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General FAQ
Are the BodyAesthetic surgeons board certified?
Yes, all our surgeons have passed the difficult written and oral examination requirements to earn certification from the American Board of Plastic Surgery.
What are your office hours?
Our office stays open until 7:00 pm on Wednesdays, and opens at 7:00 am on Thursdays because we understand that not every patient can easily take time off work for a doctor's appointment.
On Mondays, Tuesdays, and Fridays, we are open from 8:00 am to 5:00 pm.
How does smoking affect my surgical result?
Smoking slows the healing process and increases the risks of developing complications after surgery. Surgeries that involve skin flaps (which includes all lifting procedures) are especially vulnerable to poor healing in smokers. In some people, smoking can contribute to the "death" of skin and tissue, called necrosis. In addition, the quicker the healing process, the less likely you are to develop unattractive scars.
Because of the higher rates of wound healing complications among smokers, we ask all our patients to stop smoking 3 to 4 weeks before surgery and remain tobacco free for 2 weeks afterwards. Some patients are tested for nicotine use before surgery. If they test positive, the procedure will be postponed.
When can I bathe, exercise, have sex, and return to work after surgery?
Every procedure is different, so the return to everyday activities varies. The procedure descriptions on this website briefly outline some postoperative restrictions and give a general sense of what can be expected after surgery, including when different types of activities can be resumed. More detailed information about restrictions will be provided by your surgeon during your consultation. The schedule for resuming your "normal" activities will partly depend on how you heal and how strong you feel. Follow-up appointments after surgery are important so your surgeon can evaluate your progress and advise you about specific activities.
Should I do special skin care before and after a facelift or other facial surgery?
Perhaps. The use of some skin care products, such as Retin-A, should be temporarily discontinued before and after most facial procedures, including skin resurfacing. After surgery, only very gentle cleansers and moisturizers should be used for a time specified by your surgeon or skin care specialist. The skin care regimen and products appropriate for your procedure will be explained during your consultation and follow-up appointments.
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What to Know Before Electing Surgery
The best way to find out what procedures might benefit you is to schedule a consultation with one of the surgeons at BodyAesthetic Plastic Surgery, all of whom have earned board certification from the American Board of Plastic Surgery. Every patient is unique, and cosmetic surgery is not a "one size fits all" discipline. Achieving the best aesthetic results from plastic surgery requires a surgeon who combines medical science, experience, and artistic vision.
Surgical Privileges and Facilities
The American Society of Plastic Surgeons recommends that people select a surgeon who has operating privileges at hospitals and outpatient facilities that have been credentialed in plastic surgery procedures. BodyAesthetic surgeons work at such facilities because we believe they offer extra protections for patient safety.
Even if your surgery is not performed in a hospital, your surgeon should have privileges to perform the same procedure in an accredited hospital. Some minimally-invasive procedures are done in our office (such as the ThreadLift, tissue filler injections, small volume liposuction, and many skin resurfacing procedures). For most surgeries, however, we prefer the added safety of a hospital and have privileges at Barnes-Jewish West County Hospital and Missouri Baptist Medical Center. We also operate at HealthSouth Ballas Outpatient Surgery Center, a fully accredited ambulatory surgery facility.
Fees and Insurance
Fees for cosmetic plastic surgery are paid prior to surgery. Because fees depend on the complexity of an operation, BodyAesthetic cannot quote specific prices over the phone, though we can provide a range. We have to meet with you to help you decide what procedure might be best for you.
You might think you're interested in a certain procedure but then find out that another procedure is more appropriate. If you want to have more than one procedure performed, it is less expensive to have both done during a single surgery because you'll then pay for the operating room and anesthesia only once.
We offer one piece of advice: Never choose a surgeon solely on the basis of price. You should entrust your face or body only to the plastic surgeon with whom you feel most comfortable. At BodyAesthetic, the initial consultation fee will be applied to your surgery cost should you decide to proceed, and follow-up visits to check on your progress have no charge.
As a rule, cosmetic plastic surgery is considered "elective" and therefore not covered by most insurance plans. Reconstructive surgery is generally covered by most health insurance policies, although coverage for specific procedures and levels of coverage can vary greatly.
