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Mastectomy or Lumpectomy?

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Submitted by Twin City Plastic Surgery

There is nothing easy or simple about a cancer diagnosis. From the moment a patient hears the words “you have breast cancer,” she begins an exhausting schedule of medical appointments, treatments, and procedures. While much attention is given to treating the patient’s medical condition, she also needs support in thinking through her options impacting her health and appearance.

The vast majority of breast cancer diagnoses involve some type of surgical treatment with lumpectomies being more common in early-stage cancer situations. According to the American Cancer Society (ACS), 57 percent of women with early stage (Stage I or II) breast cancer have a lumpectomy or partial mastectomy and 36 percent have a full mastectomy, with others electing non-surgical options. Thirteen percent of women with late stage breast cancer (Stage III or IV) have a lumpectomy or partial mastectomy and 60 percent have a mastectomy.

The ACS also tells us 20 to 40 percent of women who undergo mastectomy have breast reconstruction which typically includes an implant, tissue from another part of the body, or a combination of the two.  Some types of reconstruction can begin during the mastecomy surgery itself, so having a reconstruction plan from the beginning of treatment is critical. Of course, some women are not candidates for lumpectomies due to the size or location of the tumor. But for a woman who has options, how does she make the decision to remove part or all of her breast?

Current data shows the type of surgery – lumpectomy or mastectomy – does not appear to impact a patient’s survival rate or possibility of cancer recurrence. Also, these surgical options do not impact the need and/or type of chemotherapy and/or hormone therapy a doctor recommends.

A lumpectomy always:

  • Allows the patient to preserve more of their breast, which can give the patient comfort and an obvious feeling of normalcy.
  • Involves a less extensive surgery in which the patient can go home the same day.
  • Requires radiation as part of the therapy to treat the breast cancer.
  • Does not involve placement of an implant.

Lumpectomy with radiation therapy (XRT) is becoming much more common versus a full mastectomy, and, therefore, mastectomies may be on the decline. From a breast conservation perspective and oncologic perspective, this is good. But there are some downsides to choosing lumpectomy/XRT that are rarely mentioned to the patient.

  • Lumpectomies can result in uneven breasts which may not give the patient the look they hoped for.
  • The defect may still leave a significant cosmetic concern, but any surgery to correct this may be considered cosmetic and be more difficult to get covered by insurance.
  • Radiation treatments can cause adverse cosmetic changes such as darkening of the skin at the treatment site.
  • Any surgery that is ever done on the radiated breast for the rest of that patient’s life, is at a much higher risk for complications due to the radiation, and, therefore, limits the patient’s options for reconstructive surgery in the future.

The decision to have a lumpectomy or mastectomy is as individual and personal as a surgery can be. Each patient should to talk with their plastic surgeon prior to making their final decision so they can be fully informed of the advantages and challenges of each option. As board-certified plastic surgeons, we have the education and experience to provide effective breast reconstruction consultations and provide our patients peace of mind during a stressful time as they reclaim their life and body from this disease.

Scar Revision….Minimizing the Reminder of a Wound or Surgery

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Submitted by Twin City Plastic Surgery

Scars are visible signs that remain after a wound has healed. They are unavoidable results of injury or
surgery, and their development can be unpredictable. Poor healing may contribute to scars that are
obvious, unsightly or disfiguring. Even a wound that heals well can result in a scar that affects your
appearance. Scars may be raised or recessed, different in color or texture from surrounding healthy
tissue or particularly noticeable due to their size, shape or location.

Scar revision is meant to minimize the scar so that it is more consistent with your surrounding skin tone and texture. Although scar revision can provide a more pleasing cosmetic result or improve a scar that has healed poorly, a scar cannot be completely erased.

Is it right for me?
Scar revision is a highly individualized procedure and you should do it for yourself, not to fulfill someone else’s desires or to try to fit any sort of ideal image. Scar revision can be performed on people of any age and is a good option for you if:

You are bothered by a scar anywhere on your body
You are physically healthy
You do not smoke
You have a positive outlook and realistic goals for your scar revision surgery
You do not have active acne or other skin diseases in the area to be treated

The success and safety of your scar revision procedure depends very much on your complete candidness during your consultation. You’ll be asked a number of questions about your health, desires and goals, medical history, and lifestyle habits.

