August 27, 2025 • 25 mins
💥 Thinking about a tummy tuck? Before you book, you need answers to the questions most surgeons gloss over. In this no-nonsense Q&A episode of Plastic Surgery Uncensored, Dr. Rady Rahban tackles everything you’ve ever wanted to know about tummy tucks—from swelling, recovery, and belly button fears, to lipo myths, blood clot risks, and the truth about BMI and “non-surgical skin tightening.”
✨ Highlights include:
✨ Highlights include:
- Do lymphatic massages really help with swelling—or make things worse?
- Is liposuction always needed with a tummy tuck?
- The #1 reason your belly button can make or break your results.
- How much help you really need at home (spoiler: more than you think).
- Why visceral fat can ruin your outcome, no matter what your BMI says.
- The brutal truth about “skin tightening devices” after weight loss.
Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:05):
Welcome to another episode of Plastic Surgery on Censored. I'm
your host, doctor Rodney Raban, and we have a fantastic
episode for you. We have your Q and a question
and answer your favorite probably some of your favorite episodes,
because there are episodes brought by you. That is, these
are your questions and we're going to answer them. And
as always, Maria, my trusty producer, is with us. We
were arguing about my attire her adcott I feel over
(00:29):
torussed the party. She's like, I'm a producer. What do
you mean, I'm a producer. Okay. Anyway, so Maria has
put together a I have to say, just as I
was talking to you saying, the questions are getting better
and better and better. You guys are incredibly well educated
and I really am enjoyed the question because historically, back
when we first started, they'd be like one hundred questions
(00:52):
and we'd have I'd only be able to like go
through like five of them because they were just silly
and not appropriate. And now they're so right on the money,
Like if I were to make questions, these would be them.
So you guys are doing a great job.
Speaker 2 (01:03):
Well, I want to start off with we got a
review on our podcast.
Speaker 1 (01:08):
We got a review? Is it a good one?
Speaker 2 (01:09):
A good one? It's called what a gift?
Speaker 1 (01:11):
A gift? And it comes if it sucks. I don't
want to hear it.
Speaker 2 (01:14):
No, no, but we've never gotten a bad review.
Speaker 1 (01:17):
I can tell you.
Speaker 2 (01:18):
We got this from lash Key and she basically here
she says, this podcast is a free gift, the gift
of knowledge. This podcast has equipped me to make wiser
choices and helped me cut through a lot of the
noise that surrounds plastic surgery. Thank you for making plastic
surgery more transparent to the general public. Making podcasts is
time consuming, Yes it is right, it is, but you
(01:40):
do it for us and we love you for it.
Thank you, thank you, and thank you.
Speaker 1 (01:44):
Oh that was beautiful. Thank you so much. It makes
us happy to hear those things because it is time consuming,
and we do do it so that there's some transparency.
And really the ultimate goal is for there to be
information for you. That is, as you said, cuts through
all the bs and get you to the point that
you need to know so you can make good choices
(02:05):
wherever you decide to do, whatever you decide to do.
So that was lovely. All right, what's the first question.
So these topics are about abdomens, so we've gone kind
of tried to cluster them together into categories or concepts.
And this is about abdomen's tummies and LiPo and things
of that nage.
Speaker 2 (02:23):
That makes it easier for me to write a description.
Speaker 1 (02:25):
All right, So that's why we do it, all right,
So what's the first question?
Speaker 2 (02:28):
Okay, this one comes from Megan and Jeff underscore zero nine.
Speaker 1 (02:32):
Megan and Jeff underscore zero nine.
Speaker 2 (02:34):
What can I do to manage swelling after a tummy tuck?
Speaker 1 (02:37):
So? What can I do to man is swelling after
a tummy tuk? The answer is nothing. You need to
just give it time. You know, it's interesting because you
know it's a whole industry. There's a whole industry revolving
around accelerating swelling, which is like lymphatic massages. And I
am not a believer of lymphatic massage. I not only
(03:00):
not a believer, I forbid my patience from doing lymphatter massage,
especially maybe I don't know if people do bbls and
all this sort of stuff which I don't do, but
like form an abdomino plassey where there's hundreds of sutures
in there. You don't want someone cranking away with some roller.
The body has a normal process. The body will get
you where you need to go. You must be patient.
(03:24):
It's an abdominoplasty, it's a tummy tech. We cut you
in half. You can't expect it eight weeks that you're
gonna be like you know, without swelling. That's not gonna happen.
If you had your teeth pulled, that's not gonna happen.
If you had a gall bladder removed, that's not gonna happen.
After a hysterectomy. It's just not how humans are. At
six weeks we tell you to go start exercising. You're
(03:47):
not gonna be swelling free for three to six months.
And even then I tell you, realistically, the body needs
a good twelve to eighteen months. So the answer is,
don't do anything, just be patient. But I think that
this idea or notion that you could somehow do some
magic something, and it's usually some kind of massage. I
think it's a mistake.
Speaker 2 (04:08):
Okay, So this question comes from Patty Grease.
Speaker 1 (04:12):
Patty Grease or Grace Grease.
Speaker 2 (04:15):
Or Grice do you always lipel the flanks or not
necessary when doing a tummy tech.
Speaker 1 (04:19):
So that's a great question. So if you were tomorrow
get up and you were to go do five consults
with five different plastic surgeons regarding abdomens, like I've had
three kids, I've had two kids, i had a set
of twins, whatever, I lost a ton of weight all
five of them. They're going to tell you need a
tummy tuck with LiPo because a Tommy tuck and LiPo
like one of my other ones that I said, you
need a browlof with an eyelid or like this combo
(04:41):
like in other words, without the liposuction, you're not going
to get the curry waste. In other words, a tummy
tuck is for flattening your abdomen, but the LiPo makes
you curry. That's not correct. If you go onto my gallery,
ninety percent of my patients have not had liposuction. Liposuction
doesn't make you curvy. Liposuction gets rid of a stubborn
(05:06):
fat that may have been there, and you need to
have a lot of it for me to remove it.
What makes you curvy is repair of the muscles in
the midline. So let's say tomorrow you have to go
to a big event, a gala, and I gave you
this really skimpy dress that you had to fit in,
kind of like a Jessica Rabbit kind of a dress.
