Select Your Procedure

Tummy Tuck or Abdominoplasty

If You’re Considering Abdominoplasty…

Abdominoplasty or tummy tuck as it more commonly known is a procedure that:

• Removes excess skin and fat from the middle and lower abdomen
• Tightens the muscles of the abdominal wall

By combining these two, the procedure can dramatically reduce the appearance of a protruding abdomen.

Am I a good candidate for abdominoplasty?

Men and women who have localized fat deposits but are otherwise in good shape  are perfect candidates for this procedure. It is essential to be as close to your ideal weight as possible. Men and women who exercise regularly but have failed to lose fat around their love handles and tummy are suitable candidates too. Many patients have lost excessive weight following a weight loss surgery and would benefit by having the pannus excised. Multiple pregnancies can also result in flabby muscles and excess skin that may benefit by an abdominoplasty. You should wait to have the surgery if:

• You intend to lose a lot of weight
• You plan more pregnancies

What are the risks?

There are always some risks and specific complications after any procedure.  You can rarely have collection of blood following surgery. It that happens you may need to have an additional surgery to have the clot removed. Rarely you can have infection in the incision. Antibiotics are given prior to surgery and for few days after surgery to reduce the chance of an infection following surgery. Smoking prior to and after surgery certainly increases the risks of these complications. Sometimes you can have a small collection of fluid or a seroma after surgery. They will generally resolve on their own. Sometimes a small needle may be needed to remove the collected fluid. Your skin on the tummy may be numb for four to six months and this will resolve after that time. The incisions generally heal with a minimum scar line which can be well hidden.

Plan for Your Surgery

During your initial visit I will ask what medications you take and whether you smoke or not. It is very important that you stop smoking prior to and after the surgery. If you have minimum or mild excess of skin I will recommend a mini-adominoplasty. If you have excessive skin you will require a regular abdominoplasty. It is not unusual to add liposuction to your love handles, or the thighs and abdomen to further enhance your outcome. You will need to wear a compression garment for around six weeks to reduce pain and swelling following surgery.

Where Your Surgery Will Be Performed

I perform both mini and complete abdominoplasties in an outpatient surgical center.

Types of Anesthesia

I select general anesthesia, so you’ll sleep through the operation.

The Surgery

Complete abdominoplasty usually takes two and half hours, depending on the extent of work required. Mini abdominoplasty may take an hour or two. The skin incision is commonly made form the right to the left hip bone just above your pubic area so that the final scar is very well hidden. The procedure is involves lifting the skin and the fat from the underlying fascia all the way up to your ribs. The skin around your navel is released. I will then tighten the muscles (your abs) and contour them by suturing them together. This dramatically changes the contour of the abdomen. If you have some laxity of skin in your flanks or on the outside of your thighs, I may sometime extend the incision into the flank. This allows me to remove excess skin from the flank and lift up your thighs. This will result in an hour glass shape and allow you wear low cut jeans and tuck your shirt in. No more of bulging on the sides. The excess skin and the fat is then trimmed so that you have no excess and wrinkly skin. A new navel is created for you and the incision is closed in many layers. You will have two drains that will be left for around three to five days.

After Your Surgery

You will have pain on the first few days following surgery. You will receive pain medications to control the pain. You will have some swelling and bruising after the surgery which will resolve soon. The compression garment will help keep this under control. The stitches are under the skin and do not need to be removed. The drains are removed in three to five days and you will have to wear a compression garment for 4-6 weeks.

Getting Back to Normal

It generally takes two to three weeks to get back to normal. You can drive in a week to ten days after surgery. It may take you two to three weeks to feel like your old self again. Generally younger patients are up and about earlier. You should be able to walk briskly in three weeks and this includes swimming. You can perform aerobic exercises in six weeks.

Your New Look

At three weeks when the swelling has all but gone you will see yourself in the mirror and see the flat tummy and the dramatic change in the contour of your abdomen. You will simply love it. Keep in mind that you will need to continue to exercise and have balanced diet to eat lifelong if you wish to enjoy your body.

