layer of the back in a quick-dissolving suture because it tends to leave thin scars and because back scars are never thin otherwise. (It did spit a few of the sutures out but that is, I understand, a known an anticipated complication with that particular suture material.) She used a slower-dissolving suture on my abdomen on the theory that it would be thin anyway, but of course, it didn`t work out that way. I`ve since moved across the country and would like to have the abdomenal scar revised. What is the name of that fast-dissolving suture that my previous surgeon used o the final layer of my back incision so that I can discuss this intelligently with a new surgeon? Thank you for your help.

  Answer:  might be Monocryl, but the redness and width of the scar might be related to the degree of tension upon closure and not the type of suture. JG 12.4.11

• Hi Dr Garcia. I am 16 days post op from a tummy tuck and lippo. I have been able to get myself to stand up straight since week 1 but am still have trouble standing up straight after I`ve been sitting down for 20 mins or so. My belly gets so tight that its uncomfortable at first so I walk hunched over for a minute or so. Is this normal? Or should I be alarmed?

  Answer:  It can be normal, the more skin that was removed and the tighter the repair of the muscles was, the longer it will take, but a little stretching out every day will get you back to normal sooner. JG 10.27.11

• Hello Dr Garcia. I had smart lippo and tummy tuck done and am a little over 2 weeks post op. I have this big dip on right side that don`t look anything at all like my left side. It looks more visible to me each day. Will this completely go away after the swelling is gone? I`m afraid my sides is going to look uneven permanently:-(

  Answer:  hard to say without seeing you, but at this point one can hope that it is mostly due to uneven swelling, which can happen. I think you need to see your surgeon for the routine follow ups and see what they say, as they can see you in person. All the best. JG 10.26.11

• I`m 16 weeks post tt. took ultrasoud,with dx of 4 x 8cm area compatible with organizing hematoma located anterior to the left hip,which communicates with small open wound approx. 1cm deep. Had previously used guaze packing, before ultrasound. Doctor now says do not pack, and just allow it to close. He has aspirated twice. 40cc the first time and 20 cc the second time. I am wearing a compression garment except while sleeping. Will this eventually all go away as he suggest, or am I facing surgury

  Answer:  I think if you continue to aspirate any fluid in there, then the capsule can close off sooner and you can avoid surgery. It would be hard for you to pack the entire 4X8 cm area, so you were likely just plugging up the more superficial part. I wish you the best. JG 10.7.11

• HI Dr G Hope this finds you well. I`m now 6 weeks post op from Abdominoplasty, healing going well my incision is a fine pale line but just underneath my incision line I am spitting a few staples, my surgeon used these not to close the skin (this was glued) but to close tissues. I have been spitting one for about 4 weeks that has been painful and has come to what looks like a big red pimple,the others are just a bit red but are not painful. My surgeon is a long drive away and has told me it will pop out on it`s own and when it does just to treat it with Iodine and loose dress it . The thing is it has been ages now and though it looks like it will pop should I wait ,will it do any harm for me to wait for me to let them pop on their own....or should I go and get them taken out by the surgeon?but will it take many trips. Do they need to be right near the surface of the skin to get them out? Thanks Dr Garcia in advance, great site. Just wish you lived in my country!!

  Answer:  I think in order to get the best scar, a trip to the surgeon is warranted, and they should be able to remove all of the problem staples in one setting. All the best. JG 7.13.11

• About how long does it typically take internal dissolvable sutures to dissolve (abdominoplasty)? And about how long does it typically take for the hard, stiff quality of swollen tissue to soften? 4 wweks? 6 weeks? Thanks very much for your kind help, Dr. Garcia.

  Answer:  depending on the type or brand of absorbable sutures, it can be 6 weeks to 3 months. As to maximal softening of the scar tissue, most of it is in 3-6 months but there can be continued changes for up to one year. JG 7.1.11

• Thank you for your quick reply to my question below about the hematoma. My next appointment with my surgeon is on July 20. Anything I should do to help the blood to liquefy in the meantime? And is there anything in particular that I should watch for that would warrant a call to his office before July 20? I`m not too worried about this but I don`t want to be careless either. (What is the worst case scenario with a hematoma like this? Necrotic tissue?) Thank you again so much for your generous time.