Different types of scars include:
Discoloration, surface irregularities and other more subtle scars can be cosmetically improved by
surgery or other treatments recommended by your plastic surgeon. These types of scars do not impair
function or cause physical discomfort and include acne scars as well as scars resulting from minor injury and prior surgical incisions.

Hypertrophic scars are thick clusters of scar tissue that develop directly at a wound site. They are often
raised, red and/or uncomfortable, and they may become wider over time. They can be hyperpigmented
(darker in color) or hypopigmented (lighter in color).

Keloids are larger than hypertrophic scars. They can be painful or itchy, and may also pucker. They
extend beyond the edges of an original wound or incision. Keloids can occur anywhere on your body, but they develop more commonly where there is little underlying fatty tissue, such as on the face, neck, ears, chest or shoulders.

Contractures are scars that restrict movement due to skin and underlying tissue that pull together during healing. They can occur when there is a large amount of tissue loss, such as after a burn. Contractures also can form where a wound crosses a joint, restricting movement of the fingers, elbows, knees or neck.

The degree of improvement that can be achieved with scar revision will depend on the severity of your
scarring, and the type, size and location of the scar. In some cases, a single technique may provide
significant improvement. However, your plastic surgeon may recommend a combination of scar revision techniques to achieve the best results.

Topical treatments, such as gels, tapes or external compression can help in wound closure and healing,
or to reduce the ability of skin to produce irregular pigment. These products may be used to treat existing surface scars and discoloration, and to aid in healing of scar revision procedures.

Injectable treatments are often used to fill depressed or concave scars. Depending on the injectable
substance used and your particular scar conditions, results may last from three months to several years.
Therapy must be repeated to maintain results.

Surface treatments are most often used for cosmetic improvement of scars. These methods can soften
surface irregularities and reduce uneven pigmentation. Surface treatments are a controlled means of
either mechanically removing the top layers of skin or changing the nature of tissue. These treatment
options include:

Microneedling is a form of collagen induction created by a mechanical force delivered to the
dermis. It also is useful for improving acne pock marks and can weld stretch marks together by
creating collagen bridging.
Dermabrasion is a mechanical polishing of the skin.
Laser or light therapy causes changes to the surface of the skin that allow new, healthy skin to
form at the scar site.
Chemical peel solutions penetrate the skin’s surface to soften irregularities in texture and color.
Skin bleaching agents are medications applied topically to lighten the skin.

Surgery is sometimes necessary for the improvement of scars especially if non-surgical means are not
possible or successful. Often the scar is excised and then closed in layers adjusting the tension or
orientation of the scar. Advanced techniques with flap closure or repositioning of the scar in a natural
crease sometimes makes it less conspicuous. More advanced techniques, such as tissue substitutes/skin
grafting or tissue expansion, may be necessary if the scar is more complex.  Give Dr. Laura Randolph a call at (309) 664-6222 to discover your scar revision options today.

Breast Augmentation … It’s A Personal Choice!

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Submitted by Dr. Laura Randolph

Reasons may vary as to why women elect to have breast augmentation surgery. According to the American Society of Plastic Surgeons, the reason is simple: women get breast augmentation surgery because they are dissatisfied with their breast size. Some women want to improve the balance of their figure and improve self-image, while other women want to restore breast volume after weight loss or child birth. But regardless of the reason why, how many women are really satisfied with their results?

Well, the results are clear:  98% of women undergoing breast augmentation surgery say the results met or exceeded their expectations, according to a study in the May 2016 issue of Plastic and Reconstructive Surgery®.  In the study of 225 consecutive women who returned for interviews at least 1 month after breast augmentation over a 5-year period, women also reported improvements in self-esteem and quality of life after breast augmentation.  In addition, on a 10-point scale, women reported an average pain score during recovery of 5.9. On average, they used prescription pain medication for 5 days and were off work 7 days. Patients felt they were “back to normal” about 25 days after surgery, the new study showed.

Furthermore, 85% of women rated their new breast size “just right.” 13% would have preferred a larger size, and less than 2% wished they had chosen a smaller size. Only 1% expressed dissatisfaction with their scars. Seventy-five percent of women rated their breast firmness “just right.” When asked to rate the result, more than half of the patients gave it a perfect 10 on a scale of 1 to 10. Almost all patients (98%) reported that the results met or exceeded their expectations.  On another note, nearly 40% of the patients surveyed experienced at least temporary nipple numbness after surgery. Persistent numbness was reported by only 2% of patients. The complication rate reported by patients was 10%.

