The problem arises during gestation when the abdominal wall and skin stretches to accommodate the growing fetus but then does not completely return to its normal condition after delivery. This is nature’s way of allowing room for the growing child. This expansion arises from hormonally induced softening of the abdominal tissues leading to the separation of the rectus muscles which softens and widens from pregnancy hormones. As a result, the muscles can remain permanently separated. This condition is called rectus diastasis. For this reason, no amount of exercise can completely return the lower abdomen to its former shape.

A “tummy tuck” tightens the muscles of the abdominal wall and removes the excess wrinkled skin and fat from the lower abdomen. This dramatically reduces the appearance of a protruding abdomen and restores a pleasing contour to the hips. The extent of the procedure is tailored to individual needs. Some women need only a small amount of tightening and tissue removal. For them, a modified procedure called a “mini abdominoplasty” is performed. This is less extensive surgery, and therefore has a shorter recovery period.

Breast enlargement is done on an outpatient basis under general anesthesia. Breast augmentation incisions may be in the breast crease, around the nipple, or in the armpit. A saline or silicone implant is inserted under the breast tissue, or under the breast tissue and the underlying muscle.

Liposuction can be performed at almost any age; the best results occur when the skin still has enough elasticity to achieve a smooth, even contour after fat removal. Areas containing stretch marks have lost their elasticity and are not the best areas for liposuction. The best candidate is an individual of normal weight and stature. The fat deposits are usually localized to several areas that distort contour and silhouette. The most common areas are the hips, thighs, and abdomen. These are the areas that often sluggishly respond to diet and exercise and may require surgery to enhance your best efforts at the gym.

The press has been replete with well publicized injuries and deaths from liposuction. Regrettably these have been performed by well trained surgeons in accredited facilities. The common identifying risk factor has been combined cosmetic procedures or massive amounts of fat removal. Lesser procedures of shorter duration will prevent this horrific complication. Other described problems with liposuction are wrinkling, unevenness, bruising and asymmetry. Infections have been described but are exceedingly rare. Overall, liposuction is the most common cosmetic procedure performed in the United States and is safe when performed by well trained surgeons who exercise good judgment.

The first step towards improving your figure is to schedule a consultation with a board-certified plastic surgeon. During this first meeting, you and your surgeon discuss your desires and establish a surgical plan. There are four basic decisions to be discussed during the meeting:

1. Implant type: Saline vs. Silicone (The FDA recently approved a new generation of silicone implants.
2. Surgical approach: under the arm, around the areola, under the breast, or through the belly button.
3. Implant placement: above or below the pectoralis muscle.
4. Implant size: large vs. small breast enhancement. (Note that 175 cc of saline increases breast size by about one cup size.)

The most common approach I use places the incision around the areola and inserts a 325 cc saline implant below the muscle. This usually increases your size by one and a half, to two cup sizes.

The surgical procedure is usually performed under general anesthesia. We inject “tumescent fluid” into the breast to numb the area, and to reduce bruising. During the procedure, the patient is placed into a sitting position on the operating table to inspect for size, shape, and symmetry. Following this exacting inspection, a permanent implant is placed in the pocket and the patient is awakened and sent home after a short recovery.

Our patients are usually up and showering the next day after surgery. The sutures are removed and you’re back to work after a week of recovery. We have found breast augmentation to consistently be a successful and satisfying procedure that remains one of Victoria’s best kept secrets.

The ideal candidates for this style of implant are petite-framed women without a lot of droop to their breasts. The implant is narrow but tall, with an increased capacity for saline filling. Once the saline is added to the implant, the shaped breast projects nicely while avoiding excessive fullness and expansion beyond the chest wall and into the underarm area. This combination works well with petite-framed women who desire larger, shapelier breasts without excessive width.

Everyone loves full and shapely breasts that do not look “overdone.” The High Profile saline implant offers the option of a larger, shapelier breast to the small-framed woman.

The FDA Panel approved the use of silicone breast implants for most women in November of 2006. After 14 years of intense study involving patients, plastic surgeons, and manufacturers, silicone breast implants are now an option for most women for first-time augmentations. The only limitation requires that patients be at least 22 years old.

Prior to this wider release, silicone implants were only available to women having reconstructive needs or anatomic abnormalities. For women younger than 22 years of age who do not fit these criteria, the FDA recommends saline implants for first-time cosmetic breast enhancement.

Additionally, the FDA recommends regular MRI scans over a woman’s lifetime to check for ruptures. If a rupture is detected during one of these exams, replacement is recommended. The most recent research suggests that 90% of silicone implants last 10 or more years. Please note that newer generations of implants are made with a “highly cohesive” silicone (like gummy bears). This new gel formulation should further improve this statistic relative to the older generations of silicone implants.

Dr. Lussier was born and raised in Minneapolis, Minnesota. Educated in New York, Houston and Los Angeles, he chose to settle in Southern California with his wife and son and build his medical practice in the Santa Clarita Valley. Dr. Lussier is certified by the American Board of Plastic Surgery in Plastic Surgery and by the American Board of Surgery in general surgery, with an extensive education in aesthetic, hand and general reconstructive surgeries. He prides himself on staying current with the latest technology and procedures. He resides on the medical staff of a number of hospitals and is an active member of the American Cancer Society, for the Santa Clarita Valley unit. Dr. Lussier is a Diplomate of the American Board of Plastic Surgery and a Fellow of the American College of Surgeons.