If you’re considering Liposuction

Liposuction or suction lipectomy is a very popular procedure to remove fat from unwanted area. These include the abdomen, hips, buttocks, thighs, knees, upper arms, chin, cheeks, and neck, liposuction, Over the years many refinements have been added to the procedure. These new techniques include ultrasound-assisted lipoplasty (UAL), Power assisted liposuction, SmartLipo® the tumescent technique, and the super-wet technique. The newer techniques allow better definition of the areas where liposuction is performed and at the same allows the surgeon to reduce the swelling and bruising after the surgery. Keep in mind that liposuction works best if you have localized areas of fat deposits which are stubborn and fail to disappear after exercises. Liposuction cannot help reduce weight.

If there is any excess skin it is common to add a surgical removal of the skin along with the liposuction. The younger the patient the better the elasticity and lesser is the need to excise the skin.

The following information will help answer your questions. There might be more questions that were not answered but please do not hesitate to ask me.

Plan for Your Surgery

During your initial consultation I will examine the areas where you want to have liposuction performed. I will also discuss with you where the liposuction will be performed, the location of the small incisions and the final outcome that can be expected. The total amount of liposuction that can be done will be estimated so that you know that liposuction can be done safely for you. I will also discuss which I s the best method of liposuction and finally what will be the best combination for you.

Where Your Surgery Will Be Performed

The procedure will be performed in an outpatient surgery center. If a large amount of liposuction is performed or if it is combined with a procedure it may require an overnight stay at the medical center.

Anesthesia For Liposuction

Small volume liposuction can be performed under local anesthesia but moderate to large volumes of liposuction need to be performed under general anesthesia.

The Surgery

It is difficult to predict the time required to perform this surgery. Small area liposuction can be performed in an hour but a longer time is needed when three to five areas undergo liposuction.
The techniques vary depending on what is the best procedure for you. A small incision is made a fluid I injected into the site undergoing liposuction. This fluid makes it easier to remove the fat and at the same time reduces the amount of bleeding and bruising. A tumescent technique or a super wet technique will be used for injecting the amount of fluid. After waiting for five a very small cannula measuring 3-4 mm (size of a pencil) will be inserted and connected to a strong medical suction. The cannula is moved back and for the till all the fat has been taken out. Sometimes a mechanical vibrating cannula is used and sometimes a ultrasonic probe is used to help the process of removal of the fat. Once the necessary amount of contouring is done the very small incisions are closed and pressure garment is applied.

How does Dr. Rane differ from other surgeons?

Dr. Rane uses Power Assisted Liposuction® (PAL) technique to perform large volume liposuction. This unique and latest technique allows him to use a liposuction cannula (hollow tube) to vibrate very rapidly. The MicroAire Power Assisted Lipoplasty Device uses a 2-mm reciprocating movement at 4000 cycles per minute to facilitate the movement of the cannula in tissue. This vibrating movement allows the fat cells to break very easily making it easier for the fat to be removed. PowerLiposuciton technique allows larger quantity of fat to be removed quickly making your surgery quicker and causes less mechanical trauma and bruising to the surrounding tissue. To learn more about this product please visit this website: http://www.microaire.com/pal/index.html

After liposuction many surgeons leave a tummy that looks flat and has no contours. A youthful tummy always has some areas that are convex (bulging) and some areas that are concave (hollow). Typically the area around the upper part of belly button is hollow but the area under the belly protrudes just a little. There is often a line that runs from the rib cage to the belly button further enhancing the shape of abs. If you want he can also create the appearance of well defined abs on your tummy too.

Dr. Rane strives very hard to give you a very natural look. He uses very special cannulas to prevent rippling in your skin which can occur after liposuction.

Many women look great from the front after liposuction but unfortunately when they look in the mirror or try to wear designer jeans with a low cut, they find that the fat still bulges from the lower back (muffin top). Dr. Rane  turns you on your tummy and on your sides during the surgery so he can specifically address the fat in this area. This creates a concave contour of the lower back and not only highlights your waist but also further enhances the projection of your buttock. (see before and after pics below). You not only look great from the front but from the back too. Say goodbye to folds in your back under your bra.

And that’s not all. Most surgeons will discard the fat that has been removed from liposuction. Dr. Rane can re-inject the clean and purified fat back into areas where you lack. The commonest area to re-inject is into your outer and central buttocks to further enhance your shape.

