Plastic Surgery: Before and After

Skin tightening options depend on the degree of laxity and whether excess fat is also affecting the contour. In this 2020 episode, Darren M. Smith, MD, a plastic surgeon in New York City, compares topical products, energy-based procedures and surgical skin removal.

He explains how loss of skin elasticity contributes to laxity, then discusses the different goals of improving skin appearance, stimulating a tissue response and removing excess skin. The device and pricing discussion reflects his practice at the time.

Key takeaways

🔬 Moisturizing and removing loose skin are different goals.

Dr. Smith describes a temporary improvement in appearance from hydration while explaining the limitations of creams for substantial laxity.

🔬 Energy-based treatments rely on a tissue response.

The recording discusses radiofrequency microneedling through Morpheus8 and procedures using BodyTite, FaceTite and AccuTite. These are different techniques with their own risks and limitations.

⏳ Changes can take time.

Dr. Smith explains that the healing response develops over months; the episode's examples should not be treated as a promised result or schedule.

🔬 Surgery removes excess skin.

Examples include face and neck lifts, arm lifts and tummy tucks. Significant laxity can require a different approach from a less extensive concern.

🔬 Fat and skin need separate assessment.

Liposuction may enter the discussion when excess fat contributes to the contour, alongside consideration of the skin.

💬 Questions answered

Will a skin-tightening procedure also remove unwanted fat?

That depends on the procedure and the tissue being treated. The episode explains why Dr. Smith sometimes discusses liposuction separately: changing the skin does not automatically address the amount of underlying fat.

Are device treatments equivalent to surgical skin removal?

No. The recording distinguishes the goals and limits of device-based treatment from excisional surgery. The degree of laxity, expected change, recovery and scar tradeoffs belong in an individual consultation.

ℹ️ Current context for this 2020 recording

The FDA's October 2025 RF microneedling safety communication reports serious complications with certain uses, including burns, scarring, fat loss and nerve damage. It concerns RF microneedling specifically, rather than every radiofrequency procedure. Microneedling penetrates skin and should not be described as completely noninvasive.

The recording also discusses platelet-rich plasma (PRP). The FDA states that microneedling devices are not approved to deliver blood products such as PRP into skin. Discuss the evidence and risks for any proposed combination. All dollar amounts and treatment schedules in the audio are historical examples, not current quotes or individualized recommendations.

🎧 Episode chapters

01:21 — Skin elasticity and topical products

03:51 — Energy-based skin treatments

09:24 — Surgical skin removal

10:30 — Liposuction and PRP discussion

12:47 — Historical pricing and treatment schedules

14:19 — Risks and home-treatment claims

🔗 Related information

Explore Morpheus8 information, BodyTite information, tummy tuck surgery, or request a consultation with Dr. Smith in New York City.

About the host — current biography

Darren M. Smith, MD, FACS is a board-certified plastic surgeon in Manhattan specializing in mommy makeover surgery, breast surgery, and body contouring. He was named to Newsweek’s America’s Best Plastic Surgeons 2026 and has co-authored authoritative peer-reviewed publications on combined breast surgery and abdominoplasty and the surgical care of postpartum patients.

Originally released July 12, 2020. Show notes updated September 30, 2026. This is general education. Current recommendations, suitability, risks and expected results require an individual assessment.

Full transcript and related resources

Localized inner-thigh fat may be treated with liposuction, but the first question is whether the fullness comes from fat, loose skin or both. Removing fat alone can leave a disappointing contour when substantial skin laxity is also present. The treatment needs to match the anatomy and the patient's goals.

In this July 10, 2020 episode of Plastic Surgery: Before and After, board-certified New York City plastic surgeon Darren M. Smith, MD discusses common reasons patients ask about their inner, or medial, thighs, including rubbing and concerns about shape. He outlines his approach to focused fat removal and explains when skin treatment enters the conversation.

Key takeaways

🔎 Start with the cause of fullness.

The episode separates extra fat from extra skin rather than treating every inner-thigh concern the same way.

🔎 Focused liposuction is one option.

Dr. Smith describes a local-anesthesia procedure using small groin-crease incisions and a cannula to remove targeted fat.

