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Monthly Archives: August 2020

Tummy Tuck

Should I get a Tummy Tuck, a Mini Tummy Tuck, or Liposuction?

Tummy Tuck

A toned, flat stomach is one of those coveted features that is desired by many, but as we all know, can be very difficult to achieve. Sometimes no matter how hard you work, no amount of dieting and crunches will cut it! Luckily in today’s day and age, safe and highly effective cosmetic surgical procedures are available for those that wish to finally get that flat stomach they’ve been hoping for. In fact, there are several different options for people wishing to improve the appearance of their abdomen, including full tummy tuck, mini tummy tuck, and liposuction alone. This post will parse out the differences between these procedures to you help you begin thinking about which one ones you are most interested in learning more about.

A full, or regular tummy tuck is one popular option for improving the shape and size of the midsection. In the past, this procedure focused on removing sagging extra skin and fat from the stomach without changing the appearance of the rest of the abdomen. However, this often had the unwanted effect of creating a boxy, unnatural-looking abdomen by selectively removing tissue from the front without touching the back or sides. Most reputable plastic surgeons today including board-certified plastic surgeon Dr. Traci Temmen have adapted this procedure to produce much better results for their patients. When Dr. Temmen performs this procedure, she combines traditional tummy tuck technique with the gentle body-sculpting benefits of liposuction to slim, shape, and smooth the midsection. She first uses the precise power of liposuction to remove stubborn fat deposits from the front, back, and sides. This helps sculpt the body evenly and smoothly while bringing in the waist and accentuating the hips, resulting in the attractive hourglass shape many women are looking for. In the second part of this procedure, Dr. Temmen then uses traditional tummy tuck technique to remove excess sagging fat and skin from the abdomen. This combination of techniques creates optimal results for patients, leaving them with a slim tummy and natural-looking, beautiful curves. The scar from this procedure is usually a little bit longer than a C-section scar, and Dr. Temmen takes care to place it low enough on the abdomen such that it is usually concealed behind a bikini or underwear. This procedure tightens the abdominal muscles and removes excess tissue from both above and below the belly button. Because of this, this procedure also includes creating a new, perfect “innie” belly button in an attractive oval shape.

Another option for patients to consider is the “mini” tummy tuck. Much like the full tummy tuck, the mini tummy tuck also includes targeted liposuction of the front, back and sides to create a slim and curvy shape. The main benefit of this procedure versus a regular tummy tuck is that a smaller incision is made, resulting in a shorter scar. The scar is usually shorter than a C-section scar, and may even be short enough to be concealed by the pubic hair. In addition, because a mini tummy tuck only targets the tissue below the belly button, the belly button does not need to be remade in this procedure like it is in a fully tummy tuck. Good candidates for this option typically have excess skin and fat that is limited to the lower abdomen. This way, they do not require a full tummy tuck to address unwanted excess skin and fat from the upper abdomen, and the procedure can be performed through the “mini” incision. People who may not be a good candidate for a mini tummy tuck are those who have excess fat and skin both above and below the belly button, making a full tummy tuck a better option.

A final option for patients to think about when considering their options for improving the appearance of the midsection is liposuction alone, without an associated tummy tuck. As described in the other procedures, liposuction is a method of gently removing fat in order to slim and shape the abdomen. Liposuction can eliminate stubborn fat deposits such as love handles, but cannot remove loose, saggy skin or tissue that hangs over the front of the abdomen. This would need to be removed during a tummy tuck or mini tummy tuck. Liposuction may be a good option for patients who don’t have sagging excess skin to remove, but are looking to sculpt the body and improve overall shape. Along these lines, good candidates for this procedure should be close to their ideal weight, have good quality skin, and be aiming to target specific fat deposits that have been resistant to diet and exercise. With liposuction alone, the resulting scars are extremely minimal as it is performed through tiny incisions in the abdomen (usually between ¼ to ½ an inch long) that are placed in well-concealed areas of the body whenever possible.

As you can see, there are several cosmetic surgical options for improving the appearance of the abdomen. Just a few of the factors that play into choosing the best option for a unique patient are their current appearance, aesthetic goals, and preferences for scar size and placement. Board-certified plastic surgeon Dr. Traci Temmen is highly skilled at all of the procedures discussed in this post (any many more!) and enjoys working with each individual to design a personalized procedure plan that is the perfect fit for them. If you are interested in learning more about if you may be a good candidate for any of these procedures, please call 813-771-6393 to schedule your one-on-one consultation with Traci Temmen, MD, today!

breast implant with breast lift

What are my Options for Breast Implant Removal and Capsulectomy when I have my Implants Removed?

