Pre-Operative Tummy Tuck Patient Consultation

Hi, I'm Dr. Williams, and we're, again, here with Krista, and we're ready now to do surgery. Prior to surgery, we're going to do some skin markings, I'm going to explain exactly what we're going to be doing in surgery.

So Krista, if you wouldn't mind, if you would just stand up here, and we're going to do some markings here prior to our surgery. Move these down a little bit here, okay. Now as you can see, we have a significant amount of skin and soft tissue laxity of the abdomen, it's kind of forming an apron, draping over the pubic area a bit here. We also have some bulging of the abdomen, that's due to laxity of the abdominal muscles. So the first thing that we're going to do is to mark the incision for the lower abdomen. And we're going to bring that within the... below the bikini or panty line.

Second thing we have to do is mark the midline. Now, this is very important, because of the fact that what we're going to do is remove this skin here, and we're going to pull this skin down. This skin right here is going to go down to the pubic area. And what we're going to do is to take this skin... all this skin... and remove it. So all of this skin through here is going to be removed. As the skin gets pulled down from this point here, above the bellybutton down to here, it's like we're taking a window shade and pulling that down. And then, the bellybutton is going to stay about where it is, and we're going to mark the bellybutton, and the bellybutton will go through a new position in the skin here.

Now, one more thing that's very important is this, that she has muscle separation and laxity, and that's what causing the bulging up here inside the abdomen. So we want to get that flat and tight, and the muscle is here, on either side, and there's a separation of this muscle. The muscle comes about like this on either side, and we're going to sew that muscle together, and we're going to sew it from the upper abdomen to the pubic area. And because that is the part of the operation that is painful, we're going to inject Exparel. Now, Exparel is a new type of medication that has little micro-spheres, little microscopic spheres of a long-acting anesthetic. And what we're going to do is inject that muscle with this long-acting anesthetic, that will last for approximately three or so days, and decrease the amount of pain that is associated with that repair of the muscle and the suturing of the muscle.

So hopefully, Krista, you won't have as much pain as often occurs when you do a tummy tuck. Not to say you won't have any pain, we give everybody pain medication, and muscle relaxants as well. But certainly this is actually a revolutionary way to decrease a lot of the problems that have been associated with tummy tucks, particularly that of pain. So I think we're about ready to get started now. Thank you.