🔬 Skin quality matters.

Existing laxity can become more noticeable when the volume beneath it decreases.

🔎 Different degrees of looseness need different discussions.

The recording covers radiofrequency for selected laxity and a medial thigh lift for more substantial excess skin.

🔎 Preferences also matter.

Dr. Smith discusses CoolSculpting for people who do not want surgery while explaining his own preference for focused liposuction.

💬 Questions answered

Can inner-thigh liposuction be done while I am awake?

The episode describes local anesthesia as an option for selected patients in Dr. Smith's practice. The anesthesia and extent of treatment need an individual assessment; the example is not a recommendation for every patient.

Will removing fat also remove loose skin?

No. Dr. Smith explains why fat removal can leave loose skin behind. He discusses a separate skin-tightening approach for some patients and skin-removal surgery when the excess is more significant.

How is a thigh lift different from liposuction?

Liposuction targets fat. A medial thigh lift removes excess skin. The recording describes the additional scar and recovery involved in choosing a lift, particularly after substantial weight loss.

🎧 Episode chapters

00:30 — Why patients ask about inner-thigh fullness

01:20 — Is the concern fat, loose skin or both?

01:38 — Focused liposuction and the 2020 procedure example

03:16 — The discussion of noninvasive alternatives

04:12 — Why skin laxity changes the plan

05:41 — When a medial thigh lift may be considered

🔗 Related information

Read about thigh liposuction, BodyTite and liposuction more broadly, or request a consultation with Dr. Smith in New York City.

About the host — current biography

Darren M. Smith, MD, FACS specializes in mommy makeover surgery, breast surgery, and body contouring in Manhattan. He was named to Newsweek’s America’s Best Plastic Surgeons 2026 and has co-authored authoritative peer-reviewed publications on combined breast surgery and abdominoplasty and the surgical care of postpartum patients.

Originally released July 10, 2020. Show notes updated September 30, 2026. This is general education. Recovery instructions, suitability, risks and achievable contours require an individual assessment; no particular thigh shape is guaranteed.

Full transcript and related resources

Breast augmentation pricing includes four main components: the surgeon's fee, anesthesia, the surgical facility and the implants themselves. In this 2020 episode, Darren M. Smith, MD, a plastic surgeon in New York City, explains how to read a quote and why two procedures with the same name can have different costs.

The dollar amounts in this recording are historical, not a current quote. Dr. Smith describes examples ranging from about $6,500 to $13,000–$15,000 in the New York City area at the time. Those figures do not establish today's prices or guarantee what any particular package includes.

Key takeaways

💬 The surgeon's fee reflects the operation being planned.

Anatomy, prior breast surgery and case complexity can affect the work involved. Training and experience are also discussed as pricing factors.

💬 Anesthesia has its own cost.

The recording describes the setting, anesthesia provider and length of surgery as contributors.

💬 The facility fee covers more than a room.

Supplies, processing equipment and operating-room time contribute. Items such as a surgical bra or an overnight stay may be included or billed separately.

🔬 Implant choice affects the quote.

Dr. Smith discusses saline, silicone and a structured saline brand available at the time. Implant selection also involves anatomy and goals.

🔎 Location affects pricing.

Geographic differences help explain why an estimate from one community may not translate directly to another.

💬 Questions answered

Is the surgeon's fee the total cost of breast augmentation?

No. The episode separates that fee from anesthesia, facility and implant charges. Ask which components are included in the written quote and which are separate before comparing totals.

Can previous breast surgery make a new augmentation more expensive?

It can change the complexity and time required. Dr. Smith contrasts a straightforward first augmentation with a case involving previous implants or other breast surgery; an individual examination is needed to estimate the actual work.

ℹ️ Current planning context

The FDA advises that breast implants are not lifetime devices and that additional operations may be needed. Current implant counseling includes risk information and a patient decision checklist introduced after this recording. Discuss ongoing follow-up and potential future costs alongside the initial surgical quote.

🎧 Episode chapters

00:26 — Four components of the price

01:21 — Surgeon fee and case complexity

04:34 — Anesthesia fees

07:47 — Facility fees and included items

10:22 — Implant choices

11:50 — Geography and historical NYC prices

🔗 Related information

Explore breast augmentation, breast implant cost information, breast implant options, or request a consultation with Dr. Smith in New York City.