Nice small waist. You're gonna wear a corset. You're gonna
wear an old fashion and pull your and the corset
(05:30):
if you're notice ties in the middle. And what it
does is it sucks in your abdomen. So in essence,
when I am doing my aggressive muscle repair, I am
sinching your muscles there by bringing your square hips in.
So I'm not using liposuction to do that. And when
you use it to do that, you're very aggressive and
(05:51):
you create sort of weird dents and divots and also
create loose skin. So to answer your question, I do
do liposuction with tummy tuck very infrequently, and the reason
I do it is to get rid of some of
excess love handle, not to create a curvy waste.
Speaker 2 (06:08):
You know, in Latinas tend to wear these really fine
but they're like they sinch at the waist and then
they have they say that when you wear these girdles
you get this like curvy, like the little waist and
I think I've seen a difference in some women that
(06:29):
wear those.
Speaker 1 (06:29):
No, it's kind of well, let's put it this way.
Have you seen the people in China that wear the
tiny shoes? You've seen it, right. What they do is
they start to get smaller and smaller and smaller shoes.
I don't know the full cultural effects of it, but literally,
like you fit all of their toes into like a pinhole.
And if you keep wearing something over and over and
over and over again, you will start to redirect bones
(06:52):
and ribs and things of that nature. But at what cost?
You have all your organs in there, and essentially you're
trying to force every into a small.
Speaker 2 (07:00):
I just think, I just think you're doing some danger
inside it. I do you are, But I do notice
a difference in some women, okay, or it's maybe that
they have the fause.
Speaker 1 (07:09):
On they do. Okay.
Speaker 2 (07:10):
So the next one comes from vanit Vany three.
Speaker 1 (07:13):
M vanny three M is blood.
Speaker 2 (07:15):
Dinner injections helpful in preventing and reducing chances of blood clots.
Speaker 1 (07:19):
After Tommy Tux wonderful question. So blood clots DVTs, A
blood clot or deep venus thrombosis often occurs behind the
knees or in the thighs or in the groin. That
blood clot can then break off and shoot to the
heart and lungs and give you a pulmonary embolas that
(07:41):
can be fatal. So that's what we're talking about. Post surgery,
orthopedic surgery, baby delivery, plastic surgery. You can get a
DVT or a blood clot which can then later create
a pulmonary emblass. Certain surgeries are more at risk than others.
You get a rhinoplast, either risk of a DVT or
(08:03):
a blood clot and a PE or much lesser than
when you get a tummy tuck. The reason tummy tucks
are at higher rate is we tend to a create
a lot of inflammation. The more inflammation in the blood,
but mostly because you're bent at the hips, your flex
and you tend to get blood clots in are veins
that are flexed. So in general, so here's the skinny.
(08:27):
In general, what most surgeons do to reduce blood clots
is a when you go to sleep in the operating room,
they put these squeezy things on your leg called leg squeezers,
their compression stockings, and the reason they use them is
because when they give you the anesthetic drugs to put
you to sleep, your veins dilate and blood pools and
(08:51):
may stay stagnant for minutes or you know, and you
could create a clot. So they use the leg squeezers
to continue circulating. That's one. The other thing that they
do is we have patient ambulate or walk very quickly
after surgery. You get a tummy tuck, you're walking out
of the surgery center and into the car and in
(09:12):
the car into your house. And while we don't ask
you to go for walks, we are having you walk around.
We do not want you laying in bed for four
days because being stagnant increases the rate, and that's what
ninety nine percent of plastic surgeons do. I add to
that blood thinners at the time of your surgery, So
(09:34):
I give you a blood thinner heprin at the time
of your surgery. With tummy tucks and those larger cases
in an effort to thin out your blood to reduce
a likelihood that you will get a DVT or a
blood clot. You can then add to that and depending
on how higher risk you are, you can then in
(09:56):
addition take blood thinners at home. I just don't use
any blood thinners once you've left because you're walking and moving.
If your stagnant, or stay home because you had an
injury or a car accident or whatever, then it's not
a bad idea. But in general I do use blood
thinners during the time of surgeries, which most surgeons don't.
(10:16):
The reason being is they're afraid then it's going to
cause you to bleed from a tummy tuck. But there
is no science that says that that doose does cause bleeding,
so I use it all the time routinely.
Speaker 2 (10:27):
Okay, next question comes from Mariposa Underscore, San Diego.
Speaker 1 (10:31):
Oh my posa butterfly.
Speaker 2 (10:33):
Yeah, if if you had a herny every pair in
the past, can you still get a tummy tuck? Is
it safe to get one?
Speaker 1 (10:41):
So let's back up here. In general, I prefer you
don't have your belly button hernia or your midline hernias corrected,
because you usually go you see a doctor if your
postpartum that means you've had a bunch of kids, you
have diastasis, muscle separation, and then they go and do
(11:01):
some repair of your hernia, and then your hernia comes
back because what they're doing is they're putting a piece
of plastic or mesh on an area that's already weak.
When I when I do all my tummy tucks, every
single case, I always correct your hernias while i'm there
without any foreign material, because what I'm doing is I'm
(11:23):
repairing the hernia that's the hole, shoving the material back in,
and then repairing the muscles back together in two layers.
That two layer closure represents the reinforcement that a piece
of plastic or mesh would do. That's ideal. Now you
come to me and be like, hey, two years ago,
a year ago, five years ago, I had a hernia repaired,
(11:46):
and now I you know it's back and or it's
not back, but I want to time me tech. The
answer is I can do a tummy tuck, and I
have done many, in which case I either have either
tried to remove that foreign matia which we call mesh,
or I have to bury it under the muscle repair.
It's not my preference, but certainly it can be done,
(12:08):
and it can be done safely. Okay, no.
Speaker 2 (12:10):
Next question comes from Megan dot Mitchell.
Speaker 1 (12:14):
Megan dot Mitchell, is there a.
Speaker 2 (12:16):
Non surgical tightening for loose skin from weight loss.