  Answer:  warm moist heat and massage, and if it gets softer, I suggest you see him sooner.The worst case scenario is that the tissue below the skin will necrose and leave you with a depression form the subcutaneous tissue loss. Hope that helps. JG 6.27.11

• Hi, Dr. Garcia. I had a butt lift last week and had quite a bit of post-op bleeding on one side, which finally stopped with 3 hours of manual compression. I am, of course, swollen and bruised but my left hip has a large spongy ball of tissue (halfway between the size of a baseball and a golf ball) protruding from it. I saw my surgeon today and he ruled out both a hematoma and a seroma. He tried to aspirate it but only got a tiny amount of blood on multiple sticks. He told me that it`s probably blood that`s just infiltrated the tissue and that it will take 4 or 5 months to dissolve on its own. Does this sound right to you? Could it be something else? Anything I can/should do to hasten its dissolution? He didn`t offer my any suggestions -- just told me to watch it for signs of infection. In the meantime, even the compression garment can`t disguise this. It looks like I have a tumor on my hip! Thank you very much for your help.

  Answer:  I still believe it is a hematoma, that is just not liquified enough yet for him to be able to aspirate it, and I think repeat visits are indicated. Once the area is softer and the hematoma is more liquified, it likely will be able to be aspirated, although sometimes a regular needle is not big enough and they have to use small liposuction cannulas.All the best. JG 6.27.11

• Hi Dr Garcia I had a full Abdominoplasty 3 weeks ago with muscle repair, the surgeon removed 2 LB of skin , lipoed very little out for contouring as I had very little body fat at 122 LBs and said I had slight muscle separation which was corrected. He said my muscles were very toned as I am an elite marathon runner. I am a great shape and he is known for pulling you very tight, I`m only just getting upright. The slight concern I have ,and I do understand it is very early in the healing is that I have a very deep grove/crease that runs up from my belly button vertically up to my bra band. He did the quilting technique so I had no drains and very little swelling , I can see my muscles now like I have done a million sit ups. He said it will flatten out somewhat but it is good to have a crease there as it really gives definition to the abs...to be honest at the moment it looks odd and if I really stretch the skin out flat with my fingers the grove is still pretty visible. I was told by the nurse that this is all due to the quilting stitches that need to dissolve. Could my compression garments contribute to this? Have you heard of this being a byproduct of this technique? Could it be down to my toned muscles being brought together and be permanent? sorry for all these questions so early but you have always been an honest opinion and a star! Thanks Dr G

  Answer:  do not think the compression garment is making it any worse, and with quilting sutures, it is common, I see it my patients, especially thin ones. In time, as the sutures dissolve and you start moving around, that crease will improve, just takes some time. Hang in there. JG 6.23.11

• 4 months after full tummy tuck, my once flat belly but with excess skin is now sticking forward, higher then it should be , the scar is very high and i am hollowed out uneder the scar between the legs and with a bulging pubis. Can a correction be done anyway to resolve this issue, i am also hollowed under the ribs. Thanks for reply.

  Answer:  might need some defatting of the tissues and then hopefully that will nto only smooth the high points down but also allow the scar to be moved downward for you.I would give it 10-12 months though for the skin to become as pliable as possible before attempting it. All the best. JG 6.10.11

• How soon after a butt lift can the scar be revised? My surgeon and I agree that my scar is too high and needs to be lowered. Wondering when it`s safe/advisable to do that. Thanks so much!

  Answer:  In your case, it cannot be done until there is enough loose skin above the scar to be able to move it down, likely year or more.Best of luck. JG 5.24.11

• 2 months after tummy tuck, the puboc area is lifted too high, also my whole tummy seems much higher then before, leaving me with a tinned out area under the scarline, as the skin is streched ouy there and much thinner then above the scar. under the scar is it like skin over bone and above the scar all the fat seems concentrated as wgere it was more even distributed before. It looks weird like with indents at the sides under the scar with elevated bulging pubic area in the middle. Will it stay like that forever. Will the fat lower again where it should be. Is this a nomal condition.