breast implant with breast lift

Breast augmentation with implants is one of the most popular cosmetic surgeries and is a source of confidence and empowerment for many women. However, there are plenty of women who later on down the road, desire to have their implants removed for one reason or another. For some, it’s simply a matter of personal preference as their idea of beauty has changed over time. Others find that their bodies change with pregnancy, aging, or weight gain in a way that no longer makes implants the best option for them. Still others no longer want to be responsible for the maintenance of their implants.  Finally, some women believe their implants are negatively impacting their health and have concerns about Breast Implant Illness (see previous posts).  Whatever their reason, Dr. Traci Temmen understands that this is a personal choice that deserves the same level of support and guidance as the decision to get breast implants. In addition, she recognizes that this may be a difficult decision for some as they consider what their breasts will look like without implants, while others may feel very confident and liberated by their decision. Dr. Temmen recognizes that all of these feelings are completely okay, and meets every patient where she is to walk their journey together. Regardless of how a woman is feeling about her breast explantation, nearly everyone has questions regarding how the procedure will be done. This post will discuss some of the different options for breast explantation with and without capsulectomy, and discuss the pros and cons of each to shed some light on this important topic.

There are multiple methods for breast implant removal, including varying options for removal of the capsule, which is the natural scar tissue the body forms around any foreign object (ie. Breast implant, knee replacement, pacemaker, etc…). One option that works well for many women is to have their implants removed while leaving the capsule behind. This means that no natural tissue is removed from the body, just the implant itself. An advantage of this approach is that leaving the capsule in place often helps to better preserve the shape of the breast after the implant has been removed. The volume of tissue in the capsule contributes, in some measure,  to the size of the breast, and the capsule architecture helps the breast hold its shape without the support of the implant. In addition, leaving the capsule in place also preserves its role in the blood supply to the breast tissue and nipple. This is a great option for a patient whose main concern is having the best aesthetic outcome possible after her implants are removed. However, it may not be a good match for those who have experienced problems with their capsule, such as capsular contracture, or feel that their implants have made them sick (called “breast implant illness”) and therefore want any tissue that has touched their implants to be removed.

As discussed above, some women may prefer for parts or all of their capsule to be removed with their implants. Select problematic parts of the capsule can be removed in a partial capsulectomy, such as when treating capsular contracture (abnormal, restrictive scar formation around the implant). In other cases, a woman may desire for her entire capsule to be removed with her implants, either in multiple pieces or as a whole that is still encasing the implant inside. These two approaches are called a total capsulectomy, and an en bloc capsulectomy, respectively. Some patients who believe they are experiencing breast implant illness advocate for en bloc capsulectomy in order to remove the implant and associated capsule in one piece and avoid the implant touching any other tissue as it is being removed. Dr. Traci Temmen respects her patient’s wishes for how they want their breast explanation to be performed, and makes every effort to honor their personal preferences. However, it is important to note that en bloc capsulectomy is sometimes not able to be done safely as attempting to remove the implant and capsule in one piece could risk damage to important underlying structures like the ribs and lungs. Dr. Temmen always prioritizes patient safety, and so in these cases will change course to a total capsulectomy where all of the capsule is still removed, but it is done so in pieces rather than as a whole.

There are many different options to consider when thinking about breast implant removal, and this can often seem overwhelming. It is important to have a board-certified plastic surgeon you can trust to guide you on your journey. Board-certified plastic surgeon Dr. Traci Temmen listens carefully to her patients and takes the extra time to answer any questions and address any concerns that they have. She is highly trained in all methods of breast implant removal with and without capsulectomy, and is meticulous and precise with her surgical technique regarding this sensitive area of the body. Patients love her gentle bedside manner, and feel reassured and supported throughout all aspects of their care, from initial consultation to post-op result. In addition, she also offers options for enhancing the appearance of the breasts after implant removal, including breast lift and fat transfer to the breast. To learn more about these options, explore the tabs under the Breast heading of the Procedures section of this website and past blog posts on these topics. Example of real patient transformations performed by Dr. Traci Temmen may also be viewed in the Before and After section of this website. If you would like to learn more about your options for breast implant removal or any other cosmetic procedure, call 813-877-2277 to book your one-on-one consultation with Board-Certified Plastic Surgeon Traci Temmen, MD, today!


What are the risks of a BBL

What are the risks of a BBL?

