Richmond's Premiere Tummy Tuck Experience

​Dr. Nadia Blanchet offers experience, quality, and service

Dr. Blanchet’s extensive experience, world class training, and commitment to patient care has consistently made her one of the top plastic surgeons in Richmond. Voted as Richmond’s top cosmetic and reconstructive plastic surgeon in 2017, the abdominoplasty (Tummy Tuck) is one of her favorite operations.

2
Times chosen as a best plastic surgeon in Virginia (according to US News & World Report 2011-Present)

5

Times honored as one of Virginia best plastic surgeons or cosmetic surgery practices (According to Virginia Living 2012-Present)

14

Times voted as best or one of the best plastic surgeons in Richmond (according to Richmond Magazine 1999-Present)

35

Patient care awards since beginning practice

Dr. Blanchet has received Institutional Review Board

approval to conduct a study to see if she can help

improve abdominal pain after abdominoplasty.

Participation is completely optional.

Dysport is a medication similar to Botox in that it helps to weaken muscles temporarily. We are hoping that an injection of Dysport at the time of surgery will help the muscle spasm and tightness that patients usually feel after this surgery for several weeks to months. The dose given will not be enough to interfere with normal activities or exercise. We have used Dysport on a few patients, and because we were so impressed with their decreased pain, decided to embark on this study.

Patients will be randomized, which means they will either receive the Dysport or not. The Dysport injection is about a $500 value and will be given at no cost to the patient. All patients will be asked to keep a pain log for several months, and then we will see if we can detect a difference in the patients who received the Dysport with those who did not. We are very excited about this research opportunity, but if it is not something you are interested in, you do not need to participate in the study.

A note from Dr. B about the Abdominoplasty

An abdominoplasty is usually indicated in someone whose weight is stable and who has excess abdominal skin and fatty tissue.  This is usually a consequence of previous pregnancies or a recent weight loss.  Often associated with this skin excess, which may be above or below the navel, are stretch marks.  These will not be removed individually although some of them will be removed with the skin that is excised during the surgery.  Often associated with the extra skin and fat is “diastasis,” or separation of the abdominal muscles, which usually comes with the stretching of pregnancy or weight gain.  A hernia or generalized weakness of the abdominal wall may also be present along with a variable amount of fat.  One or all of these may be present in any individual, and each procedure is altered accordingly.  I do not feel that this operation should be performed on someone who is planning further pregnancies soon or significant weight changes of more than 20 lbs.  It is better to lose the weight first.

The procedure takes from 1 to 2 hours and is done under sedation in my office in my accredited ambulatory surgery center or occasionally in the hospital with an overnight stay, depending on the extent of the surgery and your general health.  The scar is low on the abdomen and extends toward both hipbones.  We can design the incisions so they are hidden by your own bathing suit the day of the surgery.  The skin removed is primarily that skin beneath the umbilicus (navel) and above the pubic region.  During surgery, the skin and fat of the abdomen is elevated up to the level of the lower ribs.  The upper skin is brought down to the pubic area and the original navel, which is on a stalk, is brought through the abdominal skin.  Its actual position is not changed.  The abdominal wall is tightened with permanent sutures (stitches).  Excess skin is then removed. Liposuction is usually used for final contouring (“lipoabdominoplasty”). Sometimes additional liposuction of the lumbar rolls or “love handles” can be done at the same time to further slim your waistline, although this is a separate procedure.

A mini-abdominoplasty is less complex than a full abdominoplasty in some ways. We can leave the navel alone and only remove some of the skin of the lower abdomen, or   completely avoid the plication on someone who has extra skin but has great abdominal wall muscle tone.  Occasionally, when the navel is high on the abdomen, it can be lowered by transecting it at the base leaving no scar around the navel (“floating” the navel).

When you awaken from surgery, you will be in a semi-sitting position to keep tension off the stitches.  I rarely place an abdominal drain any more.  If I do, it will be removed a few days after the surgery when the drainage stops.  Drains come out without difficulty and with minimal discomfort. You will bring a girdle to the office the day of surgery and will wear that home.  You may need to take an over-the-counter iron supplement (SlowFe) for 1 month after your surgery. You should walk a little every day after surgery but should refrain from vigorous exercise for 2 weeks post-operatively.  Please allow 2-3 weeks for recovery.