  Answer:  I think in time that will all get better, the swelling that will sit right above the scar can take up to one year to go away, and as that does go away the difference in thickness should get better and likely the scar will also drop in the pubic region. Best of luck. JG 5.16.11

• 2 months after abdominoplasty still this pulling sensetion inside, how long does it take to feel normal again ? Above the pubis area there are some hairs that are growing inside the skin, creating some bulging on several places, is it nessesary to open those spots and remove the hair. thanks

  Answer:  it can take 6 months on rare occasions, all depends on how much skin was removed and how much adherence there is of the skin to the underlying tissues. I think seeing your surgeon to allow those hairs to be lifted out is the best option. I wish you the best. JG 4.25.11

• Dr Garcia, is it possible that my tummy is bloating (after tummy tuck) from the HGH creating water retention in the muscles or somewhere intraabdominal. If so what can be done about it. I feel better with the injections mentally but the bulging tummy is horrible, in the morning it is better but during the day when i drink and eat i feel my whole body bloating. Is the water retention because of skin laxaty ? I try to figure out. Thanks for advice.

  Answer:  have not seen that occur. I don`t think the HGH is making you bloated. JG 4.11.11

• Due to the skin removal during tummy tuck, the fat in my lower belly and stomach is more concentrated, too much skin was removed and therefore my belly and stomach is bulging up, because too much fat concentrated. Before when i took a fold of skin is was like half en inch and now it is more then one inch fat under the skin. So my muscles which were visible before are now covered by this concentyrated fat layer. Pubis and tighs are not going down, they were eleveated and pubis still sticking forward. I can not wear tight clothes any more with all the bilging in stomach, belly pubis and tighs, before the tummy tuck i had no problem with that. is this a normal condition ? More bulging belly, ALL THE FAT FROM THE SIDES IS PUSHED FORWARD. Does this condition only improves when the skin gets more loose with aging, other possible remedies.

  Answer:  it does improve, but very slowly, sorry. JG 4.10.11

• What is the reason for the tick bulging noduled skin above the scar from a tummy tuck. On the underside of the scar the skin is flat , above it , the skin is raised, 7 weeks after tummy tuck. What can be done to improve, is this normal condition, Will it stay this way, does some kind of lasers can be used to improve also for the redness, maybe IPL ? Thanks.

  Answer:  that is edema or swelling from above the incision that settles there due to gravity, but it will decrease in time and flatten out. IPL can be used to help speed the fading of the redness. JG 4.3.11

• With the tummy tuck, the skin on the hips was draped forwards, to tighten, now the fat that was previously on the hips is on the front of my lower belly, making it much more rounder then before, before the hip bones were visible, now i am as small as round, very noticible, it created more an appearance of a circel, how do i get rid of this issue, i am much too small on the hips and too round in the middle of the lower belly, probably it is a procedure used to create an houtglass figure for heavy woman, which i was not before, the tummy tuck made me rounder in lower front belly, it is not an improvement at all. all the contents of my belly seems concentrated now, in a too tight skin, what can i do to fix this issue. all the fat in the belly in concentrated forwards. Doer this settle by its own , my clothes don´t fit me any more, i am as round as small. Also in the stomach area. Above the scar there are hard nodes, bulging, The skin has been stiched a bit wrinkeled, due to the draping forwards, does the skin adapts or contracts back to get rid of the wrinkling, with the bulging underneath ? Is this a common issue, I was already so small before, did not need this, also the surgeon has done some liposuction on the hips i am afraid, so this also contibutes to be even smaller and rounder then before. Does the fat comes back where it was, do i get rid of the too round appearance ? Also my mucles are bulging out stomach area and lower belly, due too the tighetening is guess ? Do abdominal exercises help with this ? I will probably never see my hip bones again, due to the concentrated fat that is covering the area . Also my tighs are much fullerdue too the skin tighetning pulling them up as i told you before. Any solution ? My body had changed for the worse.

  Answer:  without seeing you in person, it is difficult for me to say what has happened, but in time the skin will loosen, no way to tell how much and how fast though. JG 3.31.11

• Does GH help with improvement in scar healing from surgery. My doctor claims it does as children heal much fatsre due to more GH naturally. Would i benefit from more GH for that reason. Unfortunaltly GH grows muscles (which is very noticable for me) as i did not need that, so GH does efectivally something, that is for sure, it reduces fat and creates muscles at the same time even when eating much more then before, same weight (and no exercises). I have the muscles from a teenager with the skin of someone my age, very weird also. does the muscle gain reduces when stop the GH, it would benefit my belly after the tummy tuck, to much tention.