Risk of the Surgery

Liposuction is a very safe surgery if it is performed by a trained surgeon and if the volume of the liposuction is kept below 5-6 liters. Large volume liposuction can produce excessive movement of fluid and can create complications from fluid overload. I keep my extent of liposuction less than six liters and therefore keep the risk of complications to a minimum. Some patients may notice some irregularity in their skin surface and some may have some temporary swelling. The swelling generally disappears in a few weeks but some areas may be stubborn and last for three months.

Getting Back to Normal

Healing progresses slowly and your patience will be essential. There will some firmness at the site of liposuction that will gradually soften and feel normal. Generally patients can go back to work within a few days if liposuction is very limited but it may take a few weeks if the areas are extensive or if you have had some additional surgery in association with the liposuction. The stitches will dissolve in a 10 days to two weeks. There will be some fluid drainage form the site of the incision at for the first one to two days. I will be monitoring you closely and will be available if you have any questions or concerns.

Your New Look

Once the swelling subsides you will notice the difference in the shape of your body. With every passing week you will continue to see the change until three to six months after surgery. You will look in the mirror and say “I am glad I did it”.

Maintain a good healthy diet and continue to exercise so that you can enjoy the result of the liposuction for a long time

Body Contouring after Weight loss bariatric surgery

The number of people who are undergoing bariatric procedures to lose weight has increased dramatically. The safety of these procedures has also improved significantly. This has been possible because of the both procedures Lap Band and gastric bypass procedures are being performed via an endoscope. This increase in safety has led to more patients willing to undergo weight loss procedures. At the same time there is growing evidence that many chronic illnesses including diabetes, hypertension and sleep apnea are reduced significantly in those who undergo these procedures. As the number of patients undergoing these procedures has increased, patients are left with extensive loose and sagging skin over the tummy, breasts, arms, thighs and over the buttock. Over the last five years many plastic surgeons have developed techniques to improve the outcome following these procedures.

After a significant weight loss many patients are elated that they have reached their weight goal but when they look in the mirror they are not happy. They do no know what to do about the sagginess and whom to turn to for help. This web page hopefully will give you an overview as to what is the latest and the best available to help you cope with your problems.

You are welcome to join our Oklahoma Bariatric Plastic Surgery Support Group by contacting Dr. Rane so you can join us at our next meeting and meet many patients who have undergone plastic surgery procedures to improve their self confidence.

Extended Tummy Tuck or Extended Abdominoplasty

Massive weight loss following bariatric surgery commonly leaves behind a large overhanging pannus which makes it very difficult to lose any further weight, maintain hygiene and is commonly associated with back pain too.

Patients with this large pannus commonly seek the help of a plastic surgeon asking for a tummy tuck. A tummy tuck or an abdominoplasty differs from panniculectomy where only the overhanging pannus is removed and no attempt made to tighten the muscles of the abdomen (belly) which is critical to create a well contoured abdominal shape.

Here is how Dr. Rane differs from others in tummy tucks for massive weight loss surgery

A regular tummy tuck generally does not address the outer aspect of the thighs or the excess skin and fat that overhangs over your jeans (muffin top). Dr. Rane commonly extends the incision beyond the hip bone onto the upper buttock line so that he is able to lift your outer thighs up and at the same take out the excess skin and the fat that overhangs in this area that gives you a muffin top. He also performs a liposuction of the lower back along with the flanks.

This allows him to re-shape your back just above your buttock thereby enhancing the shape of your buttock. He may even inject some of the fat back into your buttocks if they are sagging and improve its shape. This surgery has long been performed in Brazil (Brazilian butt lift) and Dr. Rane has visited the nation’s best plastic surgeon in Miami who specializes in the Brazilian butt lift. After all, body contouring means contouring the shape of your body both over the front and back and not just performing a tummy tuck. Finally, he removes fat around your new belly button so that your belly button is the deepest portion of your tummy and you have youthful concave contour of your tummy – one that will look like a saucer and hold water if your are lying flat. He believes in a three dimensional change in the contour of the abdomen and you can see his amazing results below.

