Tummy Tuck

What is different about the Kirn iTuck™ operation?

The iTuck™ operation is designed to generate results which are the same as a standard tummy tuck while minimizing pain and recovery. The iTuck™ is an outpatient procedure. It adds three elements in addition to standard tummy tuck technique: 1) long acting numbing medicine is placed into the muscle layer to decrease pain, 2) progressive tension sutures are used to avoid the need for drains, and 3) the Ivivi SofPulse device and/or Exparel are used to decrease pain after surgery.

How long will I need to be off work after an iTuck™?

This depends on how active your job is. For most patients who do office work and do not do a lot of lifting, 7-10 days off work is sufficient. It is important not to lift anything heavy (over 20 lbs.) for 6 weeks after surgery.

When can I exercise after an iTuck™?

Assuming that everything is healing normally, you can usually resume exercise which does not involve heavy lifting (over 20 lbs) two weeks after surgery

When can I drive after an iTuck™?

Patients can drive when they are off pain medication and not too sore to move quickly if that is required. You must be able to drive safely before doing so. These criteria are usually met 5-7 days after surgery.

When can I lift my children after an iTuck™?

It depends on their weight: if they are less than 20 lbs., you will be able to pick them up 5-7 days after surgery. If they weigh more than 20 lbs., plan on not lifting them for 6 weeks after surgery.

Will I have drains with an iTuck™?

No - drains are not necessary with the iTuck™? procedure.

What is the size of the scar with an iTuck™?

There will be a scar around the belly button and another horizontal scar located low on the abdomen, usually extending hip bone to hip bone. Every effort is made to locate the horizontal scar low enough so it is hidden by swimsuits and undergarments, but this can depend on how much extra skin you have.

What weight should I be for an iTuck™?

It is best to be at a stable weight you can maintain after surgery for an iTuck™ procedure. While there is no specific weight requirement, it is best not to gain or lose significant amounts of weight after the procedure.

Will I lose weight with an iTuck™?

The iTuck™ is not a weight loss operation even though skin and fat are removed during the procedure. Generally, this is not enough to yield a significant weight change. However, many patients do lose weight after the surgery due to changes in eating habits and exercise. The visible changes in body shape, removal of excess skin, and a firmer, tighter abdomen resulting from the iTuck™, will motivate many patients to lose additional weight through diet and exercise after surgery.

Will my hip contour be improved with the iTuck™?

Liposuction of the hip and flank area is a standard component of the iTuck™ and is included, at no extra charge, with the operation.

Should I have a mini tummy tuck or a standard one?

This choice is best determined during the consultation. The capabilities of the mini tummy tuck operation are less than the standard procedure or iTuck™, but in the right patient a shorter scar and quicker recovery can be achieved. Dr. Kirn always uses the least invasive operation which will achieve the surgical goals.

Liposuction

How much weight will I lose if I have liposuction?

Liposuction changes your shape, not your weight.

How big are the liposuction incisions?

The incisions are 1/4 inch or less. Usually one or two incisions are required per area of liposuction.

How long will my bruises last after liposuction?

Most bruising usually resolves within 2 weeks after surgery, but this can vary from patient to patient and area to area.

What happens if I gain weight after liposuction?

It is best to perform liposuction when you are at a stable weight you can maintain. If your weight remains stable after surgery, your result should last for a very long time. If you gain weight after surgery, you will gain it in your whole body, but it should not go disproportionately to the areas treated with liposuction.

Does liposuction help cellulite?

Liposuction is not a treatment for cellulite. Most of the time, the dimples in the skin, known as cellulite, are not changed by liposuction.

Will liposuction help stretch marks?

Liposuction is not a treatment for stretch marks, they usually remain unchanged.

Will liposuction make loose skin worse?

The quality of the result from liposuction depends greatly on the quality of the skin in the treated area. Healthy, elastic skin usually responds very well to liposuction and contracts nicely over the new fat contour. Skin which is loose before surgery will usually still be loose after surgery, but sometimes may improve with liposuction. In short, more youthful, stretchy skin responds the best to liposuction.

How long do the results of liposuction last?

