Tummy Tuck in Los Angeles - Plastic Surgeon Specialist - Dr. Maher Anous
WHO WAS THIS MERCATOR GUY? Gerardus Mercator (1512 - 1594) was a Belgian cartographer of Flemish descent. His claim to fame was in his redesigning of maritime maps so as to simplify the way sea captains traced naval courses. Traditional cylindrical maps allowed navigation only along complex curved lines (called loxodromes) that crossed fixed meridians at the same angle. Instead, the Mercator map made captains trace their courses in straight lines.
This previous paragraph is as complex as this site is going to get!!
What does history have to do with Tummy-tuck surgery? The traditional thinking and teaching about abdominoplasty design and execution over the past 60 years (1948 - 2008) heavily drew on the body being cylindrical (my colleagues reading this are going to gasp as they do not even realize it). This is why surgeons only trace the lower incision (usually placed in the inferior fold of the hanging skin) and depend on tissue stretch during surgery to decide on where to make the upper cut (if you do not believe me, watch closely your television set when you tune on the various surgical channels dedicated to plastic surgery). This last step is carried on with the operating table flexed, which adds to the compexity (and imprecision) of the act. By contrast, because the Mercator Abdominoplasty Design considers the body to be a flat surface, the tracing of the surgery is done in straight lines before the patient ever enters the operating room. The surgeon neither depends on the stretch of the tissues nor on the bend of the operating table to decide on where to make the upper cut. He knows a priori (beforehand) where every incision is going to be, is able to check the symmetry of his design on either side of the midline and is even able to anticipate where every suture is going to fall. In essence, The Mercator Abdominoplasty eliminates guess work!
What are my objections to the traditional way of planning and performing this surgery? Numerous. A picture is worth a thousand words and I would like for my visitors to go back and check results on the web. Notice the following:
Traditional Abdominoplasty Result (unacceptable in my opinion)
Most AFTER pictures are shot with an underwear on: This is not to preserve modesty (the patient's face is not showing after all) but is a sneaky way to hide the incision. It is not its quality that they do not want you to see but its position as it does not follow any anatomical lines.
If by any chance you can see the scar, check for its symmetry on either side of the midline: Because the traditional way is an "as you go" procedure with a lot of the planning of the excision done while the operation is underway, controlling symmetry is a tricky business. This is another reason to hide the scar in the AFTER pictures.
Check if the surgery has done anything to improve the anterior thigh: A properly performed operation has to exert a vertical pull on the anterior thighs. The traditional way places the incision in the lower crease of the overhanging skin and thus has a ZERO tension effect on the thighs.
Check for residual stretch marks
: Traditional abdominoplasty tracing is controlled by the fear of being unable to close the incision rather by the courage of going after all possible stretch marks that could be safely eliminated. The minute the surgeon places this lower incision in the fold of overhanging skin (a big mistake in my personal opinion
), he/she has entered a mental universe controlled by a false sense of security rather than the bold universe of esthetic perfection.
Traditional Abdominoplasty Result (Unacceptable in my opinion)
Check the shape and placement of the umbilicus (belly-button): Esthetic belly-buttons should be vertical (slit-like) and placed at a given distance from the genital area along the vertical midline. Traditional teaching retrieves the belly-button through a round incision and is arbitrary about its placement. In other words, it is more "hit and miss" than precision.
Check for the inclination of the crural lines: The crural or inguinal lines are the creases separating the abdomen from the lower extremities. The thinner and leaner the body, the more vertically inclined are those lines (please check pictures of catwalk models if you do not believe me). By choosing a lower incision that has no influence whatsoever on the final inclination of those lines, the surgeon robs the patient from an added esthetic element.
Check for the shape of the genital area (Mons Pubis): The female genital area should resemble a "bird in flight." Its side arms should rise gracefully from the central area and portray the visual clue of beauty and youth. The traditional way again falters along those lines.
Check for surgical times (if you can find them): The traditional way takes on average between 3 to 4 hours to complete because of the intra-operative guesswork it imposes.
Does The Mercator Abdominoplasty correct all of the above? ABSOLUTELY. Check it out for yourself.
Before and After pictures of Mercator Abdominoplasty
(result shown at 3 months after surgery for maximal visualization of the scar)
Dr. Anous has Tummy Tuck offices that are state-of-the-art. View the videos to learn more about his advanced surgical techniques and contact our offices for a private consultation.