  Answer:  well, it likely does, but it is not approved for that use, and actually HGH is one drug that is not allowed to be used off-label, so prescribing it for that reason would be breaking the law. As to growing muscle, if you do everything else correct, the HGH will assist in growing muscle but it will not grow muscles if you do not do all the right things at the same time. If you feel you gained muscle with the HGH, if you stop the HGH, you will lose the muscle, yes. JG 3.30.11

• Again 6 weeks after tummy tuck i still can not walk straight, back pain, not enough room in my belly for all the content what is inside, hardly to eat. Due to bad skin elasticity, the tention on the middle part of the skin is horrible, I am schrinking because of this, vagina and under the vagina , even there i feel tention. Inner tighs getting worse because of the tention, rotating forward, so the tighs are comming together under the vagina because of this, awfull appearance, when i am in a store to buy underwear, they look very strange at me. Do i need a tigh lift and vagina correction to get rid of this issue ? I doubt the skin will ever come back to normal. Is it possible that the GH i take every night tightens up the skin a bit creating this appearance. Thanks. Is there any way to have the skin underneath (vagina area) go back backwards, i feel it pulling very far.

  Answer:  I do not think that any more skin should be removed anywhere in an attempt to get things looser, that is the opposite of what needs to happen. GH will not tighten skin, I know some claim it does but after treating patients for 13 years on HGH, I have never seen any of those hundreds of patients get something like that happen. I think what has to happen is for the skin to relax, as all skin does with time. More surgery is not the answer. JG 3.29.11

• I just heared from a woman from the shapewear store that a lot of woman she has seen, where the skin was pulled too tight that they were left with horrible strech marks. Is this a common problem, can this be avoided ? How long do you have to wear the compression garment ? How long before abdominal exercises ? Above and under the belly button, it feels like a cord which is tight and can not be released, avoiding movement. thanks for advice.

  Answer:  most patients that are having tummy tucks had stretch marks to begin with, and when the skin is pulled excessively tight, it can cause some of the stretch marks to look more visible due to the uneven distribution of tension over the surface of the skin. It is avoided by not over pulling the skin. I typically have my patients wear the garment for 4-6 weeks after the tummy tuck.I wait the same amount of time for the abdominal exercises too, in order to allow the skin to re-adhere to the fascia over the muscle. JG 3.25.11

• dr garcia, as far as i can discover from the tummy tuck, it seems that the surgeon tried to tighten the skin from the love handels up to the middle part , resulting in more skin going from the sides to the midsection , and therefore more skin on the middle lower part of the belly, creating a ticker more bilging appearance, instead of pulling the skin straight down which would give me a flatter belly, he made me smaller, thats not what i wanted, just have a flatter tummy, now the opposite has happened, skin is stiched wrinkeled as far as i notice because of the skin from the sides comming to the middle also. What can be done, is it nessesary to have a redo and redrape the skin with a mini tummy tuck, pulling the sides in different direction ?

  Answer:  to redo it would involve essentially a repeat tummy tuck, where all the tissues are lifted and released and then redraped in an appropriate direction. If there are sutures in the muscle that are too tight, they can be removed. JG 3.25.11

• how long should i wait for the swelling to go downe and see the final result of the procedure. I had no idea this would be so complicated. Swollen for such a long time, not be able to wear normal garments, ticker then before............. waistline gone, eleveted forewars stiking underbelly and pubic, tighs lifted unintentionally, bulging appearance........... etc. What if after 2 months no approvement ? Same with breast uplift and implants, no way they will drop due to my heavy muscles which i can not reduce because i also take GH (better healing, mood is better, but the afwfull is that is created muscles, even without exercises. Could this have any effect on the final result ? Thanks

  Answer:  GH will not affect it in a negative way, and usually by 8 weeks things should look better, I think it best for you to go back to see your surgeon and discuss your concerns. I can pretty much guarantee you your breasts will drop in time, the GH will not stop that. You have to give it all time and follow up with your surgeon. All the best. JG 3.23.11

• Is it common to do muscle plication with tummy tuck, does plication mean, stiching the muscles over each other to make someone smaller ? I can not find the reason why my belly is rounder then before unless the muscles party stiched over each other is creating the rounder middle part especially at the lower belly. Maybe is it just a standart procedure ? thanks for clarification

