A Board Certified Plastic Surgeon in Scottsdale, AZ
Posts tagged tummy tuck Arizona
The Mini Tummy Tuck: Steps.
Aug 1st
Scottsdale – Many potential patients ask about mini tummy tuck. Here are the steps involved with Mini Tummy Tuck.
- The mini tummy tuck procedure involves use of an incision that is typically shorter than the standard tummy tuck technique incision, placed as low as possible on the abdominal area.
- The skin and fat which are judged to be excessive are then removed, via our surgical techniques half way up to the belly button, which is not completely released.
- The abdominal (six-pack) muscles from the belly button down to the pubic area are exposed and if found to be weak and separated, then a permanent suture technique is employed, which can restore the muscles to their normal anatomic position and health.
- The remaining tummy skin is pulled down to meet the low incision and closed using the most effective techniques currently available to reduce inflammation and achieve the least noticeable scar.
A mini tummy tuck is performed on appropriate candidates, the effect is the creation of a flat and tight abdominal wall; one which can resemble the individual’s original shape and size, before the disfiguring effects of pregnancy and/or weight gain.
Mommy Makeover Seminar Next Week!
Jun 16th
Scottsdale – This is just a reminder about the Mommy Makeover seminar coming up next week.
Mommy makeovers are popular because women have children. There is no doubt that having a child is one of the most fulfilling experiences a woman can have in life. Some women, however, feel self-conscious about the effects of pregnancy on their body. The body of a woman who has been through pregnancy is never truly the same. The usual problem areas are: the breasts, the tummy, the buttocks and the fat pockets. In the tummy we see stretching of the stomach muscles and tummy skin with pregnancy. The breasts are usually affected by increasing elasticity and softness. Breasts may also sag. The hips, back and thighs may accumulate fat that may not go away completely after pregnancy. The buttocks, may also soften up, become flatter and less round and begin to sag.
Mommy makeovers are combination procedures used to treat the areas that change during pregnancy. The plastic surgery techniques improve the shape and size of the breasts, lift the breasts, tighten the tummy muscles and skin, remove stretchmarks and excess skin, reduce stubborn fat pockets and lift the pregnancy butt. In my practice there are 4 major variations of the mommy makeover offered to patients including tummy tuck with breast augmentation, tummy tuck with breast lift, tummy tuck with breast reduction and tummy tuck with Brazilian butt lift.
We recommend patients prioritize the areas important to them, so we can appropriately discuss these interests and create a reasonable treatment plan that addresses your needs. A mommy makeover is performed in one stage and patients can have a single recovery period for all the surgery procedures chosen.
The seminar is being held at the AB Guerra Plastic Surgery Center, 8765 E. Bell RD., Suite 104, Scottsdale , AZ 85260. To reserve your seat call 480-970-2580. The seminar starts at 6 PM on Wednesday June 23rd, 2010.
Tummy Tuck and Muscles.
May 10th
Scottsdale – Individuals desiring tummy tuck surgery, often times, request information on the best way to tighten the tummy muscles. There are a variety of ways to tighten the abdominal muscles, but the key is that most people require some sort of muscle tightening to obtain the best results from this type of cosmetic surgery.
The patient should discuss the goals of surgery during the plastic surgery consultation with their board certified plastic surgeon. The plan for the muscle tightening is developed at the time of the consultation. My philosophy is to carefully examine the patient and discuss realistic expectations. This includes a discussion on the best way to tighten to muscles and restore the anatomy to normal.
Men rarely require abdominal muscle tightening, unless they had major weight loss with or without bariatric surgery. During the discussion for plastic surgery after major weight loss, we will address muscle tightening in those men. In males, without significant weight loss, no muscle tightening is usually recommended. It is rare to recommend against muscle tightening in women.
Most women seeking tummy tuck surgery have had children and they have an obvious muscle separation that can be easily identified on physical examination. The separation occurs as the uterus expands to accommodate the baby, and is aided by the hormonal changes of pregnancy. The actual anatomy change that occurs is an expansion of the fascia (a thick layer of connective tissue) between the two rectus or “six-pack” muscles. When this anatomic change occurs, it is not reversible with exercise and diet alone. Unless plastic surgery is performed on the tummy muscles to bring them back into order, the problem will persist.