About the host — current biography

Darren M. Smith, MD, FACS is a board-certified plastic surgeon in Manhattan specializing in mommy makeover surgery, breast surgery, and body contouring. He was named to Newsweek’s America’s Best Plastic Surgeons 2026 and has co-authored authoritative peer-reviewed publications on combined breast surgery and abdominoplasty and the surgical care of postpartum patients.

Originally released July 9, 2020. Show notes updated September 30, 2026. This is general education. Current recommendations, suitability, risks and expected results require an individual assessment.

Full transcript and related resources

Liposuction can target localized fat in many areas, including beneath the chin, the arms, abdomen, waist, back and thighs. The right plan identifies the exact areas and the tissue causing fullness. It does not mean removing every area of fat or treating all concerns in one operation.

In this July 8, 2020 episode of Plastic Surgery: Before and After, board-certified New York City plastic surgeon Darren M. Smith, MD takes a head-to-toe tour of common treatment areas. He explains why each region needs its own anatomical assessment and why a label such as Lipo 360 is not enough to define the plan.

Key takeaways

🔎 The source of fullness matters.

The male-chest discussion distinguishes fat from breast tissue, which may require a different approach.

🔬 Abdominal fat has different compartments.

Liposuction targets subcutaneous fat above the abdominal wall, not the visceral fat around internal organs.

🔎 Neighboring areas affect overall contour.

Dr. Smith discusses planning the abdomen and waist together and considering the different sides of the thighs.

🔎 Name each treatment area.

Ask whether a proposed Lipo 360 plan includes the abdomen, flanks, upper back, lower back or other specific regions.

🔬 Fat is only part of the assessment.

Existing skin laxity and underlying muscle tone influence the result. The episode also discusses skin-removal procedures and historical adjuncts such as BodyTite and Emsculpt.

💬 Questions answered

Can liposuction remove all of my abdominal fat?

No. Dr. Smith distinguishes the superficial fat beneath the skin from deeper visceral fat around the organs. His explanation emphasizes an examination to determine which compartment contributes to the abdominal shape.

Is chin liposuction actually performed on the chin?

In this discussion, chin liposuction refers to the submental area beneath and behind the chin. Dr. Smith describes treating fullness there as part of an assessment of the jawline and lower facial profile.

Does Lipo 360 always include the same areas?

The episode warns that the term alone can be too vague. Dr. Smith recommends a clear discussion of the actual regions being treated so the patient and surgeon share the same expectations.

🎧 Episode chapters

01:08 — Chin, male chest, underarms and arms

04:29 — Abdominal liposuction: superficial versus visceral fat

06:32 — Planning the waist and back

09:02 — Why Dr. Smith asks what Lipo 360 actually includes

11:18 — Thigh regions and selected calf treatment

14:18 — Skin laxity, muscle tone and historical adjuncts

🔗 Related information

Explore current practice information on liposuction, chin liposuction and thigh liposuction, or request a consultation with Dr. Smith in New York City.

About the host — current biography

Darren M. Smith, MD, FACS specializes in mommy makeover surgery, breast surgery, and body contouring in Manhattan. He was named to Newsweek’s America’s Best Plastic Surgeons 2026 and has co-authored authoritative peer-reviewed publications on combined breast surgery and abdominoplasty and the surgical care of postpartum patients.

Originally released July 8, 2020. Show notes updated September 30, 2026. This is general education; suitability, the extent of treatment, risks and expected results require an individual assessment.

Full transcript and related resources

Improving arm shape starts with identifying whether the main concern is muscle definition, excess fat, loose skin or a combination. In this episode, Darren M. Smith, MD, a plastic surgeon in New York City, uses those three tissue layers to explain why different arms need different treatment plans.

Someone seeking more visible muscle definition may have a different concern from someone bothered by hanging skin after weight loss. The recording walks through exercise, fat removal, energy-based skin treatment and surgical skin removal without treating them as interchangeable procedures.

Key takeaways

🔬 Muscle provides the foundation.