  Answer:  it is common to plicate the muscles in cases where the muscles have spread apart due to childbirth or large weight loss, they are sutured back side by side, like they should be naturally, not any tighter than that. Without seeing you before and after the surgery and knowing exactly what was done at surgery, it is hard to say but the swelling after the surgery alone can cause a rounded appearance that can last weeks in some cases. JG 3.23.11

• dr garcia, is it possible that with the tummy tuck the muscles are plicated , stiched one on top of each other creating a ticker middle belly , bulging because of the tick muscle on my tiny frame. If so, how it it possible to release the plication to have the muscles next to each other ? thanks again

  Answer:  I see no reason why a surgeon would do that to the muscles. JG 3.23.11

• How long will this take to get my skin back normal again, is this years or months ? What in case someone has still good elasticity of the skin ? thanks

  Answer:  if you are the person wit the concerns after the tummy tuck, it can take 12-18 months. The better the skin was to start, the faster it comes back. JG 3.22.11

• When the inner tissues heals from a tummy tuck, will the skin move again to normal , sliding back over the muscles to the place were they belong. Is this a common issue with tummy tuck the bulging of the pubis and tighs ? If i had known this, i would never have done this.

  Answer:  yes, the skin will move normally in time. It is common, especially when pulled very tightly. JG 3.21.11

• Will my pubis , vagina and tighs ever get back to normal shape after agressive tummy tuck ? I have a very weird appearance now. Can never walk in bikini like this. Everything bulging forward. I look like a man.

  Answer:  they should, slowly over time. Give it some time and see your surgeon for your routine follow ups. JG 3.21.11

• Other question about tummy tuck, 4 weeks later i still have the pulled up pubis and vagina, also tighs seem to be different, tissues from the inner tighs are also pulled up, kind of rotating that area forward, not any pant fits me, strabge contour on the upper tighs, bulging and rotated. Does this ever normalize, very distressing. I have a forward sticking pubis, vagina, inner and upper tighs. How long does it take for that to have a normal contour again, very distressing. Should i try to strech the skin , but i am afraid to harm the scars by pulling too much.

  Answer:  yes, but it will take a couple of months, as soon as you can start standing up straight, it will start getting better. 3.21.11

• How much ime does it take for the skin to reattach to the muscles after tummy tuck ? Do abdominal exercises speed up this process ? Is there a chance to have widened scars hen doing light exercises after 4 weeks. Can the skin reopen again by doing this. I still can not stand straight 4 weeks after the full tummy tuck. Everything is still pulling. I feel like a piece of paper which is layed over the muscles without following the contour of the abdomen leaving hollows under the skin making the belly bigger. I was lean to begin with , only loose skin, now my waist and belly are bigger. Someone mentioned the michelin syndrome, having a tiny waist due to the folds of skin and after tummy tuck the folds are gone , but the waist is permanently bigger , could that be possible. I can not see my muscle definition any more not even when i pull in my belly. All definition is gone. Did not gain weight.

  Answer:  it varies, the more swelling there is after surgery, the longer it will take, you will get some re-adherence in 4-6 weeks but total end result will likely take up to one year. The scars can stretch starting anytime after surgery, so if you have not had any stretching at this point, it can still happen in the future. I think at this time you are still swollen and the tissue needs to heal before you worry about the Michellin issue. Muscles will not show through the skin until all the swelling goes down,hang in there. 3.21.11

• Three weeks after tummy tuck, i do not see a reduction in swelling, my upper and lower belly have a fat bulging appearance that is not getting better. I had a much flatter tummy before, more sagging skin but much flatter, all the bulging is in the middle where the muscles were stiched i suppose. I feel numbness in the middle but not on the sides , is this normal, probably only the middle part of the skin was dissected, maybe not completely, creating some sort of tention and weird streching towards the middle going to the bottom where the tummy tuck scar is. Is only the part which is numb dissected ? I really don´t see any difference else then some skin removal besides a fatter appearance. Very discouraged and disappointed.