Liposuction to tummy lower back and flank
area Extended Tummy tuck

Here is how Dr. Rane differs from other surgeons

Dr. Rane places the incision in the same area but lifts the buttock in an inner and upward direction (butterfly lift). This is allows the buttock to maintain its shape. Additionally he does not remove and discard the buttock skin and fat. He may either turn the excess skin and fat as a flap and place it back into the inner aspect of the buttock so that it dramatically improves the projection of the buttock. He may additionally inject some of the fat that was obtained during the liposuction and re-inject it back into outer aspect the buttock (Brazilian butt lift) so as to further enhance the shape of the buttock.

Belt Lipectomy

A belt Lipectomy is used if you have a pannus on your tummy and have sagging of your buttocks and outer thighs. This procedure involves placement of the incision above your pubic area and then extends in an outward direction onto the hip and upper buttock area so that the entire incision goes around like a low belt and at the same time keeps it along the bikini line and therefore well hidden.

A belt Lipectomy procedure is a long procedure as it involves placing the patient on the back first to perform the tummy tuck and then turn you onto your tummy so the surgery on the buttock can be accomplished. It commonly takes five to six hours to perform and therefore done only if the patient is young and fit and can withstand the long surgery and recovery.

Here is how Dr. Rane differs from other surgeons

Dr. Rane places the incision in the same area but lifts the buttock in an inner and upward direction (butterfly lift). This is allows the buttock to maintain its shape. Additionally he does not remove and discard the buttock skin and fat. He may either turn the excess skin and fat as a flap and place it back into the inner aspect of the buttock so that it dramatically improves the projection of the buttock. He may additionally inject some of the fat that was obtained during the liposuction and re-inject it back into outer aspect the buttock (Brazilian butt lift) so as to further enhance the shape of the buttock.

Thigh Lift

Massive weight loss can lead to loss of fat and significant sagging of the thigh both over the inner (medial) aspect or the outer aspect (lateral). These sagging areas need to be elevated and corrected to create a smooth contour.

Lateral or outer thigh lift: Dr. Rane commonly passes a long instrument over the outer thigh when he is performing the extended tummy tuck and elevates or lifts the outer thigh skin and fat. He sutures and fixes this lifted tissue on to the deep tissue around your hip area and thereby creates a smooth contour over the outer aspect of the thigh. This smooth convex contour of the outer thigh merges beautifully with the concave contour in the region of the love handles. This creates an hour glass figure.

Inner Thigh

Inner or medial thigh lift: The thigh is no different than the rest of the abdomen and unfortunately it sags with some lose skin and fat collections too. Inner thigh lifts have undergone a significant improvement in its technique. Dr. Rane adopts only the latest techniques. Depending on the extent of the skin required to be removed, you may need an incision that is only in the groin crease. If you have more laxity of the skin you may need an additional incision over the inner side of your thigh. Dr. Rane limits the length of the incision so that it is only over the upper half of the thigh so that you can still wear shorts. He also attaches the deeper tissues to the inner aspect of your groin so that your results last longer and there is no alteration in the shape of your genital area. This attention to details is critical to create an excellent result. It is not uncommon to add some liposuction to the area undergoing thigh lift so as further enhance the outcome following surgery.

Breasts

Prior to weight loss many women with large breasts loose significant fat from the breast area leading to sagging and loss of volume within the breasts. The vast majority of women choose to have a breast lift and have a breast augmentation with saline or silicone implants. If the breasts are asymmetrical, then having adjustable saline implants provides a great option to create symmetrical breasts by allowing the surgeon to inject more saline in one implant than the other even six months after the surgery. Please read under breast augmentation in this web site for more information about breast implants and mastopexy.

Arm Lifts

Some women and men after surgery develop floppy skin and sagging fat on the lower aspect of the arms and this does become a source of great embarrassment. In the past surgery was done by placing a long incision over the inside of the arms. Sometimes these incisions lead to thick and wide scars. Latest techniques allow incisions to be placed in a curved lazy zig zag direction and over the back part of the arms so the incision heals with minimal scars that can be concealed very easily. Additionally if you have minimal laxity you could have SmartLipo and just have a small incision very close to your underarms.

