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Interviewer: So maybe you're considering getting a cosmetic or a reconstructive procedure done. We've all seen the before and after photos, but it's there's sometimes a journey in between those two points, and to kind of talk us through this is Dr. Courtney Crombie. She's an Assistant Professor and plastic surgeon with University of Utah Health.

Now, Dr. Crombie, what are some of these, you know, you see in magazines, you see on advertisements, you know, the before and the after. But, you know, there's a lot more involved with the recovery, regardless of what your procedure is. Why don't you walk me through some of the things that you as a surgeon really want your patients to understand when they're first thinking about these kinds of procedures.

Dr. Crombie: So most of the time, you know, our patients come and meet with us. They'll have at least one, and sometimes multiple meetings with us prior to a given procedure. And then on the day of the procedure, once again, we meet in the morning. They'll meet their anesthesiologists, and then they'll meet with us, and usually, depending on what the procedure is, we'll do our markings and our consent forms and then off to surgery.

After the procedure, we usually see them within the first week for their first follow-up appointment, and it'll either be with the surgeon, or someone on our team to check in and make sure that they're doing okay with their pain medicines and that our surgical sites are doing okay, if there is drains involved, you know, a drain check and just to see overall how they're doing.

On my service, I usually end up seeing patients probably every one to two weeks after their procedure until the kind of the final product of our procedure is done, which may be anywhere up to six weeks later. All our checkups were following drain outputs and removing drains, checking on wounds, removing Steri-Strips, and when it is time to start doing massages on massaging of scars, we will talk you through that portion, talk about sun exposure to scar, and get you through everything to the end product.

Interviewer: So beyond say scar care, wound care, pain management, what are some other things that they also should be keeping in mind? I would assume that, you know, they're going to be out for a while, they're not going to be able to, you know, lift anything, run around with the kids. What are some of those other kind of, you know, social and psychosocial aspects of all this?

Dr. Crombie: We discuss with you your daily activities of what we start allowing you to do, from walking the dog to, you know, carrying your children, playing with your kids, riding a bike. Whatever the activities are, we're usually discussing what those things are that we think is okay to do based on what wounds you have, what muscles are lying under those wounds. So we're very involved with everything because we want you to have the very best outcome for the things that we're helping you through.

Interviewer: So a patient who, you know, they hear that it's going to be a process, right? They hear maybe they're going to hurt for a while, they might have to, you know, work through one thing or another, what is something you tell them to kind of reassure them, if this is something they really want to do?

Dr. Crombie: I remind them that there are going to be good days and bad days, and on your good days, you really need to sort of tone it down so that your bad day, you don't totally crash. And I ask them about their support system, and I encourage their significant others to help them through on, you know, to be their cheerleader, and to help them through on their bad days, and hopefully they have a good support system. We want our patients to do well. It's a reflection of us, of course, and, you know, we want the best for our patients. We want good outcomes for them. And that's why we're here.

Interviewer: If you are struggling with that last little bit of body fat, that one kind of struggle area or something along those lines, you might be looking at a surgical option. But a tummy tuck, a liposuction, these are terms we might understand, but what do they really mean? We're here with Dr. Courtney Crombie. She's an assistant professor and plastic surgeon with University of Utah Health now. Dr. Crombie, liposuction, tummy tuck, what are the differences in these procedures?

Dr. Crombie: So, first of all, a tummy tuck or abdominoplasty is a surgical procedure that is meant to remove excess skin and fat in the abdominal area, and can also be used to tighten muscles underneath that skin and fat. For liposuction, this is also a surgical procedure, but it's meant to sculpt or reduce small pockets of fat that are resistant to change from diet and exercise. This can also be done on the abdominal area, but can be done in other areas of the body as well.

So liposuction is a much easier recovery because there aren't as many limitations put on you. Basically, you're wearing compression, either abdominal binder, if it's around your belly, or some compression like a girdle or something if it's other places like on your hips for probably four to six weeks. And so fairly easy to conceal because it's just under your clothes. And you're going to have pain in those areas where we liposuction, but you're getting around okay.

Now, for an abdominoplasty, if you're having a full-out abdominoplasty with the muscle placation, that's a much greater recovery. Six weeks where we don't have you lift anything heavier than let's say, a gallon of milk, you are wearing an abdominal binder, you have drains in place that you have to carry around with you for two, maybe upwards of three weeks, you may not be able to stand up straight for the first two weeks. And so it's a much harder recovery and it may be the full six weeks before you feel like nothing happened to you.

Interviewer: If I'm a patient who is looking to get one of these procedures done, what is one of the kind of first steps I should take on my journey trying to decide which of these procedures is best for me?

Dr. Crombie: If there's an area where you have loose skin, then liposuction probably isn't the thing for you because if we remove the fat under that loose skin, that loose skin is probably going to just get looser and wigglier and it's probably not the thing that you're going to want to see when you look in the mirror. You're probably looking at more at having to remove that skin along with the fat underneath. So then we're thinking more of the procedures that are removing the skin along with the fat.

Interviewer: Okay. So like the tummy tuck?

Dr. Crombie: Yeah.

Interviewer: If it's in that region?

Dr. Crombie: Exactly.

Interviewer: Okay.

Dr. Crombie: So liposuction really is to just take away areas where there's just stubborn fat that you can't get rid of, but your skin tone is really quite good there. And one thing also that I want to remind people of is that it's not a good way to lose weight.

Interviewer: What do you mean by that?

Dr. Crombie: Well, sometimes I have people coming in that want to use that as a way to take lots of pounds off, but I don't recommend that. If you're on your way to losing weight, I would recommend that you get to a point of weight loss that you want to be where you're at your comfortable weight. And it's a healthy way that you can maintain and that you're not struggling to stay there, and you're not starving yourself to stay there. But it's something that you can easily stay at comfortably, then that's the time to come see us so that whatever procedure we do is worth your while, worth your time, and worth your money. Does that make sense?

Interviewer: That? Yeah. I like that because that's just it is if you guys remove the fat and I'm just going to put it back on. Is that what you're saying or is it just . . . We want to make sure.

Dr. Crombie: Yeah. Exactly. If you're only partway there and then we do say the tummy tuck and then you go ahead and lose another 20 pounds and then your skin loosens up again, I'd hate to have to redo that procedure after you've just spent all this time and effort because with a tummy tuck when we tighten the muscles, that's a long time where we're not letting you do any heavy weight lifting, you're very immobile, you may have drains in place, and you may have a lot of time off work. And so there's a big investment of pain and suffering to get through your recovery and a lot of people don't want to go through all that again. And then plus it is costly too. So you want to be one and done.

Interviewer: That's some great advice coming from a professional because someone from the outside is like, "Oh, well, it'll just help me get thin. It'll make me look the way I want." No. That's not what we're looking for here. This is that last step. Right?

Dr. Crombie: Right.

Interviewer: So if I am looking for a procedure like this, what is my first step when it comes to finding the right surgeon, finding the right facility, etc., like right procedure? This is some stuff that I didn't know. As a layperson, I record these types of interviews all the time. If I'm just someone coming in for the first time thinking about this, what is the first step when figuring out a surgeon?

Dr. Crombie: Well, certainly you can come and see any one of us at the university. Our Consultations are free and so if you're not sure, then let us take a look, let's talk about what your goals are, and we can even help you if you're not sure, if you're at a point where you're ready to take that next step or if you're still on your journey of weight loss or toning or whatever. And we can figure out where your endpoint is and come up with a plan.