Dr. Smith discusses exercise and, in the context of his 2020 practice, Emsculpt as approaches to muscle conditioning. Neither discussion makes loose skin the same problem as muscle tone.

🔬 Fat can obscure definition.

Arm liposuction removes localized fat. Dr. Smith describes local anesthesia as an option for selected cases.

🔬 Skin quality changes the plan.

If excess skin is the main issue, removing fat alone does not address that tissue. The episode discusses BodyTite for selected patients with less extensive laxity.

🔬 An arm lift removes excess skin.

A full brachioplasty involves a longer incision along the inner arm, with a permanent scar to weigh against the contour change.

🔎 A smaller operation fits a smaller problem.

The mini arm lift discussed in the recording targets more limited excess skin near the armpit. It is not presented as suitable for every arm.

💬 Questions answered

How are arm liposuction and an arm lift different?

Liposuction addresses fat beneath the skin. An arm lift, or brachioplasty, removes excess skin. Dr. Smith explains that some patients have both concerns, so the consultation should identify which tissues are contributing to the shape.

Can a mini arm lift replace a full arm lift?

Only when the distribution of excess skin fits the smaller procedure. The episode describes a mini lift for limited upper-arm skin near the armpit, while more extensive laxity may require a longer incision.

The device protocols, compression instructions and rapid recovery examples in this 2020 recording describe the original discussion. A current plan should specify the procedure's risks, scar placement, expected limitations and individualized activity restrictions.

🎧 Episode chapters

00:33 — The three layers that shape the arms

01:30 — Muscle conditioning and exercise

03:22 — Arm fat and liposuction

05:14 — Skin laxity and BodyTite discussion

07:07 — Full and mini arm lifts

🔗 Related information

Explore arm liposuction, arm lift surgery, BodyTite treatment information, or request a consultation with Dr. Smith in New York City.

About the host — current biography

Darren M. Smith, MD, FACS is a board-certified plastic surgeon in Manhattan specializing in mommy makeover surgery, breast surgery, and body contouring. He was named to Newsweek’s America’s Best Plastic Surgeons 2026 and has co-authored authoritative peer-reviewed publications on combined breast surgery and abdominoplasty and the surgical care of postpartum patients.

Originally released July 7, 2020. Show notes updated September 30, 2026. This is general education. Current recommendations, suitability, risks and expected results require an individual assessment.

Full transcript and related resources

In this 2020 recording, Dr. Smith recommends postponing elective cosmetic Botox and fillers during pregnancy and breastfeeding because of limited safety information. Darren M. Smith, MD, a plastic surgeon in New York City, explains the reasoning behind that precaution and distinguishes cosmetic treatment from treatment of a medical condition. Updated evidence is summarized separately below.

Key takeaways from the episode

🔎 Botox and fillers work differently.

Botulinum toxin products reduce selected muscle activity; the hyaluronic acid fillers discussed in the episode add volume.

⚠️ A familiar ingredient does not establish safety in pregnancy.

Hyaluronic acid occurs naturally in the body, but that alone does not answer whether an injectable product is appropriate during pregnancy or breastfeeding.

💬 Elective and medical uses raise different questions.

Dr. Smith mentions uses such as migraine and muscle spasticity. A decision about an ongoing medical treatment requires its own assessment.

🔎 The recommendation in the audio is precautionary.

It should not be interpreted as evidence that every exposure causes harm, or as a statement that all products and uses have been studied equally.

💬 Questions answered

Why does Dr. Smith recommend waiting for cosmetic injections?

He weighs an elective appearance benefit against uncertainty about pregnancy and breastfeeding safety. The recording's recommendation is to wait rather than assume that a small dose or a naturally occurring filler ingredient settles the question.

Does this episode provide a treatment plan for migraine or spasticity?

No. Dr. Smith mentions these medical uses but does not give an individualized treatment plan. The clinician treating the condition should assess the relevant benefits, uncertainties and alternatives.

ℹ️ Current context for this 2020 recording

The FDA does not recommend cosmetic botulinum toxin injections during pregnancy or lactation. The FDA also states that dermal filler safety during pregnancy and breastfeeding is unknown.