Speaker 1 (12:20):
All right, the question I want everyone to listen to
the question again, is there a non surgical tightening for
loose skin from weight loss? Did you hear that? The
answer is absolutely not, No, way, no, how impossible, pie
in the sky. Hell no, because if there was, I
(12:42):
would have whatever device there is, I would buy fifteen
of them. I would have one in every room. I
would have a nurse or a provider, and I would
go home and spend time with my kids and my
wife on a yacht. There is no such device that
tightens anything anywhere, not the face, not the f not
that that's all nonsense. I don't know. Maybe in ten years,
(13:03):
maybe in five years, maybe in a year, but I
can assure you none of the device is currently. Who
claim to tighten anything tighten it, especially the degree of
lu skin that we're talking about after weight loss. So
the answer is, once you have lou skin in your arms,
in your neck, in your belly, in your thighs, you
either live with it or you cut it out. You
(13:26):
remove it. You get a tummy tuck, you get a
necklif you get an eyelid. You cannot remove louse skin
by some mickey mouse device. So no, and if anyone
tells you otherwise, they're lying to you.
Speaker 2 (13:37):
Okay. The next question comes from Rachel underscore Shultz.
Speaker 1 (13:40):
Rachel underscore Shultz.
Speaker 2 (13:42):
How much help do you recommend when having a tummy tuck?
Speaker 1 (13:45):
Great question, So ninety nine percent of surgeons I know
love to underestimate post operative care. Love it. How's the rest, Sagen? Oh,
you won't feel anything. You didn't be amazing. You can
do great. Actually you can play tennis in two days.
Why because when you tell a patient that the recovery
is easy, they are likely to book and then they're
(14:05):
in the aftermath and like, oh my god, I'm an outlier.
I'm in so much bain, I don't know. Yeah, we
just cut you in half. So an abdominoplasty is no
different than any other surgery. You will be uncomfortable for
about a week. You will need help for about a week.
What kind of help You're gonna get up? Then you're
(14:25):
gonna need to go pee, You're gonna need help. You're
gonna want to go back and lay in bed. You're
gonna need help. You're gonna want to go for a
little walk. You're gonna need help. You're gonna want to
take a shower. You're well, you're not gonna take a
shower because as you know, how to let your shower
for a week. But you're gonna want to eat. Someone's
gonna help you. So you're nab.
Speaker 2 (14:42):
You still have to bathe. You have to bathe somehow.
Speaker 1 (14:44):
Yeah, But my point being is you're an invalid for
a week, and anyone who tells you otherwise is lying
to you. And while you don't need twenty four hours
around the clock, you need some grown adult. It could
be your kid, it could be your neighbor, could be
your mom, it could be your friend, someone around in
the other room or somewhere that in case you need someone,
they're like, hey, hey, Maria, can you help me? I
(15:05):
just need to go to bathroom for a second. Hey Maria,
I gotta get up and sit in the sofa, so
and so forth. So one week of help, two weeks
off work. That's the case. Otherwise, don't bother doing it.
Speaker 2 (15:16):
Well, I think it's important to have help. When I
did the press surgery, which is nothing compared to nothing
in comparison, and if I didn't have my husband there
helping me brushing my teeth, I'm telling you it was amazing.
It was that was on vacation for a week.
Speaker 1 (15:30):
Yeah, if your husband can do an aftercare, he can
hire hire him to come take care of you.
Speaker 2 (15:41):
The next question comes from seven eight nine dash sixty
six six'.
Speaker 1 (15:46):
Nine is that their social security? NUMBER i don't know
what it? Is?
Speaker 2 (15:49):
Okay what is THE bmi requirement for tummy tuk?
Speaker 1 (15:53):
Lepo? Okay so that's a great. Question. Yeah SO bmi
or body mass, index is a method of determining how
overweight you. Are it's more effective than just your. Weight
so what that means it takes your weight in height into.
Consideration so if you weigh one hundred and twenty pounds
and you're five foot one and someone is five foot
six and weighs one hundred and twenty, pounds you guys
(16:14):
are both not the same as saying they're both one
hundred and twenty one. Pounds so it's more accurate. Method
and the question essentially saying is what's the right weight
concentration for doing a tummy? Tuck and the answer IS
i don't have a strict. Criteria and let me explain
you WHY i will absolutely not operate on you if you're.
Overweight it won't happen under no. Circumstance why because you
(16:38):
will not get a great. Outcome you will be, unhappy
you will be mad at, me you will go write
a nasty. Review and it's something we would have known
from the, beginning before we started having said that the
way people distribute their fat is very. Different And i've
had patients who have come to. Me let's say we
have two. Patients they're five foot six and one hundred
(16:59):
and forty five. Pounds let's say their ideal is one.
Thirty i'm making it. UP i don't. Know so the
two of them come to, me and one of them
has all of her excess. Weight let's say it's fifteen
pounds of xcess of weight right in her, belly right
in her. Gun and there's gonna be a question coming
up regarding, this And i'll explain. It it's right in her,
abdomen and she's got skinny thighs and skinny legs and skinny,
(17:23):
arms and is otherwise just right in the. Center we
call that an apple. Shape we call that visceral fat
that is common often with. Men then that person is
not going to have a good outcome because all their
fat is in their belly and they're gonna want to be,
flat AND i. Can't i'm not a. MAGICIAN i can't
remove that. Fat, conversely the other person who's five to
(17:43):
six one hundred and forty five, pounds their, abdomen it's all,
floppy and they've had kids and it's all, loose and
they're extra fifteen pounds is in their thighs and their
butt they carried in their. Arms SO i don't have A.
STRICTVM I i certainly won't operate on you if you're,
overweight but more important and then THE bmi is how
much visceral fat or fat you have in your. Abdomen
(18:06):
and if you have a, LOT i don't care what
weight you. ARE i can't hit a home run And
i'm not interested in a second base or a third. Base.
Result that's a good.
Speaker 2 (18:16):
POINT i lost weight just to do my breast. Implant
my remove my breast, implant AND i felt that it
would gave us more realistic, yeah for my. Breast.
Speaker 1 (18:29):
Yeah, listen in, general when you do plastic, surgery you'd
like to be a more realistic. Weight that's just because
you're creating the framework on that. Person but in terms
of just hitting it out of the. Park you. Can't you.
Can't you can't do an abdomalplasty and an overweight.
Speaker 2 (18:43):
Patient it's the tummi tuk is not meant to get
rid of the. Fat it's to tone it, Right it's.
Speaker 1 (18:51):
To your abdomen due to excess skin and muscle, disorder
not to remove. Fat.
Speaker 2 (18:59):
Okay then one comes From dan Underscore Elis.
Speaker 1 (19:02):
Simeon, Okay dan Underscoreless, Simon.