  Answer:  can be still a lot of fluid underneath the skin giving you that sensation, it takes time for that to go away and the skin to reattach I am afraid, got to give it some more time. Disappointment and being discouraged is common at this time period after surgery of that type, just hang in there. JG 3.14.11

• After my tummy tuck i feel even more tight when i had a full meal. I feel bloated, my tummy is sticking forward and bulging after eating. What is the best food to eat after a tummy tuck or other surgery to speed up the healing process and avoid the bloating.

  Answer:  eat your normal meals, avoid carbonated beverages, try to walk a little, and as time passes and you have to take less pain pills, it will get better. JG 3.12.11

• After a full tummy tuck my pubic area seems very elevated with a lot of tention, also my inner tighs are elevetated, creating a rather wide appearance of the upper tighs, will the pubic area and tighs go were it was before, how much time will this take, i feel a lot of skin was removed and my tummy does not have enough skin to strech in a normal way when standing up. This creates the tightness in the tigh area as the skin there is pulled up due to not enough skin in the belly area. Hope this will settle, i have bad skin elasticity. Fot over three weeks i can not walk or stand straight, giving me back pain.

  Answer:  they should relax in time, but that can take some time, the tighter they are, the longer it takes, maybe a year in some cases. Actually skin with poor elasticity works in your favor of the sin relaxing over time. Best of luck. JG 3.12.11

• Is it true that when you have had liposuction on a certain part of the body or when a certain part of the body has been truogh surgery like a breast lift or tummy tuck that you gain the lost fat from those places in other areas ? At least that is what many woman experience, gaining fat in other parts not especially with gaining weight.

  Answer:  you will gain fat in other areas only if you eat more calories than you were prior to the surgery. If you eat the same, then it will not go to those locations.It is not uncommon for patients to overeat after having a body part operated on, as proportions change and they sometimes let themselves go more easy on the diet. Surgery, especially liposuction should not used in lieu of a good diet and exercise program. You don`t get to eat a whole cheese cake everyday after liposuction and not gain fat. JG 3.10.11

• After a full tummy tuck it seems that also the skin from my tighs appears lifted pulled upwards with the skin tightening, resulting in a fatter appearance of the tighs. Is this a normal condition, will this approve with time. Also pubic area seems lifted and fatter. Will the tissues , skin go downward again with time ? What can be done , is liposuction of the tights needed in order to have the tigh bulging go away ?

  Answer:  it can happen when the tummy is lifted aggressively, but will likely not last, will relax and allow the thigh skin to go back to where it was for the most part.The pubic region is lifted due to the amount of abdominal skin that was taken out in your case and the puffiness is most likely swelling at this point. All will drop in time, yes. I would give it at least 6-8 months as much of what looks like it needs to be revised at the present will get better and not need anything done. JG 3.9.11

• 3 weeks after a tummy tuck, i notice that the scar in the middle is flat but at the sides, the upper part is bulging. Is this because of too much skin not being cut out. It feels very tight and tensed in the middle over the whole lenght, not at the sides. Will the bulging get flat or is it nessasary to remove an additional piece of skin. thanks.

  Answer:  it is due to swelling in the skin, that will take time to flatten out, but it is normal and will get better. The sensation is normal at his point. JG 3.7.11

• How much time does it take for the skin to reattach to the muscles after a full tummy tuck ? The surgeon who performed the tummy tuck also reinforced the skin with several rows of stiches in order to prevent sagging. These rows of stiches all over my belly are creating a pulling sensation, do they strech again together with the skin ?

  Answer:  those stitches will break and the skin should be reattached in about 6 weeks or so, as long as there were no large fluid collections. The skin will remain puffy though for a few months. JG 2.28.11

• I noticed today that a stich from the tummy tuck at the lower belly is loose, i think it happened after a good sneeze, the stich is protruding and the wound is painfull in that area. What should be done ? I also have the impression that the muscle repair is extremely tight, when i try to stand straight, the whole stomache area feels like i can not move more. The skin seems draped and creating some kind of lines or folds from the upper region onto the belly button. Is there anything that can be done to strech the muscles again. With the skin so tight i can not pull more due to the fact that the stiches below will break or create a wider scar.

  Answer:  there are usually a few layers of sutures, so no need to worry too much. Just put some neosporin and a band aid over it until you can see your surgeon. In time you be allowed to stretch the skin and the muscles and I think a little massage for the skin folds in the upper abdomen are a good idea as long as you check with your surgeon first. Hang in there. JG 2.25.11

• I had visible abdomen muscles before full tummy tuck. Now they seem to have diappeared, what could be the reason ? Lat time i had my body fat percentage checked it was around 14, maybe it will be 17 now, certainly not more.