There are many "gray areas" that require pre-certification as an insurance carrier decides whether your individual case is considered reconstructive or cosmetic. For example, eyelid surgery (blepharoplasty) might be covered if the eyelids are drooping severely and obscuring vision. If the weight of very large breasts causes pain or interferes with normal activities, a breast reduction might be considered reconstructive rather than cosmetic.
We work and argue with insurance carriers all the time and can give you a sense of whether the procedure you need might be covered by insurance.
Risks and Complications
Like all surgery, plastic surgery carries some uncertainty and risk, including the possibility of infection, bleeding, blood clots, adverse reactions to anesthesia, and other postoperative complications. These can occur no matter how skilled and experienced the surgeon.
You can reduce your risks by choosing a qualified surgeon and closely following his or her advice, both before and after surgery. The BodyAesthetic surgeons and staff take the time to fully inform each patient about the unexpected problems that could arise because we want our patients to be well-educated about these possibilities before surgery. Although complications are uncommon among our patients, they appreciate being informed about the possibilities in advance.
Your surgeon will check for medical conditions that could cause problems during or after surgery, such as uncontrolled high blood pressure, bleeding problems, or the tendency to form excessive scars. Be sure to tell your surgeon if you are taking any drugs, medications, or over-the-counter products, including herbs, since some of these can affect bleeding and bruising.
Because smoking increases the chances of developing a complication and slows the healing process, you will need to stop smoking two weeks before a surgical procedure and for four weeks afterwards.
Recovering From Your Surgery
For most cosmetic surgical procedures, normal activities should be restricted for a time following surgery. Your surgeon will explain the specific restrictions for your procedure, but the procedure descriptions on this website should provide a general idea of what to expect. It takes time for the visible signs of healing to subside. Plan your work and social activities to allow sufficient time for recovery.
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Tummy Tuck
St. Louis tummy tuck patients seek treatment at BodyAesthetic Plastic Surgery & Skin Care Center for assistance in tightening and toning their abdomens. The surgeons of BodyAesthetic treat these patients in their renowned St. Louis plastic surgery clinic. To learn more about the tummy tuck (abdominoplasty) procedure, please read the detailed paragraphs below.
Everyone would like to have a flat, tight tummy. As we age, that goal may not be achievable, no matter how much we exercise or how much weight we lose. People of normal body weight and proportion can still develop an abdomen that protrudes or is loose and sagging. This tummy "pooch" that just will not go away has many causes, including heredity, pregnancies, prior abdominal surgery, major weight loss, or back problems that affect posture. In addition, our abdominal muscles usually lose tone as we age.
For those who want a tighter, flatter abdomen, a "tummy tuck" (abdominoplasty) may be the answer. An abdominoplasty removes excess skin and fat from the middle and lower abdomen and, in some cases, tightens the muscles of the abdominal wall that have become weakened, stretched, or separated (as happens with pregnancy, for example). The procedure creates an abdominal contour that is smoother, flatter, and firmer.
The surgeons at BodyAesthetic Plastic Surgery perform different types of tummy tucks, ranging from a full abdominoplasty to a mini-abdominoplasty. Your surgeon will explain the tummy tuck options available and determine which procedure best suits your goals and the anatomy of your abdomen (how much excess fat, tissue, and skin you have and where it is located). Be honest about your expectations and goals during the consultation so your surgeon can design the treatment that's best for you.
Abdominoplasty can be performed on adults of any age who are in good health, close to their ideal weight, and moderately fit. But patients must understand that abdominoplasty is a major surgery that produces a permanent scar, which may extend from hip to hip, depending on the extent of the original problem and the surgery required to correct it. Most of the scar is usually located just above the pubic bone.
Abdominoplasty is most effective in correcting problems below the navel, but some tissue can be removed above the navel, usually through the same incision placed low on the abdomen. Sometimes, excess fat above the navel is best removed with liposuction, which may be done in the same surgery or in a later procedure.
Although the results of an abdominoplasty are considered permanent, weight fluctuations after surgery can cause the abdomen to protrude again. Patients who intend to lose a lot of weight should postpone the surgery until they have reached their weight goals. Also, women who plan future pregnancies should wait until they are finished having children so the results of an abdominoplasty are not undone.