Speaker 2 (19:05):
Right what is your technique with creating a natural looking belly?
Button it's my biggest fear with undergoing a tummy. Tuck
and by the, way IF i had to do a tummy,
tuk that would be my biggest.
Speaker 1 (19:14):
Fear. Yeah so when you go on people's galleries and
look at before and. Afters let me back up. Here
let's say you have a horrific. Scar it's, heinous it's
it's oh my, god it's the worst thing. Ever you
can cover, that at least you, can even if it's
a high, scar which is a terrible. Outcome you can
wear a mid. Drift but if you ever want to
wear a two piece, again and you went through all this,
trouble spent all this, money went through all this, agony
(19:35):
and you want to wear a bikini or two. Piece
if you got an ugly belly, button you know it ain't.
Happening and everyone Who if you go on people's, galleries
doctor's galleries and you look at there before and, after
you're gonna see some funky ass belly. Buttons i'm talking heart,
shade coin, size slit, size just sundial looking. THINGS i mean.
THERE i have A i have an album in my
(19:58):
phone THAT i AND i do my consoles for different,
consoles for different consoles have different, albums and one of
them is Called botched Belly, buttons And i'll pull that.
Out so absolutely the belly button's. Important and the other
thing about the belly button is a tailtale. Sign in other,
words like if there's no woman who's not going to
see another woman and see her belly, button let alone
another guy see another woman and be, like oh that
(20:21):
that's a tummy, tuck, right because a belly button looks.
Weird so to answer your, question what do we? Do
first of, all there are a lot of steps that
create a cute belly. Button number, one it's cutting the
right size of The let me explain you how we
make the belly. Button so you, understand we don't make
you a new belly. Button we don't cut off your
(20:41):
belly button and create a new. One we don't take
your belly button and move. It we don't do anything
to your belly. Button we cut around your belly button
and leave your belly button attached to your abdomen exactly
where it. Is then we move all the excess skin,
down cut it, off sew up the, muscles and then
(21:03):
make a new opening in the new skin over the
old belly button and bring the old belly button out
of the new.
Speaker 2 (21:13):
Skin because that belly butt is attached to your absom.
Speaker 1 (21:15):
Correct so your belly butun's not going anywhere because patients are,
like oh my, god my belly bun is so much.
Lower your belly bun has. Moved, Okay now what's important
is Number, one when you cut around that belly, button
you don't cut a huge. Circle, two when you make
the new, opening you don't make a huge circle because
(21:37):
these things. Stretch three you want to make sure that
the belly butN is. Puckered some, people as a result
of losing, weight gaining, pregnant getting pregnant down their belly
buttons when we when we cut around it is long and,
loose and we want to tether. It if you look
at your kid's belly, button it's tight right when you
pull on their. Stomach what prevents you from moving the
(21:59):
skin is it's to the belly. Button so you gotta
sew the belly button it down and make it snugs
so that when you bring it through the, skin it
pulls and puckers the skin. Down so absolutely there are
techniques to make belly buttons natural looking versus, ugly nasty belly.
Buttons AND i do agree that that's it's it's a big.
(22:19):
Problem oh my, god.
Speaker 2 (22:20):
WOULD i would be petrified if not coming up. Bad,
next this one comes From Elizabeth.
Speaker 1 (22:27):
Grocer Elizabeth grocial, okay.
Speaker 2 (22:30):
And her question is how does having visceral fat versus
subcutaneous fat effect the out come of a tummy?
Speaker 1 (22:36):
Tuck that's WHY i told you this is this is
probably the best question that anyone's ever asked ed asked
because going back to THAT bmi, comment at the end
of the, day what are we doing with a tummy?
Tuck we are not removing any fat except for the
fat that's attached to the skin that gets removed a tummy.
(22:56):
Tuck the ideal candidate for tummy tuck isn't individual who's
lost as much weight as they. Can they have a
bunch of blue skin above and below their belly, button
and as a result of having kids are not having.
Kids they have a protuberance to their belly that is
not due to being, fat but rather flacidity or flaccidness
to their. Muscles when the inside so, fat we carry.
(23:21):
Fat what she's referring to is visceral versus. Subcutaneous subcutaneous
MEANS i can grab. IT i literally can put my
hands on it and grab. It that is technically accessible to.
Liposuction you could liposuction. It visceral means inside your, viscera
which means around your. Organs and usually we say men
(23:43):
are apple, shaped women are pear. Shaped women carry fat
and excess weight in their thighsan and hips and. Butt
men carry fat in their. Admin while that is generally the,
case not always the. Case there are many women that
carry their fat five pounds twenty pounds. Viscerally when your
fat is, VISCERALLY i can't remove, it and WHEN i
(24:03):
go to, flatten you not remove your skin flatten. You
that fat is in the, way and you're asking someone
to shut a closet door with a washing machine in.
It you must lose the weight on your. Own there's
no LiPo stug on your own until your belly becomes
floppy and. Evacuated then the surgeon can tighten up the
(24:28):
muscles and flatten. You but with visual fat you will
never never get a nice. Outcome what you'll be is
protuberant and barrel shaped like round and stiff even after
the tummy.
Speaker 2 (24:41):
Tuck, wow well that's.
Speaker 1 (24:43):
It that's.
Speaker 2 (24:44):
It we asked all the questions regarding tummy.
Speaker 1 (24:47):
Tuck's all, right you guys did a kick ass. Job
i'm actually very proud of. You excellent. Questions all, Right,
well that wraps up yet another episode Of Plastic Surgery.
UNCENSORED i hope you enjoyed that episode as much as we.
Did as, ALWAYS i always my two final parting. Requests number,
one if you like the, show you enjoy, it it's
fascinating or, educational go write something. Nice it really does
(25:08):
make everybody excited and likes to do work on the.