Lactation evidence has developed since the recording. The September 2026 LactMed review describes limited human data on onabotulinumtoxinA and notes guidance supporting its use for chronic migraine during breastfeeding. Those findings do not establish safety for every toxin, dose or indication, and breastfeeding evidence does not establish pregnancy safety. Discuss your specific treatment and circumstances with your prescribing and obstetric or lactation care teams.

🎧 Episode chapters

00:36 — What botulinum toxin does

02:49 — The original precautionary recommendation

03:45 — Cosmetic versus medical uses

04:29 — Hyaluronic acid fillers and timing

🔗 Related information

Explore Botox treatment information, dermal filler information, or request a consultation with Dr. Smith in New York City.

About the host — current biography

Darren M. Smith, MD, FACS is a board-certified plastic surgeon in Manhattan specializing in mommy makeover surgery, breast surgery, and body contouring. He was named to Newsweek’s America’s Best Plastic Surgeons 2026 and has co-authored authoritative peer-reviewed publications on combined breast surgery and abdominoplasty and the surgical care of postpartum patients.

Originally released July 6, 2020. Show notes updated September 30, 2026. This is general education. Current recommendations, suitability, risks and expected results require an individual assessment.

Full transcript and related resources

A double chin can reflect inherited fat distribution, overall body fat, loose skin or a combination. The treatment question is therefore what is creating the fullness. In this 2020 episode, Darren M. Smith, MD, a plastic surgeon in New York City, compares approaches to fat beneath the chin and skin along the neck.

Dr. Smith explains why someone can have submental fullness despite regular exercise or a healthy weight. Weight change may affect the area, but exercising a particular body part does not selectively remove its fat.

Key takeaways

🔬 Identify fat versus skin.

Removing fat and addressing skin laxity are different goals; some people have both concerns.

🔎 Nonsurgical options have tradeoffs.

The recording discusses fat freezing and injectable treatment, including the possibility of multiple sessions and recovery after treatment.

🔬 Chin liposuction targets fat.

Dr. Smith describes it as an option for selected patients with localized fullness, sometimes performed with local anesthesia.

🔬 Skin treatment depends on the degree of laxity.

The discussion includes radiofrequency treatments and, for more substantial loose skin, neck lift surgery.

🔎 A combination may be considered.

The appropriate approach depends on anatomy and goals, rather than assuming one treatment fits every double chin.

💬 Questions answered

Can chin exercises get rid of a double chin?

The episode explains that targeted exercise cannot selectively remove fat from the chin. Overall weight change may alter fullness, but inherited fat distribution and loose skin can remain relevant.

Will liposuction also remove loose neck skin?

Liposuction removes fat. Dr. Smith distinguishes that goal from treating skin laxity and discusses additional procedures when loose skin is a separate concern. An assessment is needed to determine whether fat removal alone is suitable.

ℹ️ Current context for this 2020 recording

Kybella is an FDA-approved prescription drug containing deoxycholic acid for fat beneath the chin in adults; it is not an enzyme. Suitability and risks require a clinician's assessment.

In October 2025, the FDA issued a safety communication about certain uses of radiofrequency microneedling, reporting complications including burns, scarring, fat loss and nerve damage. This specifically concerns RF microneedling, which the episode discusses through Morpheus8; it should not be read as a finding about every type of radiofrequency procedure. Treatment preferences, prices and recovery examples in the recording reflect its original date.

🎧 Episode chapters

00:33 — Why a double chin develops

01:59 — Exercise and targeted fat loss

03:12 — Nonsurgical fat treatments

06:01 — Radiofrequency microneedling discussion

07:42 — Matching liposuction and skin treatments

12:13 — Neck lift and historical cost discussion

🔗 Related information

Explore chin liposuction, FaceTite and AccuTite, neck lift surgery, or request a consultation with Dr. Smith in New York City.

About the host — current biography

Darren M. Smith, MD, FACS is a board-certified plastic surgeon in Manhattan specializing in mommy makeover surgery, breast surgery, and body contouring. He was named to Newsweek’s America’s Best Plastic Surgeons 2026 and has co-authored authoritative peer-reviewed publications on combined breast surgery and abdominoplasty and the surgical care of postpartum patients.