What are the risks of a BBL

Throughout American history, the ideal image of beauty has continuously evolved – ranging from the thin and boyish figures of the 1920’s flappers to the voluptuous hourglass shape of Marylyn Monroe. Most would agree that the perfect figure of today’s modern woman lies somewhere in between, embodying an overall athletic shape with generous curves. This image that has been accentuated by celebrities like Jennifer Lopez and Kim Kardashian who have worked hard to stay fit and strong while also embracing their killer curves. Unfortunately, while many women work hard to achieve this look, many are not able to achieve it with lifestyle changes alone. Fortunately, the power of plastic surgery has opened doors for many women to finally achieve the look they have been dreaming of. One procedure that is one of the fastest-growing cosmetic plastic surgeries in the US is the Brazilian Butt Lift (or BBL, for short). This procedure does what nearly every woman has exclaimed in frustration at one point or another – “If only I could just take some of the fat from my stomach and move it to my butt!”. With the BBL, this is actually possible! However, while few can deny the amazing results of this procedure, this procedure has some associated risks that should be appropriately addressed. This post will discuss some of the safety concerns associated with this procedure and how they can be mitigated to ensure the highest level of patient safety without compromising on quality results.

The Brazilian Butt Lift is a surgical procedure that uses the power of liposuction to gently remove unwanted fat from the abdomen, back, and sides, which is then precisely injected into the buttocks to create a fuller, rounder shape. Through this method, the plastic surgeon is able to simultaneously slim the tummy, bring in the waistline, and enhance the buttocks – all without the use of synthetic implants or fillers. However, as the BBL has gained popularity, studies have showed its association with an elevated risk of intraoperative lethal fat embolism. Once this information came out, additional research was performed to figure out exactly why this risk was elevated, and what could be done to decrease it as much as possible. These studies looked at autopsies of patients who had suffered lethal fat emboli during a BBL, and examined what factors these cases had in common. The results showed that this fatal complication occurred in cases where there was injury to the deep pelvic veins, large blood vessels that lie deep to the gluteal muscle fascia and subcutaneous fat. When these deep veins were lacerated, fat could inadvertently reach the blood vessel and get stuck in the cardiovascular system, causing the cessation of blood flow and death. These results were supported by post-mortem examinations that showed the presence of fat deep in the muscle and laceration of a nearby deep vein.

It is important to note that in these studies, thus far no cases resulting in death have been found to be associated with fat injected purely into the subcutaneous plane. All fatal fat emboli have occurred during fat injection into the muscle. (It should also be noted that fat injected into the subcutaneous plane is separated from the deeper muscle layer by a layer of fascia, preventing it from migrating into the muscle.) Due to these findings, plastic surgeons should never attempt intramuscular fat injection during a BBL, taking care to only inject fat into the subcutaneous tissue. In order to ensure this, it is essential that surgeons are acutely aware of the location of the cannula tip at every moment, and are vigilant about confirming its trajectory by feeling the cannula tip through the skin. Furthermore, using large-bore cannulas that will not bend during injection allows surgeons to more accurately place fat in the subcutaneous plane. Dr. Traci Temmen has trained extensively in proper BBL fat injection technique, and always injects fat into the subcutaneous plane using large-bore cannulas while monitoring the location of the cannula tip at all times. Taking these essential safety precautions greatly lowers the risk of fat embolism and maximizes patient safety.

The final factor to consider when thinking about BBL safety is choosing the right surgeon. First and foremost, it is extremely important to choose a board-certified plastic surgeon. This ensures that they have been extensively trained in both the procedures themselves as well as how to prevent and handle emergencies that may arise in the operating room, and requires both completion of a plastic surgery residency and passage of all required examinations. Finally, board-certified plastic surgeons are required to practice in fully accredited surgical facilities that are certified to have all of the necessary equipment to handle an emergency should one arise. In addition to being board-certified, it is also important to choose a surgeon who you feel like you can trust, and who understands your values and preferences. In addition, they should have numerous examples of real patient Before and After pictures for you to view, showcasing their results and providing evidence of their surgical skill and positive results. Dr. Traci Temmen is a board-certified plastic surgeon who practices in a state-of-the-art surgical suite at Temmen Plastic Surgery. She is fully trained in numerous plastic surgery procedures including the BBL, and has complete knowledge of potential complications and how to manage them. Furthermore, Dr. Traci Temmen’ patients love her kind and calm demeanor and are consistently impressed with their beautiful results, many of which are showcased in the Before and After section of this website.

As with all surgical procedures, the Brazilian Butt Lift is associated with complications that should be discussed with your plastic surgeon. That being said, when performed by an experienced and highly trained board-certified plastic surgeon like Dr. Traci Temmen, these risks can be substantially lowered. Dr. Temmen fully understands the anatomy of this region and practices only the safest injection techniques, making this procedure a safe and effective option for slimming the tummy and creating beautiful curves – all from your natural supply of fat! If you are interested in learning more about this procedure, please call 813-771-6393 to book your one-on-one consultation with board-certified plastic surgeon Traci Temmen, MD, today.