Podcast and, secondly share the podcast with people you, love
people you, know people you care About you just will
never know when that person's going to go do, something
and it'll be too, late and you want to arm
them with as much information before they have the, procedure
not out for, it all, right as, always muchas Gracias
(25:28):
maria From miami From, miami and uh, yeah thanks so
much for joining. Us until next. Week i'm your, Host
Doctor Roddy rabond signing off on plastic surgery On sense
Welcome to another episode of Plastic Surgery on Censored. I'm
your host, doctor Rodney Raban, and we have a fantastic
episode for you. We have your Q and a question
and answer your favorite probably some of your favorite episodes,
because there are episodes brought by you. That is, these
are your questions and we're going to answer them. And
as always, Maria, my trusty producer, is with us. We
were arguing about my attire her adcott I feel over
(00:29):
torussed the party. She's like, I'm a producer. What do
you mean, I'm a producer. Okay. Anyway, so Maria has
put together a I have to say, just as I
was talking to you saying, the questions are getting better
and better and better. You guys are incredibly well educated
and I really am enjoyed the question because historically, back
when we first started, they'd be like one hundred questions
(00:52):
and we'd have I'd only be able to like go
through like five of them because they were just silly
and not appropriate. And now they're so right on the money,
Like if I were to make questions, these would be them.
So you guys are doing a great job.
Speaker 2 (01:03):
Well, I want to start off with we got a
review on our podcast.
Speaker 1 (01:08):
We got a review? Is it a good one?
Speaker 2 (01:09):
A good one? It's called what a gift?
Speaker 1 (01:11):
A gift? And it comes if it sucks. I don't
want to hear it.
Speaker 2 (01:14):
No, no, but we've never gotten a bad review.
Speaker 1 (01:17):
I can tell you.
Speaker 2 (01:18):
We got this from lash Key and she basically here
she says, this podcast is a free gift, the gift
of knowledge. This podcast has equipped me to make wiser
choices and helped me cut through a lot of the
noise that surrounds plastic surgery. Thank you for making plastic
surgery more transparent to the general public. Making podcasts is
time consuming, Yes it is right, it is, but you
(01:40):
do it for us and we love you for it.
Thank you, thank you, and thank you.
Speaker 1 (01:44):
Oh that was beautiful. Thank you so much. It makes
us happy to hear those things because it is time consuming,
and we do do it so that there's some transparency.
And really the ultimate goal is for there to be
information for you. That is, as you said, cuts through
all the bs and get you to the point that
you need to know so you can make good choices
(02:05):
wherever you decide to do, whatever you decide to do.
So that was lovely. All right, what's the first question.
So these topics are about abdomens, so we've gone kind
of tried to cluster them together into categories or concepts.
And this is about abdomen's tummies and LiPo and things
of that nage.
Speaker 2 (02:23):
That makes it easier for me to write a description.
Speaker 1 (02:25):
All right, So that's why we do it, all right,
So what's the first question?
Speaker 2 (02:28):
Okay, this one comes from Megan and Jeff underscore zero nine.
Speaker 1 (02:32):
Megan and Jeff underscore zero nine.
Speaker 2 (02:34):
What can I do to manage swelling after a tummy tuck?
Speaker 1 (02:37):
So? What can I do to man is swelling after
a tummy tuk? The answer is nothing. You need to
just give it time. You know, it's interesting because you
know it's a whole industry. There's a whole industry revolving
around accelerating swelling, which is like lymphatic massages. And I
am not a believer of lymphatic massage. I not only
(03:00):
not a believer, I forbid my patience from doing lymphatter massage,
especially maybe I don't know if people do bbls and
all this sort of stuff which I don't do, but
like form an abdomino plassey where there's hundreds of sutures
in there. You don't want someone cranking away with some roller.
The body has a normal process. The body will get
you where you need to go. You must be patient.
(03:24):
It's an abdominoplasty, it's a tummy tech. We cut you
in half. You can't expect it eight weeks that you're
gonna be like you know, without swelling. That's not gonna happen.
If you had your teeth pulled, that's not gonna happen.
If you had a gall bladder removed, that's not gonna happen.
After a hysterectomy. It's just not how humans are. At
six weeks we tell you to go start exercising. You're
(03:47):
not gonna be swelling free for three to six months.
And even then I tell you, realistically, the body needs
a good twelve to eighteen months. So the answer is,
don't do anything, just be patient. But I think that
this idea or notion that you could somehow do some
magic something, and it's usually some kind of massage. I
think it's a mistake.
Speaker 2 (04:08):
Okay, So this question comes from Patty Grease.
Speaker 1 (04:12):
Patty Grease or Grace Grease.
Speaker 2 (04:15):
Or Grice do you always lipel the flanks or not
necessary when doing a tummy tech.
Speaker 1 (04:19):
So that's a great question. So if you were tomorrow
get up and you were to go do five consults
with five different plastic surgeons regarding abdomens, like I've had
three kids, I've had two kids, i had a set
of twins, whatever, I lost a ton of weight all
five of them. They're going to tell you need a
tummy tuck with LiPo because a Tommy tuck and LiPo
like one of my other ones that I said, you
need a browlof with an eyelid or like this combo
(04:41):
like in other words, without the liposuction, you're not going
to get the curry waste. In other words, a tummy
tuck is for flattening your abdomen, but the LiPo makes
you curry. That's not correct. If you go onto my gallery,
ninety percent of my patients have not had liposuction. Liposuction
doesn't make you curvy. Liposuction gets rid of a stubborn
(05:06):
fat that may have been there, and you need to
have a lot of it for me to remove it.
What makes you curvy is repair of the muscles in
the midline. So let's say tomorrow you have to go
to a big event, a gala, and I gave you
this really skimpy dress that you had to fit in,
kind of like a Jessica Rabbit kind of a dress.
Nice small waist. You're gonna wear a corset. You're gonna
wear an old fashion and pull your and the corset
(05:30):
if you're notice ties in the middle. And what it
does is it sucks in your abdomen. So in essence,
when I am doing my aggressive muscle repair, I am
sinching your muscles there by bringing your square hips in.
So I'm not using liposuction to do that. And when
you use it to do that, you're very aggressive and
(05:51):
you create sort of weird dents and divots and also
create loose skin. So to answer your question, I do
do liposuction with tummy tuck very infrequently, and the reason
I do it is to get rid of some of
excess love handle, not to create a curvy waste.
Speaker 2 (06:08):
You know, in Latinas tend to wear these really fine
but they're like they sinch at the waist and then
they have they say that when you wear these girdles
you get this like curvy, like the little waist and
I think I've seen a difference in some women that
(06:29):
wear those.
Speaker 1 (06:29):
No, it's kind of well, let's put it this way.
