The Trillium Show with Dr. Jason Hall

Dr. Jessica Walker: Tummy Tucks, Body Confidence & Finding Her Calling Pt. 1 (Ep. 99)

• Dr. Jason Hall

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There’s a new surgeon in the Trillium Plastic Surgery office! And today, you get to meet her.

In this episode, Dr. Jason Hall sits down with Dr. Jessica Walker, a double board-certified plastic surgeon with extensive training in general and plastic surgery. After years of high-intensity trauma work in Detroit, Dr. Walker found her calling in aesthetic breast and body surgery, work that’s taken on even deeper meaning since becoming a mom herself.

She opens up about her personal fertility journey, balancing motherhood with medicine, and how those experiences have shaped the way she connects with her patients. Dr. Hall and Dr. Walker also discuss:

  • What makes an ideal tummy tuck candidate
  • The truth about “drainless” abdominoplasty techniques
  • Why general surgery training is invaluable for plastic surgeons
  • How motherhood changes the way surgeons think about their work

Get to know the newest member of the Trillium team and learn what sets her approach apart, both in and out of the operating room.

Follow Dr. Walker on Instagram (@dr.jessica_walker) and learn more about Trillium Plastic Surgery or book your consultation with Dr. Jason Hall or Dr. Jessica Walker here: https://drjasonhall.com/

Dr. Jason Hall:

I don't know if any of you have noticed, but we have a new surgeon in the office, and today you're going to get to meet her and learn a little bit more about what she So welcome to another episode of The Trillium Show. I'm Dr. Jason does. Hall, board certified plastic surgeon and author of the new book, Art Of Aging, which I conveniently forgot to have sitting next to me, but the link is in the bio down below, so you can go check that out. And today, I have the distinct honor to have Dr. Jessica Walker here with us so you can learn a little bit more about her and what she does. Dr. Walker is a dual board certified plastic surgeon, so we'll talk about what that is here in just a second. She did her general surgery training in Detroit, which is a lot of general surgery training, and then went to University of Louisville for plastic surgery and did additional plastic surgery training after that, so she has done a lot of training, and so without further ado, Dr. Walker, welcome to

Dr. Jessica Walker:

the show. Hi. Thank you guys for having me. I'm excited. This is my first show ever. You guys know me. I do a lot of social media, so short clips, so this is going to be my first longer show. And I'm not gonna lie, I'm a little

Dr. Jason Hall:

nervous. Long form podcasts are awesome. bit They're so much better than just the 32nd little clips. But I heard you telling a story the other day that you actually weren't planning on being a doctor, but your mom knew it from like when you were little bitty, tell me. Tell me about that.

Dr. Jessica Walker:

Yes. So ever since I was little, my best subject in school was always math. I loved math. I don't think I would love math now, it's changed. It's different, but I loved math. It was my best subject. Science was also great, and I enjoyed that as well. But going into college, I kind of went in undecided, anticipating either doing something with math or science, but I decided, after my freshman year, when I was home for summer break, my dad sent set me up to shadow a general surgeon when I was home down in Eastern Ohio. And the first day I was with this surgeon, Dr. Cross, he let me scrub into surgery to observe, and it was a bowel resection, and it was amazing to just see him take care and fix a human with his hands. And I thought that was incredible. So that's what made me decide to want to be a doctor. But my mom will always tell you that she knew since I was seven years old that I was going to be a doctor. When I was seven, my sister, my older sister, was in high school. Didn't have her license yet, so we were on our way to her volleyball game, because to watch the game, obviously, and then to bring her home, my mom stepped on our dog's ball and rolled her ankle. So my dad had to go, because he had to pick up my sister, and took my little sister with him. And I actually ended up staying home with my mom, and I was like icing and elevating her foot and taking care of her. And she knew from that moment that I was going to be a doctor, whereas I didn't know for many years later. So that's her story.

Dr. Jason Hall:

The funny thing is that when I heard you telling this from across the room, I thought that your mom stepped on the dog's balls in that you were icing the dogs. I totally missed that story, a little bit different, but still, the point is the same that you were, that

Dr. Jessica Walker:

I stayed home and took care of my mother instead of going down to watch sports and things.