When asked about psychological effects, 92% of women reported improved self-esteem after breast augmentation, and 64% reported an improved quality of life. Before surgery, the majority of women (86%) were self-conscious about their breasts. After surgery, only 13% were self-conscious about them.

Electing to have cosmetic surgery may not be right for everyone, but the choice is personal and the individual outcome is what truly matters.

 

Source:  Plastic Surgery Practice

For more information regarding breast augmentation or other cosmetic surgery procedures contact Dr. Laura Randolph—309-664-6222.

You’ve Lost The Weight … Now What??

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Submitted by Twin City Plastic Surgery

We’ve all heard countless success stories about friends, family members and even total strangers who have lost significant amounts of weight. Maybe it’s even you who has dropped 100 pounds or more, either strictly by diet and exercise or interventional methods such as bariatric surgery. While either of these results in better long-term health, your initial appearance after weight loss may be not quite what you expected.

What happens after massive weight loss?

While you’re carrying those extra pounds, your skin is stretched around areas of your body like the abdomen, arms, legs, breast and face. After significant weight loss, the skin often fails to shrink back, resulting in upper arms that may sag and appear loose or full, flattened breasts, excess abdominal skin that may lay apron-like around your sides and lower back area, and hanging pockets of skin around buttocks, groin and thighs.

Many individuals who have experienced a great weight loss are turning to plastic surgery to improve the shape and tone of underlying tissue that supports fat and skin and removes excess sagging fat and skin. The result gives your new body a more “normal” appearance, with smoother contours.

The skinny on post-weight loss plastic surgery

There are a number of procedures that may be of interest to an individual who has recently lost 100 pounds or more. They include:

Body Contouring

Also called a body lift, this is the most commonly-performed surgery after weight loss. More than 106,000 body-contouring procedures were performed in 2016, up 77 percent over the last five years, according to the American Society of Plastic Surgeons. Massive weight loss patients accounted for nearly 56,000 procedures. Body contouring is the removal of excess, sagging skin around the abdomen and a tightening of skin around the buttocks, abdomen, waist, hips, thighs and arms.

Tummy Tuck

A tummy tuck involves an incision at the bikini line and around the navel. The surgeon then manipulates the skin and tissues and repairs weakened abdominal muscles. In some cases, you may have an additional incision to remove excess skin in the upper abdomen.

Breast Lift

During a breast lift, excess skin and tissue is removed and the nipple is repositioned. Implants can be added as well to improve shape.

Brachioplasty

This procedure removes excess skin from the upper arm area.

Face “Lift”

This  procedure involves removing excess skin around the face and neck.

Are you ready for the final step?

Many consider plastic surgery the “final step” in their weight loss journey. If your weight has stabilized for at least a year and you’re in overall good health, and if you don’t smoke and are committed to good nutrition, fitness and an overall healthy lifestyle, you are likely to get the thumbs up from your doctor as well as your plastic surgeon to make the desired physical tweaks. However, this process is not one to be entered into lightly. The results may be immediate but the healing will take time, your activity will be restricted temporarily, visible scarring will remain, and it will be your job to maintain a stable weight and overall fitness for the remainder of your life.

No matter if your weight loss is due to diet or surgical means, you deserve to have the body you earned for a lifetime to come.

Saline or Silicone: Which One is Safe?

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Submitted by Twin City Plastic Surgery

Believe it or not, breast implants aren’t a modern development in the field of breast reconstruction.

In 1895, German surgeon Vincenz Czerny, the father of cosmetic breast surgery, first used a breast implant to reconstruct a woman’s breast after removing a tumor.  That first implant was comprised of excess tissue taken from the woman’s own body. Through the years, surgeons and medical researchers continued experimenting with different substances to fill breast implants, most of which proved – unfortunately – not to be safe for the patient.

The medical community developed “modern” breast implants in the early 1960s, which was welcome news for women needing breast reconstruction. Modern implants are constructed of a silicone form shaped like a breast and filled with either saline (biological-concentration salt water) or silicone (a viscous synthetic gel polymer).