When is the best time to have surgery?

Most patients lose weight for a year after bariatric surgery. It is therefore best to wait for a year when your weight has stabilized and you are not losing any more weight.

How many surgeries can be combined together?

It is best not to have a surgery that lasts over 5-6 hours. After this time complications from surgery including blood loss and low body temperature add significantly to the overall risks of the surgery. Generally it is best to combine adjacent areas together. Here are some combinations that Dr. Rane performs:

• Tummy tuck and inner thigh lift
• Tummy tuck and outer thigh lift
• Belt Lipectomy (tummy tuck and buttock lift)
• Breast surgery and Arm lifts

Where does Dr. Rane perform the surgery?

If you are considering Buttock Reshaping

You know the feeling. You love those designer jeans with the low cut. You try them on, but become frustrated because you just don’t look right. All you see is skin and fat bulging over the top of the jeans. Don’t you wish someone could take the fat away, put it back into the butt, and end up with a nice, round tush? If Jen Lo can have it,  why can’t you?

Well, now you have a solution. No more muffin tops, and you can have a Jen Lo butt, too.

If you feel that you have just too much fat in your love handles and lower back, and you just cannot define where your back ends and your buttock begins, you are a candidate for liposuction and buttock augmentation with fat. Although you can have your tush augmented with a silicone buttock implant, complication rate with abnormal shape, scar formation around the implant, and fluid collection are far too common. The latest technique, which is a rave in Miami, involves injecting fat removed during liposuction back into your buttock in very specific areas to re-create the contour you are looking for. You have your own fat to augment (enlarge) your buttock with a minimal complication rate.

The following information will help answer your questions. If you have further questions, don’t hesitate to contact our office.

Initial Consultation

During your initial consultation, I will examine the areas where liposuction is desired. We will also discuss the areas where the liposuction will be performed, the location of the small incisions, and the final outcome that can be expected. The total amount of liposuction will be estimated so that you know that liposuction can be done safely for you. I will also discuss the best method of liposuction and the best combination for you. I will examine your lower back and love handle area to determine which zones require most of the fat removal. I will also examine your buttock area and let you know specifically where liposuction will be performed, and where fat will be injected. Each person has a different shaped buttock and the plan is to create the shape and contour that best suits your body profile. The aim is not to create a large buttock but create a shapelier buttock.

Where Your Surgery Will Be Performed

The procedure will be performed in an outpatient surgery center. If a large amount of liposuction is needed, or if liposuction is combined with another procedure, an overnight stay at the medical center may be required.

Anesthesia

General anesthesia is required to perform this procedure. The duration of the procedure may vary from two hours to four hours, depending on the amount of fat to be removed and re-injected.

The Surgery

The surgery consists of liposuction first and then re-injection of the fat as a second step. The incisions are tiny and barely visible. The fat is removed and injected through these tiny incisions.

Additional incisions may be necessary only if this procedure is combined with a tummy tuck.

Liposuction is performed using power assisted liposuction. I use the latest technique and equipment to perform large volume liposuction. This unique technique allows me to use a hollow tube (liposuction cannula), which vibrates very rapidly. The MicroAire Power Assisted Lipoplasty Device has a cannula (hollow tube) that moves back and forth very rapidly. This vibrating movement allows the fat cells to break easily, making it easier for the fat to be removed. Power liposuction technique allows larger quantity of fat to be removed quickly, making your surgery quicker, causing less trauma and bruising to the surrounding tissue. To learn more about the equipment and products I use for this procedure, please visit http://www.microaire.com/pal/index.html

A significant amount of liposuction is performed in the love handle, buttock and the lower and upper back area. This greatly enhances the curve of the lower back and creates a distinction between the back and the buttock (See before and after pictures below). I strive and take pride in giving my patients a very natural look. I use very special tubes to prevent rippling in the skin, which can occur following liposuction.