Have you seen the people in China that wear the
tiny shoes? You've seen it, right. What they do is
they start to get smaller and smaller and smaller shoes.
I don't know the full cultural effects of it, but literally,
like you fit all of their toes into like a pinhole.
And if you keep wearing something over and over and
over and over again, you will start to redirect bones
(06:52):
and ribs and things of that nature. But at what cost?
You have all your organs in there, and essentially you're
trying to force every into a small.
Speaker 2 (07:00):
I just think, I just think you're doing some danger
inside it. I do you are, But I do notice
a difference in some women, okay, or it's maybe that
they have the fause.
Speaker 1 (07:09):
On they do. Okay.
Speaker 2 (07:10):
So the next one comes from vanit Vany three.
Speaker 1 (07:13):
M vanny three M is blood.
Speaker 2 (07:15):
Dinner injections helpful in preventing and reducing chances of blood clots.
Speaker 1 (07:19):
After Tommy Tux wonderful question. So blood clots DVTs, A
blood clot or deep venus thrombosis often occurs behind the
knees or in the thighs or in the groin. That
blood clot can then break off and shoot to the
heart and lungs and give you a pulmonary embolas that
(07:41):
can be fatal. So that's what we're talking about. Post surgery,
orthopedic surgery, baby delivery, plastic surgery. You can get a
DVT or a blood clot which can then later create
a pulmonary emblass. Certain surgeries are more at risk than others.
You get a rhinoplast, either risk of a DVT or
(08:03):
a blood clot and a PE or much lesser than
when you get a tummy tuck. The reason tummy tucks
are at higher rate is we tend to a create
a lot of inflammation. The more inflammation in the blood,
but mostly because you're bent at the hips, your flex
and you tend to get blood clots in are veins
that are flexed. So in general, so here's the skinny.
(08:27):
In general, what most surgeons do to reduce blood clots
is a when you go to sleep in the operating room,
they put these squeezy things on your leg called leg squeezers,
their compression stockings, and the reason they use them is
because when they give you the anesthetic drugs to put
you to sleep, your veins dilate and blood pools and
(08:51):
may stay stagnant for minutes or you know, and you
could create a clot. So they use the leg squeezers
to continue circulating. That's one. The other thing that they
do is we have patient ambulate or walk very quickly
after surgery. You get a tummy tuck, you're walking out
of the surgery center and into the car and in
(09:12):
the car into your house. And while we don't ask
you to go for walks, we are having you walk around.
We do not want you laying in bed for four
days because being stagnant increases the rate, and that's what
ninety nine percent of plastic surgeons do. I add to
that blood thinners at the time of your surgery, So
(09:34):
I give you a blood thinner heprin at the time
of your surgery. With tummy tucks and those larger cases
in an effort to thin out your blood to reduce
a likelihood that you will get a DVT or a
blood clot. You can then add to that and depending
on how higher risk you are, you can then in
(09:56):
addition take blood thinners at home. I just don't use
any blood thinners once you've left because you're walking and moving.
If your stagnant, or stay home because you had an
injury or a car accident or whatever, then it's not
a bad idea. But in general I do use blood
thinners during the time of surgeries, which most surgeons don't.
(10:16):
The reason being is they're afraid then it's going to
cause you to bleed from a tummy tuck. But there
is no science that says that that doose does cause bleeding,
so I use it all the time routinely.
Speaker 2 (10:27):
Okay, next question comes from Mariposa Underscore, San Diego.
Speaker 1 (10:31):
Oh my posa butterfly.
Speaker 2 (10:33):
Yeah, if if you had a herny every pair in
the past, can you still get a tummy tuck? Is
it safe to get one?
Speaker 1 (10:41):
So let's back up here. In general, I prefer you
don't have your belly button hernia or your midline hernias corrected,
because you usually go you see a doctor if your
postpartum that means you've had a bunch of kids, you
have diastasis, muscle separation, and then they go and do
(11:01):
some repair of your hernia, and then your hernia comes
back because what they're doing is they're putting a piece
of plastic or mesh on an area that's already weak.
When I when I do all my tummy tucks, every
single case, I always correct your hernias while i'm there
without any foreign material, because what I'm doing is I'm
(11:23):
repairing the hernia that's the hole, shoving the material back in,
and then repairing the muscles back together in two layers.
That two layer closure represents the reinforcement that a piece
of plastic or mesh would do. That's ideal. Now you
come to me and be like, hey, two years ago,
a year ago, five years ago, I had a hernia repaired,
(11:46):
and now I you know it's back and or it's
not back, but I want to time me tech. The
answer is I can do a tummy tuck, and I
have done many, in which case I either have either
tried to remove that foreign matia which we call mesh,
or I have to bury it under the muscle repair.
It's not my preference, but certainly it can be done,
(12:08):
and it can be done safely. Okay, no.
Speaker 2 (12:10):
Next question comes from Megan dot Mitchell.
Speaker 1 (12:14):
Megan dot Mitchell, is there a.
Speaker 2 (12:16):
Non surgical tightening for loose skin from weight loss.
Speaker 1 (12:20):
All right, the question I want everyone to listen to
the question again, is there a non surgical tightening for
loose skin from weight loss? Did you hear that? The
answer is absolutely not, No, way, no, how impossible, pie
in the sky. Hell no, because if there was, I
(12:42):
would have whatever device there is, I would buy fifteen
of them. I would have one in every room. I
would have a nurse or a provider, and I would
go home and spend time with my kids and my
wife on a yacht. There is no such device that
tightens anything anywhere, not the face, not the f not
that that's all nonsense. I don't know. Maybe in ten years,
(13:03):
maybe in five years, maybe in a year, but I
can assure you none of the device is currently. Who
claim to tighten anything tighten it, especially the degree of
lu skin that we're talking about after weight loss. So
the answer is, once you have lou skin in your arms,
in your neck, in your belly, in your thighs, you
either live with it or you cut it out. You
(13:26):
remove it. You get a tummy tuck, you get a
necklif you get an eyelid. You cannot remove louse skin
by some mickey mouse device. So no, and if anyone
tells you otherwise, they're lying to you.
Speaker 2 (13:37):
Okay. The next question comes from Rachel underscore Shultz.
Speaker 1 (13:40):
Rachel underscore Shultz.
Speaker 2 (13:42):
How much help do you recommend when having a tummy tuck?