Originally released July 5, 2020. Show notes updated September 30, 2026. This is general education. Current recommendations, suitability, risks and expected results require an individual assessment.

Full transcript and related resources

Plastic surgery takes its name from the idea of molding or giving form, not from the use of synthetic plastic. In this episode, Darren M. Smith, MD, a plastic surgeon in New York City, explains how that meaning connects cosmetic surgery with reconstruction after injury, illness or a difference present at birth.

The discussion moves from the specialty's historical roots to modern operations involving skin, fat, muscle and bone. Its central idea is that plastic surgeons work with tissue to improve form, function or both.

Key takeaways

🔎 The name describes shaping.

The Greek root plastikos refers to molding or giving form. Synthetic materials do not define the specialty.

🔎 Reconstructive and aesthetic surgery share techniques.

Reconstruction addresses missing, damaged or differently developed structures; aesthetic surgery focuses on changes to appearance.

🔎 Microsurgery expands reconstructive options.

Dr. Smith describes using a microscope to reconnect tiny blood vessels when transferring tissue, including an example involving breast reconstruction.

🔎 Craniofacial surgery addresses the head and face.

Examples in the recording include cleft lip and palate and differences in skull development.

🔎 Training can connect these fields.

Dr. Smith discusses how his craniofacial and aesthetic fellowships inform his approach to facial anatomy and surgery.

💬 Questions answered

Does plastic surgery always involve implants or artificial materials?

No. The name refers to reshaping tissue. The episode describes operations that work with a person's own tissues, including reconstructive tissue transfer and craniofacial surgery.

Is all plastic surgery cosmetic?

No. Cosmetic surgery is one part of a broader specialty. Reconstruction can address function as well as appearance, and the recording explains why knowledge from reconstructive work can inform aesthetic procedures.

Historical reference: The American Society of Plastic Surgeons' history of the specialty provides additional background on the name and the relationship between aesthetic and reconstructive surgery.

🎧 Episode chapters

00:08 — Why the specialty has this name

01:35 — The reconstructive mission

02:45 — Reconstruction and microsurgery

03:40 — Craniofacial surgery

04:26 — Aesthetic surgery and fellowship training

🔗 Related information

Explore Dr. Smith’s background and training, facial plastic surgery, breast surgery, or request a consultation with Dr. Smith in New York City.

About the host — current biography

Darren M. Smith, MD, FACS is a board-certified plastic surgeon in Manhattan specializing in mommy makeover surgery, breast surgery, and body contouring. He was named to Newsweek’s America’s Best Plastic Surgeons 2026 and has co-authored authoritative peer-reviewed publications on combined breast surgery and abdominoplasty and the surgical care of postpartum patients.

Originally released July 4, 2020. Show notes updated September 30, 2026. This is general education. Current recommendations, suitability, risks and expected results require an individual assessment.

Full transcript and related resources

The breast lift patterns discussed in this episode are the donut, lollipop and anchor lift. Their names describe the incisions. Choosing a pattern depends on the breast's anatomy and the amount of lifting and reshaping being considered, rather than simply selecting the smallest scar.

In this July 3, 2020 episode of Plastic Surgery: Before and After, board-certified New York City plastic surgeon Darren M. Smith, MD explains breast lift surgery, also called mastopexy. He introduces breast ptosis, or drooping, and the tradeoff between reshaping the breast and accepting permanent scars.

Key takeaways

🔎 A donut lift uses an incision around the areola.

The episode calls this a periareolar or circumareolar mastopexy and discusses it for limited lifting.

🔎 A lollipop lift adds a vertical incision.

This circumvertical pattern extends from the areola down toward the breast fold.

🔎 An anchor lift adds a fold incision.

The inverted-T or Wise pattern includes a horizontal component along the fold beneath the breast.

🔎 Nipple position helps describe drooping.

Dr. Smith explains the relationship between the nipple and the inframammary fold.

🩹 Pregnancy plans and scars belong in the discussion.

Future pregnancy can change the breast again, and a lift leaves scars even when they fade.

💬 Questions answered

Is a mastopexy different from a breast lift?

No. Mastopexy is the medical term for breast lift surgery.

