The Big Island is fortunate to have two Board Certified plastic surgeons with permanent offices, Dr. Paopao in Hilo and S. Larry Schlesinger, MD, FACS in Kona. Tummy tucks are normally done after one or more pregnancies. Historically, this has been a reconstructive surgery where you would get rid of the excess skin, repair the abdominal muscles separated during pregnancy, and create a belly button. During the last ten years, the tummy has migrated from being a reconstructive surgery to being a cosmetic surgery.
The tummy tuck is a central element in the Mommy Makeover. What we in the cosmetic plastic surgery community are trying to achieve in the Mommy Makeover is not just repair what was lost during pregnancy, but truly create an aesthetic abdomen with a beautiful belly button that can be shown in a bikini. The abdominoplasty scar today needs to be kept low, thin, and fine. Abdominoplasty incisions should not show above an average size bikini, and any portion that is visible should be very thin and pretty much invisible. The skills needed to create such a favorable scar are learned during a plastic surgery residency and can never be learned in a weekend course. Board Certification by the American Board of Plastic Surgery ensures the residents of the Big Island that they are dealing with a surgeon who has gone through rigorous training and, at a minimum, knows how to make a fine, delicate scar in most instances.
Today’s Kona tummy tuck requires that the plastic surgeon understands wound healing, suture placement, and that the modern woman on the Big Island of Hawaii wants to show off her new flat abdomen on the beach as well as in low rider jeans with halter tops.
In Hawaii as in most parts of the country, there are many physicians who want to be plastic surgeons and who hold themselves out as plastic surgeons, yet they have not gone through the rigorous training required to become a Board Certified plastic surgeon certified by the American Board of Plastic Surgery. Since cosmetic plastic surgery is truly retail medicine, the old adage in so much of the retail world, “caveat emptore” (let the buyer beware), certainly holds true.
The fact that abdominoplasties cost a lot of money is not the biggest problem. The biggest problem is that if the surgery is not done right the first time, the chances of correcting inadequate surgeries done by non-certified surgeons are very challenging. Thick abdominoplasty scars placed above the existing pubic hairline are difficult, if not impossible, to hide. Several Board Certified plastic surgeons certified by the American Board of Plastic Surgery around the country make a portion of their income correcting deformed belly buttons and abdominoplasties performed by under trained surgeons.
At the Mommy Makeover Institute of Hawaii, the abdominoplasty closure is done in four layers to decrease tension that leads to thicker, more obvious scars. The belly button or umbilicus is closed with sutures that never cross the suture line to decrease scarring, and the final suture line is closed with super glue to prevent crosshatch markings.
The bottom line is that abdominoplasties in Kailua-Kona, Hawaii should be performed by Board Certified plastic surgeons, certified by the American Board of Plastic Surgery, with years of experience doing tummy tucks in Kona and the Mommy Makeover.