Speaker 1 (13:45):
Great question, So ninety nine percent of surgeons I know
love to underestimate post operative care. Love it. How's the rest, Sagen? Oh,
you won't feel anything. You didn't be amazing. You can
do great. Actually you can play tennis in two days.
Why because when you tell a patient that the recovery
is easy, they are likely to book and then they're
(14:05):
in the aftermath and like, oh my god, I'm an outlier.
I'm in so much bain, I don't know. Yeah, we
just cut you in half. So an abdominoplasty is no
different than any other surgery. You will be uncomfortable for
about a week. You will need help for about a week.
What kind of help You're gonna get up? Then you're
(14:25):
gonna need to go pee, You're gonna need help. You're
gonna want to go back and lay in bed. You're
gonna need help. You're gonna want to go for a
little walk. You're gonna need help. You're gonna want to
take a shower. You're well, you're not gonna take a
shower because as you know, how to let your shower
for a week. But you're gonna want to eat. Someone's
gonna help you. So you're nab.
Speaker 2 (14:42):
You still have to bathe. You have to bathe somehow.
Speaker 1 (14:44):
Yeah, But my point being is you're an invalid for
a week, and anyone who tells you otherwise is lying
to you. And while you don't need twenty four hours
around the clock, you need some grown adult. It could
be your kid, it could be your neighbor, could be
your mom, it could be your friend, someone around in
the other room or somewhere that in case you need someone,
they're like, hey, hey, Maria, can you help me? I
(15:05):
just need to go to bathroom for a second. Hey Maria,
I gotta get up and sit in the sofa, so
and so forth. So one week of help, two weeks
off work. That's the case. Otherwise, don't bother doing it.
Speaker 2 (15:16):
Well, I think it's important to have help. When I
did the press surgery, which is nothing compared to nothing
in comparison, and if I didn't have my husband there
helping me brushing my teeth, I'm telling you it was amazing.
It was that was on vacation for a week.
Speaker 1 (15:30):
Yeah, if your husband can do an aftercare, he can
hire hire him to come take care of you.
Speaker 2 (15:41):
The next question comes from seven eight nine dash sixty
six six'.
Speaker 1 (15:46):
Nine is that their social security? NUMBER i don't know
what it? Is?
Speaker 2 (15:49):
Okay what is THE bmi requirement for tummy tuk?
Speaker 1 (15:53):
Lepo? Okay so that's a great. Question. Yeah SO bmi
or body mass, index is a method of determining how
overweight you. Are it's more effective than just your. Weight
so what that means it takes your weight in height into.
Consideration so if you weigh one hundred and twenty pounds
and you're five foot one and someone is five foot
six and weighs one hundred and twenty, pounds you guys
(16:14):
are both not the same as saying they're both one
hundred and twenty one. Pounds so it's more accurate. Method
and the question essentially saying is what's the right weight
concentration for doing a tummy? Tuck and the answer IS
i don't have a strict. Criteria and let me explain
you WHY i will absolutely not operate on you if you're.
Overweight it won't happen under no. Circumstance why because you
(16:38):
will not get a great. Outcome you will be, unhappy
you will be mad at, me you will go write
a nasty. Review and it's something we would have known
from the, beginning before we started having said that the
way people distribute their fat is very. Different And i've
had patients who have come to. Me let's say we
have two. Patients they're five foot six and one hundred
(16:59):
and forty five. Pounds let's say their ideal is one.
Thirty i'm making it. UP i don't. Know so the
two of them come to, me and one of them
has all of her excess. Weight let's say it's fifteen
pounds of xcess of weight right in her, belly right
in her. Gun and there's gonna be a question coming
up regarding, this And i'll explain. It it's right in her,
abdomen and she's got skinny thighs and skinny legs and skinny,
(17:23):
arms and is otherwise just right in the. Center we
call that an apple. Shape we call that visceral fat
that is common often with. Men then that person is
not going to have a good outcome because all their
fat is in their belly and they're gonna want to be,
flat AND i. Can't i'm not a. MAGICIAN i can't
remove that. Fat, conversely the other person who's five to
(17:43):
six one hundred and forty five, pounds their, abdomen it's all,
floppy and they've had kids and it's all, loose and
they're extra fifteen pounds is in their thighs and their
butt they carried in their. Arms SO i don't have A.
STRICTVM I i certainly won't operate on you if you're,
overweight but more important and then THE bmi is how
much visceral fat or fat you have in your. Abdomen
(18:06):
and if you have a, LOT i don't care what
weight you. ARE i can't hit a home run And
i'm not interested in a second base or a third. Base.
Result that's a good.
Speaker 2 (18:16):
POINT i lost weight just to do my breast. Implant
my remove my breast, implant AND i felt that it
would gave us more realistic, yeah for my. Breast.
Speaker 1 (18:29):
Yeah, listen in, general when you do plastic, surgery you'd
like to be a more realistic. Weight that's just because
you're creating the framework on that. Person but in terms
of just hitting it out of the. Park you. Can't you.
Can't you can't do an abdomalplasty and an overweight.
Speaker 2 (18:43):
Patient it's the tummi tuk is not meant to get
rid of the. Fat it's to tone it, Right it's.
Speaker 1 (18:51):
To your abdomen due to excess skin and muscle, disorder
not to remove. Fat.
Speaker 2 (18:59):
Okay then one comes From dan Underscore Elis.
Speaker 1 (19:02):
Simeon, Okay dan Underscoreless, Simon.
Speaker 2 (19:05):
Right what is your technique with creating a natural looking belly?
Button it's my biggest fear with undergoing a tummy. Tuck
and by the, way IF i had to do a tummy,
tuk that would be my biggest.
Speaker 1 (19:14):
Fear. Yeah so when you go on people's galleries and
look at before and. Afters let me back up. Here
let's say you have a horrific. Scar it's, heinous it's
it's oh my, god it's the worst thing. Ever you
can cover, that at least you, can even if it's
a high, scar which is a terrible. Outcome you can
wear a mid. Drift but if you ever want to
wear a two piece, again and you went through all this,
trouble spent all this, money went through all this, agony
(19:35):
and you want to wear a bikini or two. Piece
if you got an ugly belly, button you know it ain't.
Happening and everyone Who if you go on people's, galleries
doctor's galleries and you look at there before and, after
you're gonna see some funky ass belly. Buttons i'm talking heart,
shade coin, size slit, size just sundial looking. THINGS i mean.