Since that time, medical research and media reports have continued to cast doubt and shed new light on breast implants. Most of the controversy focused on the safety of silicone implants. Many women still remember the coverage of the 1992 decision by the US Food and Drug Administration (FDA) to stop manufacturers from selling silicone implants due to safety concerns. However, in 2006, the FDA began allowing the sale of certain types of silicone implants as continued research didn’t support the prior concerns. Today, both kinds of implants remain on the market and are considered safe.

Dr. Laura Randolph is a board-certified plastic surgeon that works with women every day who use breast implants to restore their bodies after cancer. Thirty-six percent of women with early stage (I or II) and 60 percent of women with late stage (III or IV) breast cancer have a mastectomy, a surgical removal of the breast, as a part of their cancer treatment. Of these women, 20 to 40 percent of women also have breast reconstruction.

Patients benefit greatly from having their plastic surgeon as a part of their healthcare team as soon after diagnosis as possible. Medical procedures are unique to each patient, including mastectomies and reconstruction. Plastic surgeons work with reconstruction of the breast which sometimes can be started during the initial mastectomy surgery. Other times, it’s best for the patient to have their reconstruction as a separate procedure. Plastic surgeons who handle the actual placement of the implant can work with patients in advance to discuss the advantages and challenges of immediate and delayed reconstruction.

One of the many decisions plastic surgeons help patients with is determining which implant type is best for her needs. Here’s a few things to consider:

 

Type Which is … Pro Con
Saline Sterile salt water Leakage, if it occurs, is safely absorbed by the body. If a rupture happens to occur, the patient will see a noticable change in their breast structure.
Silicon Plastic gel Many women say they feel more like natural breasts. Also, if a rupture happens to occur, the patient may not see an immediate change in their breast. However, the plastic gel will to leak within the patient and possibly cause medical complications which may be difficult to detect. MRIs are recommended every few years to check for “silent rupture.”

 

There are some things patients with implants should know, regardless of the type of implant used:

  • Implants aren’t designed to last forever. Over time, the size and shape of your breast may change requiring the implants be replaced. And, of course, there is potential for other medical issues to develop which may require the implant be replaced.
  • Mammogram recommendations are different for women with implants. In general, women who have had a mastectomy for breast cancer followed by reconstruction with implants do not need to have regular mammograms. However, there are exceptions to this. Each patient needs to work with their doctor to determine what type of monitoring is needed.

Give Dr. Laura Randolph a call at (309) 664-6222 to set up a consultation or discuss your options further.

Mastectomy or Lumpectomy?

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Submitted by Twin City Plastic Surgery

There is nothing easy or simple about a cancer diagnosis. From the moment a patient hears the words “you have breast cancer,” she begins an exhausting schedule of medical appointments, treatments, and procedures. While much attention is given to treating the patient’s medical condition, she also needs support in thinking through her options impacting her health and appearance.

The vast majority of breast cancer diagnoses involve some type of surgical treatment with lumpectomies being more common in early-stage cancer situations. According to the American Cancer Society (ACS), 57 percent of women with early stage (Stage I or II) breast cancer have a lumpectomy or partial mastectomy and 36 percent have a full mastectomy, with others electing non-surgical options. Thirteen percent of women with late stage breast cancer (Stage III or IV) have a lumpectomy or partial mastectomy and 60 percent have a mastectomy.

The ACS also tells us 20 to 40 percent of women who undergo mastectomy have breast reconstruction which typically includes an implant, tissue from another part of the body, or a combination of the two.  Some types of reconstruction can begin during the mastecomy surgery itself, so having a reconstruction plan from the beginning of treatment is critical. Of course, some women are not candidates for lumpectomies due to the size or location of the tumor. But for a woman who has options, how does she make the decision to remove part or all of her breast?

Current data shows the type of surgery – lumpectomy or mastectomy – does not appear to impact a patient’s survival rate or possibility of cancer recurrence. Also, these surgical options do not impact the need and/or type of chemotherapy and/or hormone therapy a doctor recommends.

A lumpectomy almost always:

  • Allows the patient to preserve more of their breast, which can give the patient comfort and an obvious feeling of normalcy.
  • Involves a less extensive surgery in which the patient can go home the same day.
  • Requires radiation as part of the therapy to treat the breast cancer.
  • Does not involve placement of an implant.

Lumpectomy with radiation therapy (XRT) is becoming much more common versus a full mastectomy; from a breast conservation perspective and oncologic perspective, this is good. But there are some downsides to choosing lumpectomy/XRT that are rarely mentioned to the patient.