Dr. Jason Hall:

So, you know, I trained in Dallas, you know, knife and gun club. What was general surgery? Training in Detroit like

Dr. Jessica Walker:

so Detroit has, everyone knows Detroit's reputation, and that's it's the same. It's knife and gun club. There is not a shortage of that every single night level one traumas. So I definitely am very well versed in trauma training, and I still feel well versed in that when I hear about things, and I can kind of predict what's going to happen, just because I did that. And I was an instructor for ATLS, which is our trauma life support that we teach. So I did get a ton, a ton of trauma. And I was in a hospital that was in East Detroit. It's now Henry Ford St John, but it was Ascension St John when I was there, and it you just, you're getting everything. And we were a level one trauma center. We did pediatrics, we did adults, so lots of trauma, but I felt very well rounded that had I left the program and not done extra training, I absolutely could have been a general surgeon with my eyes closed. I mean, that's and you don't hear that often. I feel like most surgeons nowadays do extra training, but I fell in love with plastics in my third year, and I knew that was my calling. So I chose to do that, and I matched it my number one choice, which was Louisville, and that's actually where I met my husband, and I tried to convince him to go back to Detroit. I would have went back to Detroit in a heartbeat. I loved I loved Detroit, and I love the surrounding areas and just the state of Michigan, and as a whole, it's a beautiful state to live in, but I. Knoxville is where he's from, and that's kind of where we decided to move back to because I fell in love with the mountains and just the area once

Dr. Jason Hall:

We all follow your Instagram account, which is awesome, by the way, if you don't follow her, you need to follow we'll put her we'll put her link in the bio down below. But you seem to have entered with all the orange and white and the Tennessee Vols, you seem to have have integrated pretty well, especially during

Dr. Jessica Walker:

football season. Yes. So my husband and my brother in law both went to UT, so the whole family are all in lots of aunts and uncles and things like that. My in laws, I was born and raised on Notre Dame, so I am also a Notre Dame fan. On the side there, they're having a we'll just call it a questionable season right now. But I just love college football as a whole. I also watch professional football, but I tend to lean towards college as well. But as you and I both are, we are both another sad team right now. Are the Steelers, but they're winning. As I walk in this room, they're still winning.

Dr. Jason Hall:

They're winning. They don't have an offensive line, they don't have a defensive line, no, but they're still winning. So we'll, you know, we'll let Aaron Rodgers ride off into the sunset with the Steelers.

Dr. Jessica Walker:

Hopefully that's what he chooses to do and not keep going. But no, my Steelers in my brain is Jerome Bettis, the last Super Bowl, which was in Detroit. That's what my terrible talent is. Is that Super Bowl era? And that's my always thought of the Steelers. Is that team.

Dr. Jason Hall:

So, yeah, that's, I have a picture on my wall of that game. We were, we were at that game because we, you know, my my dad grew up in Pittsburgh. This is nobody watching this actually really cares about you're not watching this for football, but the Steelers have been a lifelong passion having my dad grew up there, and so that has been, everything has been black and gold. So it's good to have another Steelers fan in the office too. Now my wife doesn't have to listen to it. I can talk to her about it. So shifting gears a little bit. One of the, one of the things that we started talking initially about was kind of breast and body contouring that seems to be something that you you are, your results are certainly fantastic and something that you really enjoy. And specifically with abdominoplasty surgery. What is it about that that kind of drew you to it? Why do you like it?

Dr. Jessica Walker:

So it's a little bit hard to describe. I just, you know, I enjoy doing face, and I can do face, you know, blefs, face lifts, things like that. But as I was doing the surgeries, I'm like, I just don't enjoy this as much as I do like doing breast and body contouring. And I don't know if it's now being a mom and having had a C section, I'm breastfeeding right now. So my changes in my body is what 90% of my patients are going through and telling me about. So I think I feel that I understand them and can help get them back to that body pre baby, because that's, I mean, your body, it's amazing what the body does and what it goes through. And now that I've seen that, it just makes me want to help them regain that confidence that they used to have, and bring them back to that pre baby. So I think it's kind of a combination of, I like what I like to say is macro surgery. I like big surgery. The face is very tiny movements, tiny surgery. I like macro, seeing big results, and then now that I can relate to my patients on that level, I feel like I'm helping them. And that's what I like to do. They're very thankful, and they they're very realistic in their goals.