And that’s not all. Most surgeons will discard the fat that has been removed from liposuction. Dr. Rane can re-inject the clean and purified fat back into areas where you lack definition. The most common area to re-inject fat is into the outer and central buttocks to further enhance the shape. The fat that is removed during this procedure contains traumatized or damaged fat cells. These damaged fat cells are then removed, along with any other impurities. The healthy fat is transferred back into syringes and re-injected into the buttock. The re-injection is performed very selectively into various zones of the buttocks. The technique requires a high level of understanding of the underlying shape, and an artistic touch, to say the least. The final shape is customized to create a well-rounded and aesthetically correct buttock shape. All the injection and the liposuction are done through very small incisions measuring 1/8 inch in length.

Even performing liposuction of the lower back, buttock and love handle without any fat injection into the buttock can dramatically alter the shape of the waist and enhance the shape of the buttock.

Risk of the Surgery

Liposuction is a very safe surgery if performed by a trained surgeon, and if the volume of the liposuction is kept below 5-6 liters. Large volume liposuction can produce excessive movement of fluid and can create complications from fluid overload. I keep the extent of liposuction to less than six liters, therefore keeping the risk of complication to a minimum. Patients may notice some irregularity in the skin surface, and some may experience temporary swelling. The swelling generally disappears in a few weeks but some areas may be stubborn and last for up to three months. Generally, some firmness and tightness may be felt in the buttocks for three to six weeks. Very rarely the fat may not completely soften and may become infected, a rare condition which may require removal of this small area of fat. Swelling subsides and final results are seen in six weeks to three. It is worth the wait.

Getting Back to Normal

Healing progresses slowly and patience will be essential. Staying off the buttocks for one week following surgery will be required, and sleeping on your sides and not on your back will be essential. A small degree of firmness at the site of liposuction will gradually soften and feel normal. Generally patients can go back to work within a few days if liposuction is very limited but it may take a few weeks if the areas are extensive or if you have had some additional surgery in association with the liposuction. The stitches will dissolve in 10 days to two weeks. A small amount of fluid may drain from the site of the incision for the first few days following surgery. I will be monitoring you closely and will be available if you have any questions or concerns.

Your New Look

Once the swelling subsides you will notice the difference in the shape of your body. With every passing week you will continue to see the change until three to six months after surgery. You will look in the mirror and say “I am glad I did it”.

Maintain a good healthy diet and continue to exercise, so that you can enjoy the result of your shapelier body for a long time.

If you are considering reshaping your labia

Some of us born with labia that are not shaped correctly. This is more common than you think. This can become a source of embarrassment or can project so much that it is difficult to maintain good hygiene in this area. As we age the labia (vaginal lips) can lose fat and this may make them look less youthful too. There are two lips to the vaginal area. The outer ones, labia majora can lose fat and look aged. The inner lips or labia minora can become stretched and can extend well beyond the labia majora. They need to be trimmed to make them look normal and not be source of bad hygiene.

Initial Consultation

During the initial consultation, I will examine the area and find out what you wish to be altered. There is no need to perform an internal examination during the consultation. The consultation is performed in the presence of nurse with least discomfort so that you do not feel embarrassed.

The Surgery

The surgery can involve two steps depending on your request for alteration.

If you have the inner lips or labia minora that stretch beyond the outer lips then these can be trimmed by taking out the excess tissue. The incisions are placed on the inner side of the lips so that cannot be seen and the external appearance of the labia is still normal. The incisions are closed with a dissolving suture so that the sutures need not be removed.

If you wish to have some rejuvenation of the outer lips, microfat injection is performed. To do this, a small amount of liposuction is performed in the pubic area or the mons area at the level of the pubic hair. The fat is then purified and processed and re injected with fine cannulas (microfat). Microfat injection increases the survival of the fat making your results last longer.

The surgery lasts one to two hours depending on the extent of procedure.

The surgery can be performed under local anesthesia with oral Xanax and oral pain medications. Alternatively it can be performed under general anesthesia at a surgery center as an outpatient procedure.

Getting Back to Normal

The swelling subsides soon following the surgery. There may be some tenderness in this area. Intimate relationships can be started few weeks after surgery once the incision has healed.

All Surgery Carries Some Uncertainty and Risk

The procedure has minimal risks. There may some residual asymmetry. Rarely the incisions can remain tender for longer periods. There will be some bruising and swelling that may last longer than expected.