  • Lumpectomies can result in uneven breasts which may not give the patient the look they hoped for.
  • The defect may still leave a significant cosmetic concern, but any surgery to correct this may be considered cosmetic and be more difficult to get covered by insurance.
  • Radiation treatments can cause adverse cosmetic changes such as darkening of the skin at the treatment site.
  • Any surgery that is ever done on the radiated breast for the rest of that patient’s life is at a much higher risk for complications due to the radiation, and, therefore, limits the patient’s options for reconstructive surgery in the future.

The decision to have a lumpectomy or mastectomy is as individual and personal as a surgery can be. Each patient should talk with their plastic surgeon prior to making their final decision so they can be fully informed of the advantages and challenges of each option. Dr. Laura Randolph as a board-certified plastic surgeon has the education and experience to provide effective breast reconstruction consultations and provide patients peace of mind during a stressful time as they reclaim their life and body from this disease.

Dermal Fillers

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Dermal fillers are one of the most popular procedures for achieving a more youthful appearance.  These products are injected into the skin and will soften or even eliminate the look of fine lines and wrinkles around the eyes, nose and mouth. Additionally, fillers can be used to add volume to the cheeks and lips— creating a more contoured look in the process.

While fillers are most commonly used to minimize laugh lines, crow’s feet and frown lines, as well as to plump up lips and cheeks, there are also the following ways that fillers can be used that most people aren’t aware of.

Recessed Scars

One good thing about scars is that they tell a story, but the bad thing is that they can make you feel self-conscious and embarrassed. Fillers can be used to temporarily alleviate the appearance of recessed scars by adding volume to the skin— creating a smoother texture in the process.

Facial Contour Deformities

If you have had a surgical procedure to correct facial deformities that were caused by accident or surgery, facial fillers can be used to help with creating natural looking contours across your face. By injecting fillers around your cheekbones, mouth, nose, and chin, fillers can help you temporarily eliminate facial imperfections.

What About BOTOX?

BOTOX is the most popular injectable available, but it is not a dermal filler.  BOTOX injections work by weakening or paralyzing certain muscles or by blocking certain nerves so that wrinkles are less noticeable.  BOTOX is most commonly used to lift areas like eyebrows, eyes, and forehead.  There is no downtime with BOTOX, meaning you can resume your normal activities right away.  The effects last about three to four months, depending on what is being treated. BOTOX is also used for many other conditions including underarm sweating.

It’s important to realize that dermal fillers and BOTOX are medical procedures, not cosmetic treatments.   These should only be done by a board-certified plastic surgeon or dermatologist who is knowledgeable about injection techniques and product safety. Because there is a wide variety of different types of dermal fillers, and choosing the correct injection site is crucial, only your physician can recommend the specific strategy that will give you the results you are seeking. Dermal fillers are not appropriate for everyone and although the procedure is very safe, there are certain risks.  Your physician will do a complete medical history to make sure that you are a good candidate, explain the procedure in detail, and answer questions that you may have.

Although temporary, facial fillers provide solid results that can help treat some major areas of concern. The results are usually immediate and will last 6 months to over a year depending on the patient and the type of filler used.

Tummy Tuck, Redesigning Your Mid-Section

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Sometimes all of the exercising and dieting in the world cannot get rid of the midsection that results from a lifetime of weight fluctuations or pregnancy.  The body changes that a woman will experience to her midsection with one pregnancy, let alone multiple pregnancies, can lead to unwanted changes such as sagging skin, stretch marks and even muscle separation in the abdominal wall.

What is a tummy tuck?

The tummy tuck is designed to correct several of the changes brought about by pregnancy or massive weight loss in women.  Men also benefit from abdominal wall contouring after weight loss.  The procedure can improve the appearance of excess abdominal fat, skin and tissue in healthy adults, leading to a flatter, more trim waistline.

A full tummy tuck, or abdominoplasty, is defined by an incision that runs from hip to hip along the lower abdominal area.  An additional incision is made around the navel, and excess upper and lower abdominal skin and fat is pulled down and trimmed, creating a flatter, more contoured abdominal wall.  The rectus muscles that shape and provide core strength to the abdominal wall are also repaired and brought back into closer alignment, further contouring the waist.

