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Tummy Tuck Overview From Dr. Karen Horton

Dr. Karen Horton recently joined us for a comprehensive Q&A session regarding her unique approach to tummy tuck surgery at our San Francisco Plastic Surgery practice. Below are her answers detailing the cosmetic body-contouring procedure from consultation to recovery.

Q: How popular is the tummy tuck procedure at your practice?

Dr. Horton: I perform at least 1-3 tummy tuck surgeries each week. Of my patients who are seeking rejuvenation of their bodies after they have finished having their children – otherwise known as a “mommy makeover” – the tummy is often a woman’s number one bodily concern. Additionally, some other patients who see me for breast cancer reconstruction have the benefit of using their abdominal skin and fat to help make a new breast after cancer therapy, known as the DIEP flap, which I perform weekly. This procedure involves a tummy tuck as a bonus of the breast cancer reconstruction!

Q: Why do you feel the tummy tuck is so popular?

DH: A tummy tuck, also known as an abdominoplasty, is a wonderful procedure that truly reconstructs the abdomen in a way that cannot be matched by physical therapy, compressive undergarments like “Spanx,” or losing weight. This procedure trims excess skin and fat from the abdomen, removes stretch marks if present, repairs the rectus abdominis muscles back together in the midline, and smoothes the contour of the belly. A tummy tuck truly is a three-dimensional surgery and is one of my very favorite procedures to perform!

Q: Who makes an ideal candidate for a tummy tuck?

DH: The ideal candidate for a tummy tuck is a woman – or man – who is physically fit; healthy; at or near ideal body weight; and who has excess abdominal skin and fat or a loss of abdominal muscle tone from pregnancy or dramatic weight fluctuation.

There are specific changes that occur in a woman’s body after pregnancy, and the effects are cumulative – that is, after every pregnancy, she often observes more loose skin, stretch marks, loss of abdominal tone, and a “mommy bulge” in her abdomen. Many moms crave the smooth and flat contour of their pre-pregnancy form or to have a flatter tummy than before. Only a tummy tuck can reach these goals.

Q: What are common reasons your patients generally give for wanting the procedure?

DH: There are three main categories of individuals who are seeking a tummy tuck. Number one, moms who have finished having children and are tired of seeing redundant tummy skin, stretch marks, stretched out abdominal muscles, and excess fat in their abdomen. Number two, men or women who have lost a significant amount of weight and have excess, crepe-like skin that does not match their underlying fit and firmer body. And number three, individuals who have noticed their abdominal contour has changed with age and wish to achieve a firmer and flatter tummy contour.

When planning for an abdominoplasty, my personal goal for each of my patients is to get them feeling free to run around in a bikini, to love their abdomen, and most of all, to feel comfortable in their own skin. Unfortunately, many moms feel an immense amount of guilt when they considering having a tummy tuck. Mothers give so much of themselves to others each day – their children, their spouse, their family members, and coworkers – so at the end of the day, they have little time or energy left for themselves.

As a woman, I can relate to the impossible goal of trying to “do it all” – juggling work and home life while being a mother, wife, friend, sister, daughter, and still wanting to feel feminine and excited about my body at the end of the day. I educate mothers that it is not vain or selfish to want to feel sensual, fit, healthy, and sexy, and that sometimes a tummy tuck can help to improve the contour of the abdomen so that this becomes an area of a woman’s body that she is proud to show off.

Q: What type of care do you provide your patients both before and after the procedure?

DH: When I meet a new patient in consultation for a tummy tuck, we spend at least 45 minutes together on our first visit getting to know one another and exploring the reasons why an individual is seeking improvement of their abdominal contour. My goal is to get to know my patients “inside and out,” including their medical history, their personal histories, hobbies, lifestyles, family situations, and professional lives. I examine their abdominal regions and inspect for hernias, which are repaired at the same time as an abdominoplasty. I also assess for “lipodystrophy” or areas of fatty deposits that are contributing to their abdominal contour that might be appropriate for liposuction in addition to an abdominoplasty.

