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Tummy Tuck

Tummy Tuck Surgery in Beverly Hills with The Mercator Technique:
A Revolutionary Concept

Abdominoplasty (tummy tuck) is an operation designed to restore the abdomen’s original svelte and muscular form after damage to its underlying structure has occurred from life events such as weight gain and loss or pregnancy. Women want the hourglass appearance; men, a six-pack. Arriving at these results demands from the surgeon, not only an understanding of the anatomy and physiology of the abdomen and rib cage, but also an eye for building individual plans, tailored to every patient.

A tummy tuck is not a one-size-fits-all surgery where everyone gets the same design and the same operation. This is precisely why Dr. Anous has, meticulously, over the years, devised and implemented the concept of the Mercator tracing. With this technique, the patient’s unique body shape informs the planning and execution of the surgery. Learn more about the methodology behind the Mercator design, here.

Much like an architect, a surgeon should build the foundations of their technique with the goal being to create improved aesthetics. As of the date of this writing, Dr. Anous has performed over 900 tummy tucks using his Mercator abdominoplasty concept. His results speak for themselves.

slim blonde woman in butterfly printed short dress

Dr. Anous' Approach to Individualized Abdominoplasty Surgery

The clinical examination of any tummy tuck patient should start at the rib cage and chest wall, and not at the abdomen. This is because of the Scissors Principle, introduced and named by Dr. Anous, (Fig.1) that controls the relation between the volume of the lungs and of the abdomen. The combined core volume (chest + abdomen) is constant. This means that if you increase one you must correspondingly decrease the other one for the relation to remain constant (Fig. 2). This has major implications not only regarding the shape and protrusion of the belly, but in how your operation is designed to rectify to correct laxity of the abdominal wall.

By starting the examination at the rib cage, Dr. Anous can better understand the configuration of the belly. The form of the ribs helps him to evaluate the strength of the core abdominal muscles (rectus abdominis and obliques). The tone of those muscles, in turn, dictates how much the internal structures can exert forward pressure on them; weak abdominal muscles typically allow for greater protrusion and the appearance of a stomach “pooch.” Dr. Anous also evaluates the quality of the skin, which influences the formation of laxity and stretch marks.

The form of your belly is the result of a pyramidal structure, with its base starting at your ribs and its tip ending at your skin.

Planning Your Mercator Tummy Tuck with Dr. Anous

As no two individuals are the same, it doesn’t serve the patient or esthetic surgeon to follow the same design for every tummy tuck surgery. For Dr. Anous, the most logical way to approach tummy tuck treatment planning is to tailor the operation to the patient’s specific body shape; this is the concept of the Mercator abdominoplasty.

Decisions about your tummy tuck surgery should not be made while the operation is in progress. Every aspect of the surgery should be put in place before the patient is asleep under anesthesia. With the Mercator abdominoplasty, most of the planning is done with the patient standing to properly take into consideration the effect of gravity.

The Mercator tracing follows very rigorous lines and fixed anatomical spots. The grid created with these tracings allows Dr. Anous to create proper navigation lines and design your surgical plan. There are a variety of tracings that could be applied, depending on patients’ individual body shapes:

  1. The M-Design (Fig. 3)
  2. The Inverted V-Design (Fig. 4).
  3. The Reverse Abdominoplasty Design (Fig. 5)
  4. The Fleur-de-Lys Design (Fig. 6).
  5. The half Manta Ray Design.
  6. The full Manta Ray Design (Fig. 7).
Learn more about Dr Anous’ Tummy Tuck Planning

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Successful Abdominoplasty Surgery, Satisfied Patients

At Dr. Anous’ Beverly Hills practice, a tummy tuck operation is successful if it accomplishes the following:

  • A flat, hourglass abdominal configuration
  • A properly placed, properly rejuvenated Mons pubis (female hair-bearing lower abdomen)
  • A properly oriented belly button (vertical and slit like)
  • The elimination of most, if not all, stretch marks
  • A very low position for the scar, placed in the thigh crease lines (and not between the belly button and Mons pubis)
  • A six-pack central configuration as bonus

Now you understand why most “after” pictures you see on the Internet are shot with the subject wearing their underwear, to conceal scarring. On Dr. Anous’ website, our tummy tuck before and after gallery demonstrates the full results of surgery and does not conceal any post-treatment scarring.

