Ask Dr. Garcia - The Archives

• 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 tamaņo? 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 remo