People who have had previous abdominal surgery may find that these scars are more prominent because abdominoplasty tightens and stretches the skin. However, a pre-existing horizontal scar on the lower abdomen can often be removed during an abdominoplasty.
Tummy Tuck (Abdominoplasty) : The Surgery
Abdominoplasty is usually performed under general anesthesia. A full abdominoplasty takes 2 to 4 hours, depending on the extent of work required. A mini-abdominoplasty takes 1 to 2 hours. These two procedures, described below, are basically the two extremes, and variations between these extremes are possible. Your abdominoplasty surgery will depend on how much correction of the abdominal contour is desired and practical.
In a full abdominoplasty, the surgeon makes an incision from hipbone to hipbone, just above the pubic area. A second incision is made to free the navel from its surrounding tissue. The surgeon then separates the skin from the abdominal wall all the way up to the ribs and lifts the skin flap to reveal the vertical muscles in the abdomen. These muscles are tightened by pulling them close together and stitching them into their new position. This provides a firmer abdominal wall and narrows the waistline.
The skin flap is then pulled and stretched downward toward the pubic area, the extra skin is removed, and the skin above and below the incision is stitched together with absorbable sutures (which do not need to be removed). A new opening is cut for the navel, which is then stitched in place. Incisions are sealed with DermaBond (the medical equivalent of superglue) to keep the wound clean, dry, and secure.
For a mini-abdominoplasty, the incision is much shorter and the navel may not be moved. The skin is separated from the underlying tissue only between the incision line and the navel. This skin flap is stretched downward, the excess is removed, and the skin above and below the incision is stitched together and secured.
What To Expect After A Tummy Tuck
There are always risks associated with surgery and specific complications associated with abdominoplasty. Postoperative complications such as infection and blood clots are rare but can occur. Infection can be treated with drainage and antibiotics but will prolong your hospital stay. You can minimize the risk of blood clots by moving around as soon as possible after the surgery.
Poor healing, which results in conspicuous scars, may necessitate a second operation. Because smoking can increase the risk of complications and delay healing, smokers should stop at least 2 weeks before surgery and remain smoke-free for 1 month after surgery.
If you have a mini-abdominoplasty, you may be released on the day of surgery. A full abdominoplasty usually requires 1 or 2 days in the hospital. For the first few days, the abdomen will be swollen, bruised, and painful, but medications can control the discomfort.
You will probably be unable to stand up straight for at least a week after a full abdominoplasty. Even if you can't stand straight, it is still important to start walking as soon as possible, usually the evening of surgery. This is the best way to reduce the chance of getting a blood clot in the legs, a risk that accompanies most types of abdominal surgery. Bending, straining, or lifting anything must be avoided for several days so the incision is not stressed or stretched.
It may take weeks before you feel like your old self again. If you start out in top physical condition with strong abdominal muscles, recovery from abdominoplasty will be much faster. Some people return to work after 2 weeks, while others take 3 or 4 weeks to rest and recuperate.
Exercise will help you heal better. Even people who have never exercised before should begin a gentle exercise program to reduce swelling, lower the chance of blood clots, and tone muscles. Vigorous exercise, however, should be avoided until you can do it comfortably.
Tummy tuck scars may appear to worsen during the first 3 to 6 months as they heal, but this is normal. Expect it to take 9 to 12 months before your scars flatten out and lighten in color. Although they will never disappear completely, abdominal scars will not show under most clothing, even bathing suits.
Length Of Surgery
1 to 4 hours, depending on the extent of the abdominoplasty
Anesthesia
General
In/Outpatient
Usually 1 night in the hospital, though mini-abdominoplasty may be done on an outpatient basis.
Tummy Tuck : Side Effects
Temporary pain. Swelling, soreness, numbness of abdominal skin, bruising, tiredness for several weeks.
Tummy Tuck : The Risks
Blood clots. Infection. Bleeding under the skin flap. Poor wound healing resulting in conspicuous scars or skin loss. Need for a second operation.
Tummy Tuck : The Recovery
Back to work: 2 to 4 weeks.
More strenuous activity: 4 to 6 weeks or more.
Fading and flattening of scars: 6 to 18 months.
Duration of Results
Considered permanent, unless weight gain or pregnancy occurs. Some skin and muscle tone is lost with aging.