Can I Have a “Mini’ Tummy Tuck Instead?

Not according to Dr. Anous. The designation of “mini” is meant to attract those afraid of the surgery by making them believe that the operation is minimal, and treatment is somehow less extensive; this is never the case. Plastic surgery of any kind should be regarded seriously, and patients should be wary of cleverly-labeled treatments.

Tummy-tuck operations either work or they don’t. They work if the expected results are delivered. This can only happen if surgeons understand the proper concepts and foundations that allow them to deliver desired results for the Beverly Hills and Pasadena, CA patient.

Recovering from your Abdominoplasty

Post-operative recovery is a matter of ten days to two weeks at most. This is the time needed for most patients to feel that they are back to their normal selves. You will be able to walk from day one and we would encourage you to do so in order to prevent the formation of clots. You will also be asked to shower twice per day to keep your incisions clean and to ensure you feel refreshed.

Most likely, you will not have drains. The use of drains is very selective in Dr. Anous’ Beverly Hills practice and is the rarity rather than the rule. An abdominal binder, called a compression garment, is required to help support the abdomen and control any swelling. Walking, sitting, and bending may be challenging right after surgery, but they are doable with the proper attitude and mindset.

Lifestyle changes are required during the healing interval. Rigorous exercise is restricted, while the ability to lift will be added in small stages. Strict adherence to the instructions will help to prevent any complications.

Dr. Anous offers individualized care that helps you define your goals and construct a personalized treatment and recovery plan. The attention to detail and willingness to work closely with each patient to achieve realistic goals are fundamental to Dr. Anous’ Pasadena and Beverly Hills practice.

Mercator Tummy Tuck

Tummy Tuck FAQs

Patients seeking tummy tuck surgery generally have similar requests: To look good in their clothes; to look good in their bathing suits; and to look appealing while naked. While the three requests might seem similar they, in fact, demand different attributes, namely (in sequence): Shape (silhouette); Youthful belly button and absence of stretch marks; and scar visibility and Mons pubis (hair bearing lower abdomen) form in addition to the previous attributes.

There should not be any post-operative swelling in a properly performed abdominoplasty.

Absolutely! One of the aims of the surgery is to improve sexual attractiveness, which typically leads to activity favoring pregnancy if precautions are not taken.

Ten days to two weeks is the short answer. This will be the time needed for you to psychologically and physically feel that you are back to being your normal self. Healing will however continue for at least six months and will proceed in milestones.

A properly performed operation seldom has “complications.” There are normal events that happen with this surgery, like small opening in the suture line or even fat necrosis for more extensive designs, that while being a nuisance, are not complications and will heal in time without the need for any intervention. True complications are very infrequent: Bleeding; infection; blood clots; fluid collection and others.

While liposuction of certain areas situated outside the tummy tuck field is a very common addition to the abdominoplasty surgery, the inclusion of areas of liposuction in the general zone of the surgery should be approached very cautiously and only on a case-by-case basis. On the other hand, liposuction of the back and fat transfer  (Brazilian Buttock Lift) is commonly performed at the same time.

ALWAYS! It is not only a matter of aesthetics but also an important measure of tension relief from the incision closure.

Liposuction encroaches on the blood supply of the area being treated. Since the tummy tuck is generally regarded as an operation of “tension”, the inclusion of muscle etching with this surgery could be regarded as a “double whammy” against proper healing.

Yes, but only if the starting conditions (skin thickness; fat deposits) are adequate.

The “average” weight loss is between 6 to 10 lbs. for the M-design; 12 to 20 lbs. for the FDL-design; and 14 to 22 lbs. for the Manta Ray-design. Inverted-V and Reverse abdominoplasty designs are usually not accompanied by any significant weight loss since they are aimed at body shaping in already very thin patients.