  Answer:  there can be a prolonged period of time of swelling on the abdominal wall skin that can make those muscles hide, so it is a little swelling, a little body fat increase, and also to some degree, the inability to work those muscles out for a bit after surgery. They should all get visible again, in time. JG 2.25.11

• How long will it take for the scar tissue underneath the skin on the upper abdomen to relax after a full tummy tuck. Skin feels hard and stiff and a bit lumpy. Is this a normal condition ?

  Answer:  in some cases it can take 10-12 months. It is a normal thing, yes. JG 2.25.11

• Dr. Garcia, thanks for reply on the abdominoplasty question. What do you mean by if the skin on the upper abdomen was tick ? IDo you mean fat in that area. My skin itself is not very tick, i have thin skin, could it be the streching of the skin , making my previous curves less prononciated and creating a straither silhouette with a fuller waist. Second question, seems that after the surgery, my fasting glucose level is much higher then before, is this related to the narcose,or something else ? Thanks again.

  Answer:  I meant to type, thick,so yes, fat underneath the skin. Tightening of the skin should not make you lose your curves. At times the fasting glucose is higher as you are not as active and not burning as many calories. Best of luck. JG 2.21.11

• Dr. Garcia, A few days ago i had an abdominoplasty and now it seems that first i have a big belly, a fatty elevated pubic area, and also my waist is like 4 inches bigger then before. Is this because the fat and skin that was on the stomach area it pulled down, making my waist that much bigger, also the skin was streched a little forward to tighten the loose skin on the sides, does all this contributers to bigger waist and belly ? I also had a breast lift with replecement of old implants, the old 225 cc implants were replaced by 200 cc implants, however my breast are bigger then before ? How much bigger in cup size does 200cc ? Concidering a tiny frame on a tiny person ? Would it be possible to remove the implants and replace them by smaller ones after a few days ? Does that affect the breast lift ? Thanks for answer.

  Answer:  hard to say without seeing you before, it could be swelling, but if the skin of the upper abdomen was thick, and it was pulled down, it might be that also. The breasts are also swollen at this point. The difference from 200 to 225 would be less than a 1/4 cup. I think there are not many sizes smaller than what you had placed and a breast implant will not lift a breast, especially going smaller. JG 2.20.11

• Hello Dr Garcia. I had a FTT with umbilical hernia repair in July 2010. Six months post op, I`m generally pleased with my results. However, I don`t have unrestricted movement in my right hand side, for 2/3 inches above the scar. At night I feel a pulling sensation when I lie on that side. I strongly suspect I have adhesions; i was told after my last c section that I have severe adhesions, so possibly I am susceptible to this happening after surgery. I live in a different country to my PS, so can`t ask him; he saw me at 3 months and discharged me. This is not a huge problem, but at the same time is a little frustrating.I assumed that any pulling sensation would have stopped by now. Can I take any steps to resolve it? Thank you for your time

  Answer:  at this point, stretching exercises, like Yoga or Pilates will, slowly, stretch the scar tissue that has formed, but it can take up to one year to get full mobility. All the best. JG 2.2.11

• Not sure what happened to my question so I will try again. 3-4 years ago I had a ftt. I still have no feeling straight down the mid section of the abdomen directly under the rib cage and above the navel. Is this normal? And if so why does it hurt then when that skin gets stretched or pulled such as when rubbing up against something. Also, the incision directly below my belly button did not heal well. I have about a 6 inch section where I had open wounds for several weeks and the scar is much wider and redder there. If I got just this part repaired would I run the risk of the same thing happening all over again? I think the skin there is thinner because of the stretch marks I had. Also, it seems as though the skin on my abdomen is loosening up again. I have never been over weight and at the time of the surgery weighed around 117 lbs. I am now 123 lbs but I wouldn`t think that would do it. I exercise regulary and am 52 years old. Is it just my age? I was 22 and at 113 lbs (5` 3 ) with my first child and had three more after that. I did not gain much weight with each child but was very large in front. Love handles have also appeared in the last year. I wasn`t expecting that with the tt being done either. It just seems to be a never ending battle with the stomach area. Thanks for your reply.