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Lower Body Lift
All plastic surgery procedures called "lifts" basically reposition and tighten skin and underlying tissue to the location where it used to be when we were younger. Lifts reverse what gravity and time have done, so a facelift or a breast lift produces a younger-looking contour. A body lift is no different.
Sometimes, more than one part of the body has irregular contours, excess fat, and loose, sagging skin. The solution may be a full lower body lift that re-contours multiple body regions at once. This becomes an option if there is loose skin and tissue that liposuction alone cannot treat, or an abdominoplasty will not meet a patient's goals because it cannot correct the contour of the buttocks, hips, flanks, and thighs.
A circumferential body lift basically combines several procedures to treat the complete circumference of the body-front, back, and sides. It is also called a lower body lift because it has the greatest impact on the contour of the abdomen, waist, hips, buttocks, and thighs. A circumferential body lift produces a firmer, more youthful-looking contour by addressing many areas at once:
- The abdomen, lower back area, and flanks
- The buttocks, which may be sagging, flat or unevenly shaped
- The front, back, and outer thighs
A full body lift is a lengthy surgery but can produce remarkable improvements in all-over body contour. The surgeons at BodyAesthetic Plastic Surgery are nationally recognized as being leaders in this type of full-body surgery, and they have developed innovative techniques for achieving excellent results in their circumferential body lift patients.
In a circumferential body lift, excess fat and sagging skin are removed and the remaining tissue is repositioned. Although sometimes performed in combination with liposuction, a body lift differs from liposuction because it tightens and lifts the skin and underlying tissue. For some patients, a body lift is needed after large-volume liposuction to remove (excise) loose skin that no longer has the elasticity to retract and re-form to the post-liposuction contour. A body lift also improves a dimpled, irregular skin surface, commonly known as cellulite, by tightening the skin.
Body lift surgery may be appropriate for people who have "loose" tissue in multiple body areas but are of stable weight that is reasonably proportionate to their height and body frame. It is also the best option for massive weight loss patients who have large excesses of loose, sagging skin.
A lower body lift can be performed on any healthy adult who has realistic expectations and is willing to accept the fact that a scar will extend around the body circumference. Even though this is a large scar, it is acceptable to most patients because its location is hidden by clothing, even most bathing suits.
Some patients receive sufficient benefit from a less than circumferential body lift, in which the abdominoplasty component of the surgery is continued around the flanks but not across the whole width of the lower back. Other patients desire that the lifting effect be extended to their hips, buttocks, and thighs. The posterior portion of a circumferential body lift, called a thigh and buttock lift, is the most effective and long-lasting way to improve cellulite caused by skin laxity.
Your surgeon will explain all the options and help you decide how much "lifting" will best meet your body contouring goals. Because the extent of a body lift depends on each patient's anatomy and preferences, no two body lifts are exactly alike.
The greatest advantage of a circumferential body lift is that multiple areas are re-contoured in a single surgery, though this surgery is lengthy and recovery is not quick. It is appropriate for people who have lost a lot of weight, those who have suffered sun damage that contributes to premature aging and sagging of the skin, and people showing signs of the natural aging process or results of pregnancy, which cause skin and tissue to lose its tone and elasticity over time.
Other body contouring procedures may be performed separately or in the same surgical session as a body lift, such as liposuction, a breast lift, male or female breast reduction, brachioplasty (arm lift) or inner thigh lift. Not all patients are good candidates for combined procedures and safety may dictate that liposuction or re-contouring lifts in areas other than the lower body be staged, or performed in a separate surgery. Your surgeon will explain your options based on your general health, medical history, and lifestyle.
The Surgery
Most circumferential body lifts of BodyAesthetic Plastic Surgery patients are performed by two surgeons working together to reduce the total operative time. Even with two surgeons, a circumferential body lift takes between 3 to 5 hours. If additional procedures are performed in the same surgery, the operative time will increase. For example, a breast lift or breast reduction will add approximately another 1-1/2 to 3 hours to the time of a lower body lift.
Body lifts are performed in the hospital under general anesthesia, and patients are admitted to spend 2 to 3 days in the hospital, depending on the extent of the surgery, a patient's health status, the need for pain medication, and the amount of assistance a patient needs for moving around.