Yes and is done all the time in the case of umbilical hernias and common midline ones. Inguinal and other less common hernias are usually not repaired at the same time as the tummy tuck surgery because of differences in conceptual approaches.

Drains are very uncommon in my practice, as the Mercator design and approach have eliminated the need for them. When used on very selective cases (mostly due to intra-operative findings), they remain for one week on average.

With the Mercator Abdominoplasty, scar extent depends on designs, which in turn depend on the amount of skin removal needed to attain the desired shape.  All scars uniformly fade away within six months and rarely a little longer.

The only sutures that will need removal are those around the belly button. No other sutures are visible above the skin.

Two weeks in most cases.

Two weeks should elapse before light exercising is resumed; Four weeks for normal exercising to be possible.  

While this is allowed whenever you feel you have the strength to do it (depending on your baby’s weight), you are not likely to do it for psychological reasons before ten days. However, your help can put your baby in your lap whenever you feel like it.

This is not likely. The body has an incredible ability at calibrating movement and pain. Whenever pain is perceived, the brain automatically shuts down movement to prevent damage.

This question was asked above and answered with a “yes.” Nothing will really happen as a pregnancy following a tummy tuck is very similar to a first time one. However, the tightened muscles might play a positive role in restraining the extent of abdominal wall distension thus decreasing stretch marks development.

While in all honesty I have never had one, my patients tell me that it is not. Admittedly there will be discomfort mostly related to the early bent position needed, but all pain should be quite manageable with the medication you are given.

Yes, 100% of the time.

Very carefully, thank you very much. Esthetic belly buttons have specifications, as could be judged from picking up Health & Fitness or Sports Illustrated (the Swim Suit issue). Round belly buttons are not esthetically pleasing most of the time as they tend to convey old age.

While cost in Beverly Hills is generally a little higher than elsewhere due to the higher pricing of operating rooms, the cost of a tummy tuck depends on the design needed to achieve an esthetically pleasing result. On average, the cost of this surgery in Beverly Hills runs from a low of $15K all the way to $50K for the most demanding operation (Manta Ray design with liposuction of flanks and back).

The Mercator planning session is a meticulous affair lasting about 30 minutes. This is done before surgery with the subject awake and alternatively standing and lying down. This insures the watertight precision of the 5 “S’s”: Symmetry; Silhouette; Scar; Speed and Safety.

Because the Mercator Design is “locked” with precision before the surgery ever starts, all major decisions are made before the patient ever sets foot into the operating room. This frees the surgeon from making arbitrary (and often inaccurate) decisions during the surgery and makes the operation not only fast but also safer. Typically, an M-Design is a one hour and ten minutes surgery; FDL-design lasts for two hours and a Manta Ray design for three hours. The Inverted-V and Reverse abdominoplasty designs typically are a one hour-long operation each.  

“The Best” is a subjective judgment as there are no competitions to tell us who is. However, finances not withstanding, there are criteria other than pure emotional ones to help patients arrive at the decision of surgeon’s choice: Philosophy and experience. A tummy tuck is not a cookbook recipe where every patient gets the same operation as every other patient. It is a highly specialized operation that should be specifically custom-fitted to the body under study. The surgeon should be able to convey his vision to his patient, not in vague terms but in very specific ones and with well-defined goals. The surgeon’s demeanor during the consultation is a window into her/his general philosophy about the operation (and life in general): a non-hurried easy-going attitude with confident mannerism is probably the hallmark of a charismatic personality and a solid inner core. Be weary about learned phraseology and your easy manipulation of the practitioner into what it is that you want to hear. Thus, “you need a mini tummy tuck” should alert you to a suspicious situation unless the surgeon can justify scientifically the pronouncement. “Scientifically” has stringent criteria that only those thoroughly versed in the art of the tummy tuck can define (but always in simple terms).

Contact Dr. Anous for Your Beverly Hills Abdominoplasty

The tummy tuck procedure can dramatically change the way you look and feel. The emotional satisfaction of looking and feeling your best will stay with you for many years to come. Your self-esteem and confidence will thank you for having had the courage to make this step. Contact Dr. Anous’ office today.