Like a Tummy Tuck, Without Surgery

Welcome to the holistic and scientific podcast with board Certified plastic surgeon Dr. Robert Whitfield, Austin's natural choice for plastic surgery and the expert in smart laser and energy treatments.

So today we're going to talk about tummy tuck, Smart tummy tuck and evolv. So those are three things that have never been put together probably on a podcast ever in the history of the world. I know this because I came up with a smart tummy tuck in my office. And Evolve is a brand new device produced by Inmode. Tummy tuck's been around for decades, essentially one of the main things taught to plastic surgeons. So let's unpack what a 49 year old woman with a couple kids comes into my office. What can I offer her? What's best for her? What fits her in this particular instance? This person has had two kids. She's interested in abdominal rejuvenation, specifically of the lower abdomen. She doesn't have much in the way of excess skin and doesn't have really significant stretch marks. She wants to know, based on her friend's referral to her of me, about options available to her. So in particular she makes a very big deal about scarring. She's plays tennis all the time you're in Austin doesn't want to have any more visible scarring than absolutely necessary. And so I speak to her about first Evolve. So Evolve is completely non invasive. You can treat in rows the upper and lower abdomen with these applicators. Trim will reduce fat and cellulite takes about 15 minutes. You follow it up with a tight applicator and a layer of ultrasound gel and that will help tighten the skin. That takes about 45 minutes. And then the tone element basically will cause the abdominal muscles to contract. And so think of like doing a crunch, except for it'll be the most intense crunch you could ever do because the muscle will fully contract when the actual device fires. So that's a non invasive way to give abdominal rejuvenation. The next way would be to do a smart tummy tuck. And so a smart tummy tuck is a layered approach. Think about liposuction, traditionally done to decrease or debulk an area of stubborn fat. That could be love handle areas, lateral thighs, tummies. Those are the traditional places where we accumulate fat that we don't like and we want to get rid of what makes a good liposuction result versus a bad and what's a great one. So basically it's your age. So when you're 20 and you have liposuction your elasticity is high and your collagen level is high in your skin. And everything looks great when it's done, provided it's done properly. So always get a credentialed board certified plastic surgeon, by the way, to do your liposuction. If you want to have the best possible results, you got to have somebody who knows what they're doing. Now, as you age, your skin will become more lax. And by the time you're in their 30s and 40s, if you've not had children, that result will start to wax and wane a little bit. It'll loosen up. We see this most frequently in chins. Honestly, chin liposuction done in the 20s and 30s looks a little bit ragged when you get in your fourth and fifth decade of life. And so how does that get us to a smart tummy tuck? If somebody has accumulated fat, the lower abdomen and upper abdomen, you can always debulk that, reduce the fat with liposuction. There's different ways to do liposuction. There's power assisted, there's ultrasound assisted, there's laser liposuction. I prefer power assisted liposuction. I feel like I have a lot of control with it and that's most important to me. How do I get a better skin tightening result when we're doing this, if in fact they're older? So if you use equipment to tighten the skin like body tight, like morphe, say like fractura, you can get about 30% more skin tightening. So body tight can be done through small openings inside the inner diameter of the belly button. And you can hide all this pretty easily. So once you fill the area with fluid before you do liposuction, you can actually do the body tight. You just use a layer ultrasound gel. Body tie is like a pair of electrified forceps. One limb goes beneath the skin, one's above the skin, and you treat these areas, think of like a pie chart, just do it in quadrants. We use a thermographic camera to evaluate the intensity of the treatment coupled to the feedback of the machine. And I won't parse it out too much, but after a limited treatment time, you can actually have tightened the skin in real time. Then you can go and do the liposuction, you can thin this out, you can debulk areas without a great deal of concern for loosening up the skin too much at the very, very end. Once everything's cleansed and closed, all your incisions are closed and I glue everything shut. So there's really limited chance for any type of bacterial infection. Then we'll do microneedling. And first I'll start with like a Morpheus 8 microneedling at different depths, 4 millimeters, usually down to 3 to if there's a lot of stretch marks, I like to use the Fractor microneedling device. It's a fixed microneedling device, but it really works on superficial texture issues like stretch marks. And that's really all told to smart tummy tuck takes a couple hours in the office under local transitioning that to a traditional tummy tuck. When you evaluate patients for tummy tuck, depending on how much waist rejuvenation they need, do they have for instance a lot of left handle fat, lower back fat? If the surgeon doesn't evaluate this by just rotating the patient around, you're not going to be able to see what really the end result will be. Because basically a tummy tuck takes the lower abdomen tissue and moves it forward, excises it and tightens. It also tightens the musculature on the inside. This is usually where the big recovery issues come into play with tummy tuck. Whereas EVOLV has no recovery, the smart tummy tuck is done at a local in the office. You walk in, walk out and your recovery is basically edema or just swelling after liposuction. Because radiofrequency skin tightening doesn't give you a need for recovery period. Now a tummy tuck will have a recovery period because when you realign the rectus abdominis muscles to take care of the diastasis and tighten that, people feel that it changes their core. And when you engage your core, you'll feel it. So basically one way to mitigate this is to use liposomal bupivacaine, which is called exparel and block all that in addition to blocking the external oblique. Basically you can get better control of this. But if in fact you haven't done liposuction of the lower back love handle flank area, however you want to parse that out, you will masculinize a female waist. So you want to take somebody who's a little pear shaped and you want to carve out, you want to debulk the area by usually starting them in the prone position, approaching it from the just below the sacral area between the butt cheeks, really it'll be hit by a thong, but you will take that fat out, you reduce it and then when you flip them back over now when you excise that tissue, remove all the fatty tissue and basically close, you've now sculpted the waist more. Now tummy tucks leave you a relatively lengthy scar from hip bone to hip bone. There's really no way about that. Very few people are candidates for minis. Most people need a full tummy tuck and so the downtime a couple weeks, six weeks of recovery, walking with a stoop for a while, plus or minus a drain. I don't drain tummy tucks. I do drainless tummy tucks. So there's still a lot to deal with for that client. The effects of general anesthesia. And so in my 49 year old had two kids, plays tennis. She chose a smart tummy tuck. Reason she chose a smart tummy tuck is she was adamant about her result and wanted to return to playing tennis in a couple days. I don't limit the activity of the patient who has either evolve or a smart tummy tuck because it's not necessary. With a traditional tummy tuck you have to limit their activity. They can't just go out and do everything as we unpack. Did that do enough for this patient? Well, she lost about 2 inches off of her waistline. Yes. Her skin's tighter. Check the texture of the skin is better. Check. No downtime, no recovery period. So for her it's great. That's why our friend referred her to me because I have more options for non invasive and minimally invasive approaches rather than just everybody who shows up gets a tummy tuck. To learn more about a smart tummy tuck, please go to our Show Notes or visit my website@drrobertwitfield.com.

Take a screenshot of this podcast episode with your phone and show it at your consultation or appointment or mention the promo code. Podcast to receive $25 off any service or product of $50 or more. Dr. Robert Whitfield is a board certified plastic surgeon located in Austin, Texas near 360 and Walsh Tarleton in Westlake. To learn more go to drrobertwitfield.com or follow Dr. Robb on Instagram at doctorrobertwitfield Links to learn more about Dr. Rob's smart procedures and anything else mentioned on today's show are available in the show Notes. The Holistic and Scientific Podcast is a production of the Axis T H E A X I S IO.