In a complete lower body lift, the front, back, and sides of the body are re-contoured. On the front, the incision is made just above the pubic bone and extended toward the back in a curved fashion below the protrusions of the hip bones. The skin and tissue above and below the incision are elevated (raised) as tissue flaps, which are pulled downward or upward into a new position. The excess skin and fat of the flaps are then excised. The deeper tissues that have been elevated and repositioned are tacked down to provide support and prevent them from moving.
If the skin around the navel has been removed, a new navel is created in a procedure called an umbilicoplasty. The skin and underlying tissues around the navel and above the waist are pulled downward to contour the waist and upper part of the tummy. When the skin and tissues below the incision are pulled upward, the front of the thighs and sagging in the groin area are "lifted."
To treat the back, the incision is carried around the hips and across the back and buttocks below the waist. This incision is placed slightly lower than what is called the bikini line. When the skin flaps are raised, the tissue above the incision is pulled downward to re-contour and smooth the waist and flank area (roughly that region over the kidneys). The skin and tissue below the incision are pulled upward to lift the outer and posterior thighs and the buttocks into a new position. The excess skin is trimmed off from the upper and lower flaps, and the underlying tissues are secured in the new position.
The skin above and below the incision in front and in back is stitched together and sealed with DermaBond (the medical equivalent of superglue) to keep the wound clean, dry, and secure.
What To Expect After A Circumferential Body Lift
Body lift patients usually have 4 drainage tubes that exit in the pubic area to prevent fluid from collecting beneath the skin flaps that were repositioned during surgery. You will also probably have a urinary catheter at least through the first night after surgery so you don't have to worry about going to the bathroom. In addition, you will receive fluids through an IV tube in your arm. This means you will have more tubes coming out of your body than you've probably ever had before, but they are there to make you more comfortable and prevent complications--and they won't remain for long.
With an incision that encircles your lower torso, you will find it difficult to get comfortable for a few days, and you will be unable to stand up straight. You will receive pain medication in the hospital and to take home with you. Even though you will be in pain and have trouble moving, you must get out of bed and walk, starting the morning after surgery, to help prevent blood clots from forming in the legs, which is the most serious potential complication that can occur after a full body lift.
Such a large incision will take some time to heal. Bending, straining, lifting, standing fully upright, or doing anything that will put stress on the incision must be avoided for several days. Basically, you need to protect the internal sutures that are supporting your new contour as well as the incision you can see. Your surgeon will give you detailed instructions for what you may and may not do until you have healed.
Incision stitches are usually removed in 7 to 14 days, depending on how you heal, though the majority of sutures are beneath the skin and do not have to be removed. You should be able to return to work and light, normal activities within 2 or 3 weeks, as long as you do not engage in heavy lifting or vigorous exercise.
Even though you will be swollen for a few months and bruised for a few weeks, your new body contour will be immediately apparent. However, the final result may take several months to emerge completely as the swelling gradually subsides and your skin and tissues settle into their new positions. You will likely have some numbness in areas of your skin, which will also feel unusually firm, but this will diminish over time. It may take a year or more for your scar to fade and refine, though it will never be invisible.
Even though a circumferential body lift is a lengthy surgery and the first few weeks may be difficult and uncomfortable, patients who have this surgery are extremely satisfied with the final results. Their new smoother, smaller, and lifted body contour makes a remarkable difference in how patients feel about themselves, activities they can engage in, and clothing they can wear.
Length Of Surgery
3 to 5 hours
Anesthesia
General
In/Outpatient
Inpatient, with a hospital stay ranging from 2 to 3 days or longer if other body contouring procedures are also performed.
Side Effects
Temporary pain and discomfort. Difficulty moving for several days. Swelling, soreness, bruising, and numbness of skin. Tiredness for several weeks.
Risks
Blood clots. Infection. Bleeding under the skin flaps. Poor wound healing resulting in conspicuous scars or skin loss.
Recovery
Back to work: 2 to 4 weeks.
More strenuous activity: 4 to 6 weeks or more.
Fading and flattening of scars: 6 to 18 months.
Duration of Results
Considered permanent, unless weight gain or pregnancy occurs. Some skin and muscle tone is lost with aging.
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