Complications from this procedure are unusual but include bleeding (which is possible in any surgical procedure).  Infection may occur after surgery, especially because the incision is close to the groin area.  The risk of this is less than 3%.  Some of the skin may not heal well, and this can lead to a scab and rarely even some skin loss, which will eventually heal on its own.  This is especially true in smokers who do not heal well. This procedure should not be performed in smokers unless they can absolutely abstain from tobacco for 1 month before and after surgery. Nicotine screening may be necessary the day of surgery.   Many patients have numbness of the lower abdominal skin; this is usually temporary.  The scar is well hidden within the bathing suit line.  For the past few years, I have been using dissolvable internal staples called Insorb sutures, and the scars have been much finer.  Some abdominoplasty scars fade very quickly, but others can be quite noticeable for up to several years.  This is unpredictable.  Patients who are “chunky” at the time of surgery seem to take significantly longer for swelling to resolve.

Three other recent innovations in my abdominoplasty practice are Exparel, Progressive Tension Sutures (quilting sutures) and Dysport.  Exparel is a long-acting numbing solution/anesthetic and is injected into the wound while you are under sedation.  As expected, it has dramatically helped with post-operative pain for the first week after surgery. What I have been pleasantly surprised to discover is that the second and third weeks are much better as well. This apparently has to do with “memory stimulation” and pain pathways. I am also injecting a muscle relaxant into the muscle to help with post-op discomfort, as part of a pain study (described above ).  Progressive tension sutures (quilting sutures) are now used to tack the skin down to the abdomen during surgery so that the drain is usually not necessary.

The worst complication that can happen from abdominoplasty is probably the development of a clot in one of the veins of the legs which can go to your lungs and cause a pulmonary embolus.  Luckily, the risk of clots in the legs and lungs is divided by half when the procedure is performed under deep sedation, as it will be in my office, as compared to surgery done under general anesthesia.  In order to prevent clots, you will need to get out of bed the very first night after surgery and make sure that you keep walking so that blood does not have a chance to clot in your legs.  You will also have “intermittent venous compression stockings” on during the procedure to help blood flow.  Because of this risk, I am usually reluctant to do this procedure on extremely overweight patients who are at increased risk or to combine other complex procedures at the same time with an abdominoplasty (“mommy makeovers”) unless the combined procedures will be less than 3 to 4 hours of anesthesia.  If I think that you are at higher risk for a clot in your legs, I will occasionally prescribe a blood thinner for several weeks post operatively. I will purchase health insurance for you that will cover the rare incidence of a medical complication within six weeks of your surgery.  This program is called “CosmetAssure” and is needed because your medical insurance does not cover any complication from a cosmetic procedure.

I hope that this information has not been overwhelming in that it describes all the possible complications of this procedure. The vast majority of patients have successful, uncomplicated surgery and are quite pleased with the results.  I will be happy to discuss the details of this procedure and show you before and after photos in my office in consultation.

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“The beauty of a woman must be seen from in her eyes, because that is the doorway to her heart, the place where love resides.”
-Audrey Hepburn

Accessibility

As a patient, Dr. Blanchet will provide you with her personal email to ensure patient accessibility.

Award Winning Quality

Dr. Blanchet and her staff have been consistently recognized as providing top quality care to their patients.

Video Tutorials

Dr. Blanchet and her staff have produced a series of post-op care videos to ensure effective at home care.

 

Commitment To Philanthropy

Dr Blanchet and her husband have been doing volunteer surgery internationally for over 25 years.

For her entire life, Dr. Blanchet has been driven to make the world a better place. Now a board member of the World Pediatric Project, Dr. Blanchet is never happier than when she is using her skills to help those less fortunate, and make the world a better place.

Learn More About the World Pediatric Project

WPP Caribbean - A Love Story

Dr. Nadia Blanchet and her husband, Dr. Kent Rollins, speak about the genesis of WPP Caribbean and the tremendous impact it has had over the years.

Posted by WPP Caribbean on Friday, March 3, 2017

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