THERE i have A i have an album in my
(19:58):
phone THAT i AND i do my consoles for different,
consoles for different consoles have different, albums and one of
them is Called botched Belly, buttons And i'll pull that.
Out so absolutely the belly button's. Important and the other
thing about the belly button is a tailtale. Sign in other,
words like if there's no woman who's not going to
see another woman and see her belly, button let alone
another guy see another woman and be, like oh that
(20:21):
that's a tummy, tuck, right because a belly button looks.
Weird so to answer your, question what do we? Do
first of, all there are a lot of steps that
create a cute belly. Button number, one it's cutting the
right size of The let me explain you how we
make the belly. Button so you, understand we don't make
you a new belly. Button we don't cut off your
(20:41):
belly button and create a new. One we don't take
your belly button and move. It we don't do anything
to your belly. Button we cut around your belly button
and leave your belly button attached to your abdomen exactly
where it. Is then we move all the excess skin,
down cut it, off sew up the, muscles and then
(21:03):
make a new opening in the new skin over the
old belly button and bring the old belly button out
of the new.
Speaker 2 (21:13):
Skin because that belly butt is attached to your absom.
Speaker 1 (21:15):
Correct so your belly butun's not going anywhere because patients are,
like oh my, god my belly bun is so much.
Lower your belly bun has. Moved, Okay now what's important
is Number, one when you cut around that belly, button
you don't cut a huge. Circle, two when you make
the new, opening you don't make a huge circle because
(21:37):
these things. Stretch three you want to make sure that
the belly butN is. Puckered some, people as a result
of losing, weight gaining, pregnant getting pregnant down their belly
buttons when we when we cut around it is long and,
loose and we want to tether. It if you look
at your kid's belly, button it's tight right when you
pull on their. Stomach what prevents you from moving the
(21:59):
skin is it's to the belly. Button so you gotta
sew the belly button it down and make it snugs
so that when you bring it through the, skin it
pulls and puckers the skin. Down so absolutely there are
techniques to make belly buttons natural looking versus, ugly nasty belly.
Buttons AND i do agree that that's it's it's a big.
(22:19):
Problem oh my, god.
Speaker 2 (22:20):
WOULD i would be petrified if not coming up. Bad,
next this one comes From Elizabeth.
Speaker 1 (22:27):
Grocer Elizabeth grocial, okay.
Speaker 2 (22:30):
And her question is how does having visceral fat versus
subcutaneous fat effect the out come of a tummy?
Speaker 1 (22:36):
Tuck that's WHY i told you this is this is
probably the best question that anyone's ever asked ed asked
because going back to THAT bmi, comment at the end
of the, day what are we doing with a tummy?
Tuck we are not removing any fat except for the
fat that's attached to the skin that gets removed a tummy.
(22:56):
Tuck the ideal candidate for tummy tuck isn't individual who's
lost as much weight as they. Can they have a
bunch of blue skin above and below their belly, button
and as a result of having kids are not having.
Kids they have a protuberance to their belly that is
not due to being, fat but rather flacidity or flaccidness
to their. Muscles when the inside so, fat we carry.
(23:21):
Fat what she's referring to is visceral versus. Subcutaneous subcutaneous
MEANS i can grab. IT i literally can put my
hands on it and grab. It that is technically accessible to.
Liposuction you could liposuction. It visceral means inside your, viscera
which means around your. Organs and usually we say men
(23:43):
are apple, shaped women are pear. Shaped women carry fat
and excess weight in their thighsan and hips and. Butt
men carry fat in their. Admin while that is generally the,
case not always the. Case there are many women that
carry their fat five pounds twenty pounds. Viscerally when your
fat is, VISCERALLY i can't remove, it and WHEN i
(24:03):
go to, flatten you not remove your skin flatten. You
that fat is in the, way and you're asking someone
to shut a closet door with a washing machine in.
It you must lose the weight on your. Own there's
no LiPo stug on your own until your belly becomes
floppy and. Evacuated then the surgeon can tighten up the
(24:28):
muscles and flatten. You but with visual fat you will
never never get a nice. Outcome what you'll be is
protuberant and barrel shaped like round and stiff even after
the tummy.
Speaker 2 (24:41):
Tuck, wow well that's.
Speaker 1 (24:43):
It that's.
Speaker 2 (24:44):
It we asked all the questions regarding tummy.
Speaker 1 (24:47):
Tuck's all, right you guys did a kick ass. Job
i'm actually very proud of. You excellent. Questions all, Right,
well that wraps up yet another episode Of Plastic Surgery.
UNCENSORED i hope you enjoyed that episode as much as we.
Did as, ALWAYS i always my two final parting. Requests number,
one if you like the, show you enjoy, it it's
fascinating or, educational go write something. Nice it really does
(25:08):
make everybody excited and likes to do work on the.
Podcast and, secondly share the podcast with people you, love
people you, know people you care About you just will
never know when that person's going to go do, something
and it'll be too, late and you want to arm
them with as much information before they have the, procedure
not out for, it all, right as, always muchas Gracias
(25:28):
maria From miami From, miami and uh, yeah thanks so
much for joining. Us until next. Week i'm your, Host
Doctor Roddy rabond signing off on plastic surgery On sense
Popular Podcasts
Dateline NBC
Current and classic episodes, featuring compelling true-crime mysteries, powerful documentaries and in-depth investigations. Follow now to get the latest episodes of Dateline NBC completely free, or subscribe to Dateline Premium for ad-free listening and exclusive bonus content: DatelinePremium.com
Stuff You Should Know
If you've ever wanted to know about champagne, satanism, the Stonewall Uprising, chaos theory, LSD, El Nino, true crime and Rosa Parks, then look no further. Josh and Chuck have you covered.
Law & Order: Criminal Justice System - Season 1 & Season 2
Season Two Out Now! Law & Order: Criminal Justice System tells the real stories behind the landmark cases that have shaped how the most dangerous and influential criminals in America are prosecuted. In its second season, the series tackles the threat of terrorism in the United States. From the rise of extremist political groups in the 60s to domestic lone wolves in the modern day, we explore how organizations like the FBI and Joint Terrorism Take Force have evolved to fight back against a multitude of terrorist threats.