  Answer:  sorry for the glitch with your question. As to the loss of sensation in the upper abdomen, I am afraid it is not common, but it can happen and it is from the nerves being cut during the surgery, not much that can be done to repair those nerves I am afraid. Stretching the area can cause more pain as the scar tissue can pull on the nerves that are trapped there. I think revising the lower abdominal scar should not have any additional risks but there has to be enough loose skin for that scar to be able to be excised and then closed again. Your age should not be any large component in your case. As to the love handles, they are fat accumulations and the prior tummy tuck will never prevent them from growing with weight gain. All the best. JG 1.9.11

• I have four questions for you, Dr. Garcia. 1)How long should a scar mature (on the lower back from a buttocks lift) before a tattoo can be placed over it? I`ve never had a tattoo, but the scar is, obviously, permanent so I`m thinking that a little art (like a small vine) on top of it might make it slightly less ugly. 2)In general, do you find that tattoos on such scars take well? Alternatively, in your experience, do these scars tend to fade so much over time that a tattoo isn`t necessary -- though, of course, no tattoo is necessary? 3)If you`ve had patients who`ve chosen to get tattoos over lower torso scars, have they generally ended up being pleased with their decision or have they more often regretted it? 4Not that I would get a tattoo with the intention of having it removed, but if I do elect to get one, should I only choose blue or black ink, since reds and yellows are difficult to remove by laser? Thank you for your insight on this weird topic, Dr. Garcia. (Weird for me, anyway!)

  Answer:  I would wait at least 6-8 weeks for the scar to heal before contemplating a tattoo. The ink does take well, but it might have to be touched up a little more often than normal tattoos as the scar tissue can be a little resistant in holding the ink, not a big problem though. A scar might get better over a 12 month period, but that area will always have a scar and scars in that area are rarely hairline thin scars. I have not had a patient that got a tattoo over a scar that regretted it. Dark blue or black are the easiest colors to remove with a laser down the road, so if possible, those colors would be what I might suggest. Best of luck. JG 11.29.10

• Hi Dr. G! I had a tummy tuck about 4 or 5 years ago and I`m having a hysterectomy within the next 4 weeks. I`m not sure if the doctor plans on opening me up or doing it vaginally ( I meet him next week to set it up). I have painful endometriosis and just found out why I had all the pain when I had emergency surgery to remove my right ovary with a 6cm cyst on it about 2 months ago. My Obgyn will be removing the other ovary, uterus and cervix and all signs of endometriosis he can. If he wants to open me up how will this affect my tummy tuck? :/ I am hoping he can remove it all by laparoscopically assisted vaginal hysterectomy. Thank you for your time and expertise. :)

  Answer:  If you skin is tight from the tummy tuck and he repairs everything he cuts to perform the surgery, it should all look the same afterwards. All the best. JG 10.21.10

• How long do I have wait to get a tummy tuck after getting a c-section? This is my 4th one.

  Answer:  I prefer to wait 6 months. JG 10.15.10

• Dr. Garcia, First, thanks for answering all these questions. Your site is a wealth of ihformation and I appreciate your candid answers. Over the past year I have lost 53 pounds through diet and exercise. I have pretty good muscle tone and I am in the best shape of my life with one exception. I have a small, saggy belly (Looks like a balloon that deflated over time over time) and my belly button needs stretched horizontally because of the extra skin that has melted in to it. I am not interested in a full tummy tuck as I have good muscle tone and not a lot of extra fat. I am 5`4 and weigh 137 pounds with a muscular build. I would love to wear a bikini to the pool but am very self conscious of my belly. Would a mini tummy tuck leave the large scars I have seen on some of the photos. I already have a C section and gall bladder removal scars, so not too crazy about the idea of having huge scars. What is the cost difference between full and mini abdominoplasty? Thanks!!!

  Answer:  firstly, congratulations on the weight loss using the best method out there. Whether a mini tummy tuck will give you a good result depends on how much loose skin there is above the belly button. A mini tummy tuck will not tighten any skin above the belly button, so if ther is laxity there and a full tummy tuck is not performed, then the lower part will look smoother and the part above the belly button will look different. Hope that helps differentiate what you might need. All the best. JG 9.29.10

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