A full abdominoplasty is a major operation that can take two to four hours in the operating room and it should be performed by a board certified plastic surgeon.  Recovery time is usually four to six weeks and individuals should expect to wait six weeks before returning to their exercise routine.

A mini tummy tuck, which uses a shorter incision in the lower abdomen, is perfect for patients who have a small to moderate amount of skin and fat excess but do not need repair of the upper abdominal muscles.  No incision around the navel is required with a mini tummy tuck.  Liposuction is used in a limited fashion to the lateral hip area in both full and mini tummy tucks.

The Effects of Pregnancy

A tummy tuck is used to correct rectus diastasis, a condition where the abdominal wall muscles have separated.  The most common reason these muscles become weakened is multiple pregnancies.  Many women have some degree of this condition and might not know it.  Women come to our office frustrated at the appearance of their abdomen, despite a great exercise routine and good nutrition.  Abdominoplasty surgery closes the muscle separation and flattens the abdomen in a way that even vigorous exercise cannot, supplementing and enhancing a patient’s goal of a more attractive midsection.

Post-partum women seeking a toned tummy should wait at least 6-12 months after nursing before considering abdominoplasty.  We advise our patients to certainly wait until they are done having children before having this procedure – as the benefits of surgical abdominal wall contouring are lost if a patient were to become pregnant again.

 5 Highlights of Tummy Tuck Surgery:

  • Choose only a doctor certified by the American Board of Plastic Surgery.
  • Agree only to surgery performed in an accredited facility with a board certified anesthesiologist or possibly a certified nurse anesthetist to administer anesthesia and monitor your health.
  • Review before and after photos, understand what a realistic result looks like and what the scars look like. Come with a list of questions for your surgeon about the procedure.
  • Ask specifically where the incision will be and accept that you will have scars. Scars may heal wide, red or raised, even if you follow all the instructions you were given.
  • Accept that your procedure will require a recovery of days to weeks and that, as with any surgery, there are some risks involved.

 

 

To Tuck or Not To Tuck

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Local nurse and mom of 8 shares her decision to have a tummy tuck.

By Linda Hankemeier

As the mom of eight, Tere (pronounced “Terri”) knows what it means to work hard to get her figure back after childbirth. However, after her last pregnancy — giving birth to triplets at age 51 — the exercise and diet that had worked so well after her earlier pregnancies wasn’t successful in getting “everything” back to normal this last time.

“I had triplets, which included a C-section. But even with the demands on my body, I was able to restart my exercise routine and managed to get back down to my prepregnancy weight,” Tere shared. “But, even with reaching that goal, I was still surprised that my midsection never went back to normal. The excess skin in my stomach wasn’t going anywhere.”

As all eight of her children grew, Tere continued her active lifestyle and her healthy habits such as exercise and proper diet. But, her midsection never seemed to change. Ten years later, her stomach looked pretty much like it did six months after her last delivery. And the extra weight around her midsection made it difficult for her to run, try on clothing, and maintain the active life she wanted. “I wasn’t worried about having the perfect body or making a spouse happy, as my husband loved me just as I was,” Tere commented. “This surgery was about getting my life back to normal.”

Realizing the shape of her stomach was beyond her control, Tere made the decision to look at medical options. She began researching abdominoplasty, more commonly called a “tummy tuck,” and met with one of the board-certified plastic surgeons of Twin City Plastic Surgery.

As a nurse, Tere was an informed patient. She researched types of procedures, consequences, and recovery times, and had many questions for the doctor and staff that were specific to her health and medical situation. “The number one question on my mind regarding any surgery was risk versus benefit, especially at my age.” Tere shared. “After all, I have eight kids and a husband. I needed to know my options, weigh the pros and cons, and make an informed decision.”

Twin City Plastic Surgery’s doctor and staff worked closely with Tere discussing in depth the surgical procedure itself, the process, recovery, and even recommended to Tere different possible procedures to address her concerns. In the end, she decided the tummy tuck and muscle wall repair would give her the results she wanted, and her surgeon confirmed she was a great candidate for the procedure. She was physically strong and maintained a healthy lifestyle, so a tummy tuck would be a great way to remove the excess skin and fat and return her to the active lifestyle she had prior, which was greatly needed as her triplets were nearing the preteen years.