When the fascia expands, patients will see this as a “pot belly” or “pooch” that doesn’t go away and is especially noticeable when the client relaxes her tummy muscles.
Fortunately, abdominal muscle tightening with permanent sutures offers an excellent opportunity for correction of the tummy muscle weakness. In the average case, the technique incorporates a row of sutures that corrects the fascial expansion. Sutures are placed in the vertical fashion below and above the belly button, until the excess tissue is tightened. Normally, 2 layers of sutures are recommended. A detailed video demonstration of the tummy tuck procedure can be found here.
After about 6 weeks your body deposits enough collagen over the sutures to support the repair and allow the patient to have a long-lasting tight looking tummy. There are situations when the abdominal muscles could “loosen” back up if you are not careful:
- If you smoke cigarettes.
- If you gain weight.
- If you have a collagen disorder.
- If you have a large volume of fat inside the abdominal wall (apple shaped body).
- If you do not follow the doctor’s instructions and perform vigorous exercise soon after surgery.
The tummy tuck procedure is one of the most popular operations performed at the AB Guerra Plastic Surgery Center, Scottsdale, Arizona. More blogs on this subject and other important topics will be posted in the near future.
Don’t forget the On-Q Pain Pump.
Apr 7th
Pain relief for my breast augmentation in Scottsdale, Arizona patients.
Scottsdale – Pain is a big concern of my patients when undergoing breast augmentation in Scottsdale. There are several techniques to alleviate pain during cosmetic surgery procedures.The On-Q pain relief system is a highly effective means of relieving postoperative pain after breast augmentation.
During your Arizona plastic surgery, a small tube is inserted into the area of surgery. These tubes are attached to a plastic pump filled with medicine which can reduce your pain. The pump allows the numbing medicine to enter the area about a teaspoon per hour for the next several days. Studies demonstrate pain relieving pumps are effective in relieving pain in breast augmentations.
Use of the On-Q Pain Buster allows you to feel less pain with breast reconstruction and tummy tuck cosmetic surgery. It works great with breast implants placed under the muscles. The pain relief system also allows you to take less narcotic pain pills, reducing nausea, constipation, and possible vomiting after aesthetic plastic surgery.
New lady in red? Octomom in a bikini.
Jan 25th
Scottsdale – Foxnews.com reports on Octomom’s new bikini layout in Star Magazine. Of course, the controversy continues. According to an article in newsoxy.com Nadya Suleman now weighs 120 pounds and she lost 150 pounds with proper dieting. According to Suleman, the quick comeback is not because of plastic surgery. She said she would have felt like she cheated if she did go under the knife.
However, the rumors spreading say the exact opposite. Plastic surgeons, doctors who sculpt Hollywood’s bodies have mentioned that it is virtually impossible to bounce back that fast without some sort of help.
I am not going to give my opinion here, but I will ask you to see for yourself? The best photos of Octomom can be found at www.thesuperficial.com.
The 34-year old mother of 14 was the first woman to give birth to 8 kids. Women who are pregnant can lose the belly fat on their own, but tightening the skin is a little harder. She said she has been on a proper diet and exercise program.
Mommy Makeovers: Top 5 Procedures.
Dec 1st

Mommy Makeover Specialist
Scottsdale – A mommy makeover refers to the unique combination of plastic surgery procedures designed to counteract the physical effects of pregnancy and childbearing. These procedure are used to restore and enhance your body. If you are a woman, have children and are not happy with the effects of pregnancy, then the mommy makeover is for you. The combination of procedures listed below gives you the best opportunity to regain the body you love.
3. Tummy Tuck (Abdominoplasty).
4. Liposuction.
For more information on mommy makeovers check out our websites at www.MyFaceAndBody.com and www.TheMommyMakeover.com or give us a call at (480) 970-2580 to schedule a complimentary consultation (model used in illustration).
Plastic Surgery after Major Weight Loss: The Modified Vertical Abdominoplasty.
Nov 1st

Plastic surgery after major weight loss.
Scottsdale – After major weight loss many people experience notable skin excess in almost all the areas of the body. For many, the anterior abdominal wall becomes a priority. For most, a comprehensive circumferential body contouring procedure, such as, a body lift offers the best overall improvement. However, many patients believe the bodylift is too aggressive or they do not want an incision that goes all the way around their body for other reasons. Those patients may present themselves requesting a traditional tummy tuck. Unfortunately, the standard tummy tuck does not address all the excess skin that is usually present after major weight loss.