If I feel they are an appropriate candidate for a tummy tuck, we discuss the abdominoplasty procedure in detail, including risks and benefits, potential complications and realistic outcomes for surgery. I show them tummy tuck pictures to demonstrate realistic early postoperative and long-term results, including swelling and scars, as well as provide phone numbers of some of my patients who have offered to speak to others about the procedure. We discuss scar placement and demonstrate where potential scarring will lie – often hidden in low bikini bottoms.

After meeting with me for their tummy tuck consultation, new patients will meet my Patient Coordinator, Mary, who gives them a complete package that reviews the procedure in detail, provides additional information and literature, associated fees, and patient reference information. Patients are invited to visit with me again for an additional “discuss surgery” visit to answer any additional questions or to bring their spouse or a close friend to learn more about a tummy tuck.

When a tummy tuck procedure is scheduled, a preoperative visit is arranged, which takes place 1-2 weeks before surgery. At that visit, we recommend that patients arrange for a friend or close family member to accompany them to the office so that they can also learn about the procedure, postoperative recovery, and how to best help out after surgery. Our entire staff strives to make the tummy tuck journey positive and rewarding. We aim to fully educate, and in turn, empower those who are seeking improvement of their bodies to do so safely and with the knowledge they need to have the best results possible!

The preoperative visit usually lasts at least 90 minutes and involves extensive additional education about abdominoplasty: how to prepare for the procedure; what happens in the hospital; an overnight stay; their expected postoperative recovery; when driving is permitted; returning to work; and physical restrictions while healing. Patients spend time both with me and my Registered Nurse, Nurse Mari, who also gets to know our patients intimately and helps out with any necessary paperwork for employers or insurance companies.

After surgery, I see my patients regularly – at least weekly – for the first month to ensure they are healing well without any difficulties, to remove their drains when they are ready, and to educate them about scar therapy at the 6-8 week mark. We also take follow-up photos at around 3, 6, and 12 months after surgery, and we educate them about different stages in their healing as these points in time occur.

Q: What techniques set you apart from other Plastic Surgeons?

DH: I am not only a Board-Certified Plastic Surgeon, but I myself am a mother of twins. I can relate to my patients in many areas. Most of my patients are also women who confide they feel most comfortable discussing their bodily concerns with another woman.

I view the Doctor-patient relationship more as a partnership in achieving a woman’s goals rather than the traditional, paternalistic one of the past. I believe patients deserve to be treated with respect and autonomy so they can make the most educated decisions about their bodies. Education is key!

Each of my patients is given my personal cell phone number. I am available to them 24 hours a day, 7 days a week, both before and after their procedure. I continue to follow up with my patients yearly after surgery so that I can evaluate their long-term outcomes and changes in the future so that we can ensure they are looking good and feeling good many, many years later!

I strive for excellence in all my surgeries, like most Plastic Surgeons, and I use my brains, my hands, my artistic talent, and my creativity to help give each patient the results they are individually seeking. Growing up, I always thought I would be an artist. My aptitude in school was math, science, and art, and I followed in the footsteps of my father, a breast cancer surgeon. I found the perfect mix of science, artistry, caring for others, and giving attention to body image, self-esteem, and a little psychology in the discipline of Plastic Surgery! Whether I am performing a tummy tuck or a complex breast reconstruction utilizing Microsurgery, each patient and the planning for their goals, performing their procedure, and meticulous follow up is equally vital and significant to me.

Most of my patients are extremely happy, and I in turn feel honored and privileged to care for them and to play such an intimate role in helping them achieve their goals for their bodies. I love my job, and look forward to each new day and to helping another individual achieve his or her goals.

Schedule Your Tummy Tuck Consultation

If you are interested in reading more about tummy tuck surgery, feel free to check out our abdominoplasty page. To schedule a private consultation with Dr. Horton, please contact our office today.



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Dr. Karen M. Horton, M.D. - Plastic Surgery, Physicians & Surgeons - Medical-M.D., San Francisco, CA