Transcript of the Discussion
Interviewer: So when does it get to a point where a woman needs a tummy tuck over liposuction?
Dr. Chasan: It all is based on their anatomy, on their skin quality. And that’s one of the things they have to come in, and I have to examine them. A lot of times, after kids, their muscles stretched out in the midline. So a lot of women, very active, they exercise. They work on their abs. And they still don’t have a flat abdomen. Generally, that’s because the tissue strength between their two rectus abdominis muscles has stretched. It’s called diastasis recti. So part of a tummy tuck would be to repair that.
Interviewer: So by the way, so I understand this correctly, so the abdomen muscles stretched.
Dr. Chasan: Yes.
Interviewer: And so even if they’re lean, they may have a little pooch.
Dr. Chasan: Pooch, yeah.
Interviewer: And you are doing what?
Dr. Chasan: I’m actually suturing those muscles together, kind of like an internal corset, and that flattens their abdomen. So I look at that. I look at their skin quality. If they don’t have a separation in their muscle and their skin quality is good, they can have liposuction. And so I always will lean towards liposuction if they’re going to get a good result. And there are people who are clearly liposuction people, and there’s clearly those people who are tummy tuck people. And then I don’t know if you remember those Venn diagrams we used to do in second grade, you know, where those two circles intersect, there’s that group in between where you could do…and I have to talk to ’em and see how much surgery they want. And, you know, it’s a communication. It’s a process. And if I can talk to them and understand what they want for their abdomen, how much surgery they want, sometimes a tummy tuck is a better option. Sometimes liposuction’s a better option.
Interviewer: Now, you are known for low incisions on tummy tuck. And smaller incisions, or scarring, I should say. Tell me why.
Dr. Chasan: Going back to that philosophy of taking tension off the incision. Take tension for your… delicate when you cut the skin and you don’t use any extra cautery on the skin, when you close it, I use a technique called progressive tension suturing. And actually, once you elevate the abdominal flap, what we used to do is just flex the bed and close it. That puts all the tension on the skin. But now, what I do is I suture underneath that flap, progressively suturing down that flap. And what that does is it does two…well, it actually does three things. It allows me to get a scar that’s lower. That’s very important. It allows me to take tension off that incision so I have a better scar. And also, it diminishes the potential for fluid collections or seromas in the abdomen. So this technique, progressive tension suturing, which is a relatively new technique…
Interviewer: And most guys don’t do it that way?
Dr. Chasan: Most guys don’t. And it’s been revolutionary for my tummy tucks.
Interviewer: So just for a thinner, lower…
Dr. Chasan: Thinner, lower…
Dr. Chasan: And then, as I mentioned before, I like that scar to be a perfect, linear crease to look…I want that scar to look like an underwear crease line. That’s what I want it to look like.
Interviewer: So it’s really almost undetectable.
Dr. Chasan: Yes.
Interviewer: And do you see, as a surgeon, I know you wanna be positive here, but you see tummy tuck incisions…
Dr. Chasan: Yes.
Interviewer: …sometimes from other doctors and you shake your head?
Dr. Chasan: I shake my head, because, you know what? If it’s not a curvy, linear line, it’s laziness. It’s just surgical laziness. That’s it. You know what? A dog ear doesn’t go away by itself. An irregular scar doesn’t go away. To me, I’m only as good as my last surgery. I want it perfect. And if I’m on the table and it’s not perfect, I’m going to make it perfect.
Interviewer: What about the belly button?
Interviewer: You can create a natural-looking belly button?
Dr. Chasan: Yeah. Actually, it’s the person’s own belly button that you’re using. And so you actually cut around the belly button. You dunk it. You close the abdomen. And then you tease it out and create a…so you create the frame around it. I’m prideful about how the belly button…the belly button has to look good. So I’m very prideful about that. So, you know, if you go on to my website, you’ll take a look, and you can look at the belly buttons.