A Modified Vertical Abdominoplasty, on the other hand, has been shown to compensate for most of the excess skin and can help patients achieve a better result. Other options might include an extended tummy tuck (will be covered in a forthcoming issue of the blog). While for others the only option may still be the bodylift. An exam by a plastic surgeon will be necessary to see which procedure might ultimately be better for you.
The modified vertical abdominoplasty has been around for a long time. It was, however, seldom used until the popularity of weight loss surgery exploded a few years back. An article published in Plastic and Reconstructive Surgery, presents a significant experience using this technique out of Harvard Medical School. The authors present a 2 year experience, in 64 consecutive patients and noted the outcome and complications. The average patient in the series was 44 years old, had lost 59 kilograms, and had surgery done 22 months after bariatric surgery. Some of the patients had hernia repair performed at the same time as modified vertical abdominoplasty. Seven other patients had brachioplasty (arm tuck) or breast surgery.
The procedure involves creating a horizontal abdominoplasty excision combined with vertical triangular excision of the tissues above the belly button. It is an ideal design for patients that already have an open bariatric surgery scar. The design of the skin excision compensates better than the traditional tummy tuck for the amount of excess skin seen in major weight loss patients. Final closure of the incision leaves an upside-down T design on the abdomen.
The results of the study demonstrate that the procedure can be carried out efficiently, with an average time of 2.5 hours by itself and 3.6 hours with hernia repair. The weight of the tissue removed, on average, was 3.8 kilograms. The most common complication was wound breakdown at the T junction, experienced in 17 patients, seroma formation (trapped fluid) in 3 patients, hernia recurrence, and minor wound separation.
Importantly, the authors only identify one potential risk factor for wound healing complications at the T junction- and that was a Body Mass Index (BMI) of 35 and above. In fact, they no longer offer the procedure to patients with a BMI greater than 35, instead they encourage those patients to loose weight until they can have surgery. Abdominal scars, diabetes and smoking were not independent risk factors for wound healing complications.
Patients should realize that Modified Vertical Abdominoplasty is an option after weight loss surgery that “partially compensates” for all the excess skin. Bodylift is still considered the best operation. However, the MV Abdominoplasty may be associated with less risk than body lift. Wound healing complications at the T junction are common as this article shows, but most wounds healed efficiently with treatment. The authors of the article stated that all wounds healed by an average of 4 months. This is not unusual since bariatric patients suffer from profound malnutrition and it takes a long time for most wounds to heal completely (model used in illustration).
Know your Options: Plastic Surgery after Pregnancy.
Oct 28th

Options after pregnancy.
Scottsdale- Body contour changes after pregnancy are well known. In the abdomen, most women develop excess skin, stretch marks, and loose abdominal muscles. Others may develop a variety of breast deformities, such as asymmetry of the breasts, saggy breasts, and atrophy or softness of the breasts. Yet others, may never loose that “baby” fat. The recommended Phoenix plastic surgery procedures will vary from patient to patient. However, the breast and tummy combination with or without liposuction is known as the mommy makeover. On the blog, I plan to review important articles related to post-pregnancy plastic surgery options currently available to patients.
Some of the topics included include:
One stage augmentation and breast lift.
Safely combining tummy tuck and breast surgery.
Abdominoplasty combined with additional Arizona plastic surgery.
10 years of outpatient abdominoplasty: safe and effective.
Seroma risk for combined liposuction with abdominoplasty.
Extreme cosmetic surgery.
Decision making in abdominoplasty.
Revision augmentation/mastopexy.
and many more…..
(model used in illustration).
Composite Body Contouring: Safety is demonstrated in new study.
Oct 27th
Scottsdale – Composite body contouring is relatively new on the plastic surgery scene. The composite body contouring procedure includes a tummy tuck along with a certain amount of lipo, based on the patient’s desires and needs and fat grafting to deficient areas. In many cases, the liposuction can be circumferential and can include lipo of the upper and lower back, love handles and extremities. A modified technique is used to perform the tummy tuck which can reduce the risks of wound healing complications. Restoration of body contour with fat transfer can be used to give better shape to the buttocks or thighs. I have been performing composite body contouring since 2005 and have been impressed with the outcomes.