Even her recovery went well. “Prior to surgery, I spent time exercising my legs to be stronger. Two days after surgery I was up walking, but careful. I walked bent over for about two weeks to make sure I didn’t pull any stomach muscles or loosen my stitches.”

As a part of her procedure, a pain pump tube was inserted in Tere’s stomach along the incision area. The pump provided her round-the-clock pain management. At times the pain was a little more severe, but she was able to manage it with oral pain medication. Within the first week, she found that extra strength over-the-counter pain medication successfully managed the pain. Within two weeks of surgery, she started working part-time again, and could comfortably walk, sit, and drive a car.

Tere resumed her normal exercise routine about two to three months post-surgery, starting first with walking and biking. Six months after her tummy tuck, Tere completed a 100-mile bike ride and was feeling fit again.

One year after her surgery, Tere said she feels amazing. Her stomach is hard and toned, with no lingering side effects of the surgery. Even her scar is hardly noticeable. “I’m so thankful I had a tummy tuck,” Tere shared. “I feel like my stomach is back to normal. But, more importantly, my life is back to normal.”

Scars and the Art of Plastic Surgery

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A scar is nature’s thread, mending broken or cut skin with a waterproof closure. A skin cut initiates a complex inflammatory process designed to manufacture that thread. Like a skilled army, specialized cells lay down a clot to stop the bleeding, while wound-healing chemicals flow to the rescue. One of those chemicals is histamine.

Histamine stretches out a blood vessel like a stocking, opening up little holes to allow special healing cells to leak out. You might be familiar with a certain side effect: Histamine can make scars itch.

Collagen-producing cells go to work like a garment factory, knitting the wound closed. Just as the factory needs electricity to run, those cells need extra energy and oxygen.

In the lungs, red blood cells load up oxygen like cargo boats, and they float down the blood vessels, handing out oxygen where it’s needed. For a wound to heal, however, the limited network of blood vessels isn’t sufficient to supply enough oxygen.

What’s a body to do?

How about… grow more blood vessels? And that’s exactly what happens. The body creates more capillaries to bring more oxygen-rich blood. The red blood inside the capillaries flows just below the scar’s surface. The result is sort of like… a blush.

That’s why scars are pink.

In the final phase of scar-making, the disorganized, heaped-up, young collagen reorganizes into its flat, mature form. (It’s like seeing a teenager grow up.)

Once the job is done, the extra capillaries are no longer needed, so they disappear, slinking off without a trace.

That’s why scars fade.

The ideal scar is thin, flat, and asymptomatic, but that takes time, up two years. (Some scars take even longer to grow up, just like some humans.)
So how do you get a ‘star’ scar?

Plastic surgeons create scars every time they cut skin. Part of the art of plastic surgery consists of hiding incisions—in folds, within hair, and along contour changes. But those incisions leave scars. (Plastic surgeons aren’t magicians.)

It’s natural for patients to hope for a perfect scar: thin, flat, and white, but not everyone heals that way. Factors that affect scarring include:

1. Genetics: You inherit your scar-forming qualities from your parents.
2. Tension: An incision closed under tension is more likely to be thick, raised, and wide.
3. Location and type of skin: Eyelid scars are typically better than back or chest scars.
4. Age: Children are more likely to develop thick scars between the ages of 8 and 16, while older people with thin skin are more likely to form fine scars.
5. Wound condition: Shredded skin edges are more likely to cause thick scars than cleanly cut ones.
6. Proper closure: Surgical technique can impact the result, though the best technique won’t overcome other factors.
7. Blood supply: Factors such as smoking can result in death of skin, leading to delayed healing, a wider scar, and the need for surgery to close the wound.
8. Infection: A wound infection can disrupt the wound and lead to a wider scar.
9. Poor diet: Inadequate nutrition can delay healing and result in opening of the wound.
10. Health: Medications, medical conditions, and previous radiation can affect wound healing, so share your medical history with your doctor.

And that’s the story of scar formation.

It’s really sort of magical if you think about it!

Potential patients may be concerned about scars after plastic surgery. Though no one can predict how an individual will heal, one’s parents’ and siblings’ scars can give an idea of inherited scarring potential. Patients can improve their chances of good scars by being honest with their doctors about their medical histories and finding an ABPS board-certified plastic surgeon trained to minimize and/or hide scarring. The chances are they’ll be pleased with the results.

Call Dr. Randolph (309) 664-6222 for a consultation. Contact Us

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