Robert H. Gotkin, M.D.
Does a belt lift usually include a tummy tuck, or are they two separate procedures?
A tummy tuck (abdominoplasty) usually addresses the abdomen with attention directed to tightening a lax muscular abdominal wall and removing excess fat and skin to the extent that each exists. A belt lift, or belt lipectomy, is more of a circumferential procedure - like a belt, it goes all the way around the trunk. It involves the removal of excess skin and fat and is often employed in individuals who have undergone massive weight loss and have significant hanging excess skin. With that said, most plastic surgeons performing tummy tucks understand that our patients are 3-dimensional - that the abdomen is connected to the hips and the hips connected to the flanks - and that aesthetically appropriate body contouring is usually a circumferential procedure. When a tummy tuck is performed, liposuction is usually added to extend the procedure all the way around the trunk; if circumferential skin excision is necessary to deliver the best result, then it should be performed. So, a belt lift does not necessarily include a tummy tuck, but the two procedures are intimately related.
I am a very active 50 year old with exceptionally small breasts, 36AA. I would like to consider augmentation, but do competitive martial arts that include high impact kicking and punching to the chest. We wear chest protectors, but the impact is still significant. Is augmentation an option? How likely is deflation with this kind of impact?
As a second-degree black belt in Tae Kwon Do, I feel very qualified to address this question. Breast augmentation is certainly an option for you -- even with your competitive martial arts practices. During your early postoperative recovery following breast augmentation, the first 4-6 weeks or so, you would have to refrain from any upper body impact / contact sports. In the first 3-4 weeks, even strenuous upper body exercises could be detrimental. In reality, after about 6 weeks or so, as long as you are comfortable, you could resume your martial arts. Deflation in the setting of impact martial arts is highly unlikely and you should do quite well. I would recommend submuscular (under the chest wall muscles) as opposed to submammary (under the breast tissue, but on top of the pectoral muscles) breast augmentation.
I want to have microdermabrasion. However, I have Diabetes Mellitus and have read that people with this condition may be poor candidates for the procedure. What are the dangers of microdermabrasion for people with diabetes and if precautions are taken, would it be safe to have this done?
An individual with diabetes may certainly undergo microdermabrasion as long as the person performing the procedure is an experienced aesthetician who performs microdermabrasion in the office of, or under the auspices of, a board-certified plastic surgeon. An individual who is a member of the Society of Plastic Surgical Skin Care Specialists would be such a person. This individual has the training and experience to treat a person with diabetes in a safe and effective manner. While persons with diabetes may have poor wound healing abilities, this should not be a factor in a well-performed microdermabrasion procedure. No specific precautions need be taken as the procedure is limited in its scope to the epidermis - the most superficial layer of the skin.