It is very important to provide the greatest amount of safety for our patients when performing such cases and the key with this set of procedures is to perform them only in a surgical facility that can admit patients for recovery and observation for at least 24 hours after surgery. I use a specialty surgery hospital that is specifically designed to meet the needs of cosmetic plastic surgery patients.
In many ways, “the composite” is a variation of the “mommy makeover” concept of combining multiple procedures to reverse the changes associated with pregnancy. Previously published studies demonstrate that the combination of cosmetic breast surgery and Arizona tummy tuck is safe when performed in an appropriate environment. That combination of surgery is the classic “mommy makeover” duo I have used since 2003. On the other hand, the “composite” mostly excludes breast surgery, but targets different areas that can affect women either post-pregnancy or with weight gain or loss, including the tummy, back, thighs and buttocks. I report here on a recently published study that documents the safety and efficacy of composite body contouring.
The article was published in the July issue of Aesthetic Plastic Surgery. The study included 64 consecutive female patients who underwent tummy tuck and circumferential liposuction with fat grafting to the buttocks (45), thighs only (6), and buttocks and thighs (13). The surgeons report a 90% satisfaction rate with the surgery, with 63% of patients judging the results as excellent or very good after a follow-up time of 3.2 years. Approximately 10% of patients were dissatisfied with their results.
The group reported that, on average, they removed 2478 milliliters (range 1500 to 4600 ml) of fat with lipo. The average injected volume into the buttocks was 346 ml (range 165 to 625 ml) and into the lower limbs, it was 195 ml (range 75 to 270 ml). The revision rate was 14% for the entire group, but a good number of these were related to the abdominal scar, which can often times be revised under local anesthesia. The major immediate complications after surgery included infection (3%) and bleeding with hematoma formation (2%).
I find that the complication and revision rate is acceptable for this extensive set of procedures. Patients should realize that there is no perfection in plastic surgery. Even these world-renowned experts had a dissatisfaction rate of 10% in their patient population. The more procedures you have, the more likely a revision will be required. Revision in this study included the need for additional liposuction, fat grafting and scar revision. Two patients requested silicone buttock augmentation.
The authors should be congratulated in keeping the number of immediate post surgery complications at a low level. Patients should realize that a bleeding complication usually requires immediate re-operation to evacuate the trapped blood collection, probable blood transfusion and a possible hospital admission. Infection may also require admission for the administration of intravenous antibiotics. This review goes to show that no surgeon or technique is free from complications and patients should be thoroughly prepared for the known potential complications before undergoing composite body contouring. This article is an important contribution to the advancement of Phoenix plastic surgery techniques.


The case above demonstrates the typical results with composite body contouring. In this case the patient had a tummy tuck and liposuction, including her back performed elsewhere 5 years before consulting with me at the AB Guerra Plastic Surgery Center. The patient is shown before and 6 months after composite body contouring procedure with revision tummy tuck, circumferential liposuction, and buttock fat grafting. The benefits of the surgery are a flatter and tighter tummy, a smoother back with a significant reduction of the rolls, and firm round buttocks. For more before and after photographs please see our main website at www.myfaceandbody.com
Shorter scars while combining Liposuction with Tummy Tuck.
Oct 24th
Scottsdale – I have combined abdominoplasty and liposuction since I began my own clinical practice in 2002. I have found the combination of these techniques to be safe and effective in producing better results when compared to the tummy tuck without liposuction.
There are several advantages of the combined techniques, including, a reduction in the fat volume in the love handles and upper tummy. This translates into a smaller waistline and a tighter, flatter tummy. I have noticed that many patients benefit by having shorter scars when the tissue over the hips is removed with lipo as supposed to extending the incision farther.
A study published in the Annals of Plastic Surgery, has confirmed that a shorter scar can be seen after tummy tuck when using liposuction in the love handles with a tummy tuck. The study measurements were made with a 3-dimensional laser surface scanner which more objectively measures the outcome of the surgery and the scar length. The study also demonstrated that liposuction did not increase the number of complications with the tummy tuck procedure. Other studies have confirmed this finding.
Patients should be offered the opportunity to have liposuction when pursuing a tummy tuck. I always discuss the pros and cons and the potential complications that come along with adding this additional procedure. However, most healthy individuals can the have the procedure without increasing the risks of complications as previous studies have confirmed.