If you maintain your weight, the result of liposuction should change very little over time. Although, natural changes with aging to the skin and fat will still occur.

Will I change a clothes size after liposuction?

Sometimes yes, sometimes no - it depends on the area being treated, how much fat is removed, and how well the skin retracts. Liposuction makes contour changes to the treated area(s), but it is not a weight loss method.

What type of liposuction should I have - power assisted, laser, ultrasound?

Dr. Kirn's preferred method of liposuction is the Power Assisted Liposuction (PAL) system. The PAL vibrates the liposuction cannula back and forth very fast, so that with each full stroke of the cannula, there are multiple smaller strokes made at the same time. He has used PAL technology for over ten years with great success. Compared to standard liposuction, it seems to minimize trauma to the tissue and therefore minimizes bruising and swelling. Ultrasonic and laser liposuction add heat energy to the liposuction process. The added heat is not necessary for removal of the fat cells and can lead to development of abnormal scarring and a greater risk of skin irregularities. There can be specific circumstances where those technologies may offer an advantage, so a consultation is always the starting point to plan the best procedure for you.

Why should I have liposuction instead of just having an injection to dissolve away the fat?

Although injections can dissolve fat, their ability to do so is very limited. Many injections are required and the result usually falls far short of what can be achieved with a single session of liposuction.

Why not use an external laser or cold therapy to dissolve fat instead of liposuction?

New technologies involving ultrasound, laser, and cold therapy have recently become available to dissolve fat. Each of these works through a different means. Most of these treatments are limited to small areas, require significant treatment times, and usually multiple treatment sessions.

Mommy Makeover

What is a Mommy Makeover?

Most commonly it is a combination of breast surgery (augmentation, lift, or augmentation-lift) with a tummy tuck. In our case, the breast surgery is combined with Dr. Kirn's iTuck™ procedure.

What are the advantages of combining the Mommy Makeover surgeries together?

By combining procedures you have one trip to the operating room and one recovery period, so this is more efficient from a time standpoint. Many operating rooms and anesthesiologists charge by time in surgery, so combining operations can also be beneficial from a cost standpoint.

What are the disadvantages of combining Mommy Makeover surgeries together?

Although there is only one recovery period, it may be slightly longer or harder than if you had a single operation. The risk of blood clots in your legs probably increases when multiple procedures are combined. Although preventative maneuvers are taken during surgery to avoid this problem, it is important for the patient to walk and move around after surgery also.

Body Contouring after Massive Weight Loss

Will insurance pay for body contouring after massive weight loss?

Our experience in getting insurance to pay for body contouring has been dismal. Insurance companies require that a "functional benefit" must be achieved to justify medical necessity. Most of the problems created by having extra skin, such as rashes, can be controlled with medications and hygiene much less expensively than surgery. Hence, the insurance carriers are unlikely to pay for these procedures which have a dominantly cosmetic benefit.

How many body contouring operations after massive weight loss will be needed?

This depends on how many body areas are affected and just how much extra skin there is. Most folks who have lost 100 lbs. of weight or more will benefit from several operations to achieve the best shape. Usually, these are performed one or two at a time and separated by several months between each session.

What are the most common body areas treated after massive weight loss?

The most common areas addressed are the abdomen, breasts, arms, and thighs. Many patients also choose to address neck contour as well.

Can multiple body contouring operations be combined together?

Yes, it is efficient to combine two or more procedures together, but this must be done judiciously always keeping safety in mind. Dr. Kirn prefers to keep all body contouring operations in an outpatient setting.

Arm Lift (Brachioplasty)

Is it possible to do an arm lift (brachioplasty) without a visible scar?

Patients who have fat in the arm without a lot of extra skin usually do well with liposuction of the arm and do not need a true arm lift (brachioplasty) operation. Younger, healthier skin contracts better after liposuction, so the quality of the skin also plays a part in the quality of the result from liposuction. Patients who have extra skin or a combination of extra skin and fat will require a scar to achieve an improved contour.

Where is the scar from an arm lift located?

The scar is located along the crease on the inside of the arm and usually extends from the armpit down to the elbow. The goal is to have the scar hidden when your arm is at your side.