Can I choose a donut lift just to avoid a longer scar?

The episode describes a donut lift as a more limited approach. The incision pattern needs to match the amount of correction being considered; a smaller incision is not automatically the right operation.

Will the scars disappear?

No. Dr. Smith explains that scars can become less noticeable over time, but they are permanent. Their likely position and the shape change you hope to achieve are part of the decision.

🎧 Episode chapters

00:37 — Goals of mastopexy and pregnancy considerations

01:57 — Understanding breast ptosis

02:47 — The donut or periareolar lift

04:11 — The lollipop or circumvertical lift

04:35 — The anchor or inverted-T lift

06:14 — Permanent scars and the shape tradeoff

🔗 Related information

Explore breast lift surgery, breast procedure information, or request a consultation with Dr. Smith in New York City.

About the host — current biography

Darren M. Smith, MD, FACS specializes in mommy makeover surgery, breast surgery, and body contouring in Manhattan. He was named to Newsweek’s America’s Best Plastic Surgeons 2026 and has co-authored authoritative peer-reviewed publications on combined breast surgery and abdominoplasty and the surgical care of postpartum patients.

Originally released July 3, 2020. Show notes updated September 30, 2026. This is general education. Current recommendations, suitability, risks and expected results require an individual assessment.

Full transcript and related resources

A tummy tuck, or abdominoplasty, is surgery that can address excess abdominal skin and abdominal-wall laxity, sometimes with liposuction for fat. It involves scars and a staged recovery. Early movement, returning to work and resuming exercise are separate milestones.

In this July 2, 2020 episode of Plastic Surgery: Before and After, board-certified New York City plastic surgeon Darren M. Smith, MD describes how tummy tuck surgery and follow-up were organized in his practice. He repeatedly notes that arrangements and recovery decisions vary by patient and practice.

Key takeaways

🩹 Understand the scar tradeoff.

Dr. Smith describes a low horizontal scar and a scar around the belly button for the operation discussed. Scars remain even as their appearance changes.

🎯 Plan the early support.

The episode covers anesthesia, the recovery room and postoperative nursing arrangements used in his practice at that time.

🔎 Drains have a purpose.

He explains that drains remove fluid during healing and discusses monitoring before removal.

🩹 Recovery happens in stages.

The conversation separates gentle walking, the initial recovery period, desk work and exercise.

🔎 Appearance continues to evolve.

Swelling and the tissues' adaptation to the new contour take longer than the initial time away from work.

💬 Questions answered

Does a tummy tuck leave permanent scars?

Yes. The episode emphasizes that scars are part of the decision to have surgery. Their location and visibility should be discussed before choosing the operation.

When does Dr. Smith describe returning to work and exercise?

In this 2020 recording, he gives examples of about two weeks before desk work and four to six weeks before regular exercise, while emphasizing individual clearance. These historical examples are not instructions for your own recovery.

When is the final contour apparent?

Dr. Smith explains why the early appearance is not the final result. He describes changes over six months to a year as swelling settles and tissue adapts, rather than promising that everyone follows the same schedule.

Preparation note: Obtain current written fasting, medication, drain-care and activity instructions from your surgical and anesthesia teams. The recording describes an older practice protocol, not instructions to follow independently.

🎧 Episode chapters

00:28 — What a tummy tuck addresses

01:49 — Incisions and the scar tradeoff

02:43 — Anesthesia and the day of surgery

04:15 — Recovery-room assessment and early support

06:49 — Early healing, drains and activity

08:31 — Why the contour keeps changing

🔗 Related information

Explore tummy tuck information, preparing for plastic surgery, or request a consultation with Dr. Smith in New York City.

About the host — current biography

Darren M. Smith, MD, FACS specializes in mommy makeover surgery, breast surgery, and body contouring in Manhattan. He was named to Newsweek’s America’s Best Plastic Surgeons 2026 and has co-authored authoritative peer-reviewed publications on combined breast surgery and abdominoplasty and the surgical care of postpartum patients.

Originally released July 2, 2020. Show notes updated September 30, 2026. This is general education. Current recommendations, suitability, risks and expected results require an individual assessment.

Full transcript and related resources