Dr. Jason Hall:

And you were, you were very public about your challenges conceiving and with your you know your whole pregnancy journey is out there, on on social media. How has becoming a mom kind of changed your perspective with surgery, so with plastic surgery itself.

Dr. Jessica Walker:

So yes, we were I wasn't open as I was going through it, but there was a time where I was like, I need to tell my patients, because I had to cancel things, you know, I had, we got pregnant initially in the Fall of 2022, I told my husband I was pregnant the day after Christmas, and the day after that, I had a ruptured ectopic. So it was an ectopic pregnancy, and then I subsequently got pregnant after that, and miscarried, and then got pregnant again, miscarried, and at the same time, my husband was actually diagnosed with kidney cancer. So it was all just a lot going on. And then we met our fertility doctor. My husband is now in remission. He is doing phenomenal. We met our fertility doctor. I did end up having to do IVF, and it was basically because I'm older, and there's actually studies that do show that female surgeons, specifically female plastic surgeons, have higher rates of infertility. So I kind of anticipated it, but now our first embryo transfer turned into our perfect, perfect going through a four month sleep regression right now, perfect baby boy, and I love him, motherhood, you know, going into it, I was like gung ho, surgery career, and as soon as I saw that baby the first time after surgery, I completely understood why people want to be stay at home moms like that. He is the love of my life, outside of my husband and my German Shepherd, and I would do anything for that baby. So I feel like I understand a lot now it's just it's changed my whole perspective and outlook on life and career. I mean, I love my job, but it's nice to get done early one day so I can go pick him up early and hang out with him and do those things. So it whereas before, I was like, All right, let's work. Let's do this 6am to 8pm let's keep going. And now I'm kind of finding that work life balance. So it's been great.

Dr. Jason Hall:

That's something that medical training, certainly surgical training, doesn't prepare you for. Is the is getting married, having kids, and having to integrate those two very different worlds. Because you're right, it's, it's the just like any job. I mean, I think, you know, friends that do investment banking and that Do you know, say, Oh, they're in sales and running big sales teams. The work is always there. There is always an opportunity at nine o'clock at night to be working or to stay in the office until nine o'clock at night. But I think having family, you know, being married, having children, especially kind of puts a somewhat of a balance on, you know, when

Unknown:

you want to be home. Now, the

Dr. Jason Hall:

problem with us is that medicine is not exactly a non you can't just, like, turn it off and, you know, pick it up back the next morning, something happens. We got to be there, right? And that's the that's why it's nice having multiple people in the same group to be able to kind of watch surgery.

Dr. Jessica Walker:

You know, the acuity of our patients. You know we're doing procedures on them, so if something goes wrong, somebody needs to be available. So I feel like even though our you know, our hours to say simply, are better in a work life balance. I feel like I'm still on 24/7 for my patients. I answer them when they message me through social media, or if they call the office, we're always calling them back. We have to be on that 24/7 but it's definitely I've learned kind of like what you explained that unless it's obviously an emergency, like things in life, they'll happen eventually. You got to slow down, be where you're at at that time, and not stress over things that don't need to be stressed about.

Dr. Jason Hall:

And you've you've reached this so much that is so much earlier in your career than I did. So congratulations to that. Let's talk a little bit about procedures. Specifically we kind of alluded to earlier, specifically abdominoplasties, because you and I do things a little differently, and kind of talk to me a little bit about the ideal tummy tuck candidate. Okay,

Dr. Jessica Walker:

ideal tummy tuck candidate. You know, what we do is elective surgery, so we really want to optimize the health of our patients. There's nothing that we do that has to be done. And I would never tell a patient they need to change something about themselves. I think everyone's beautiful. If you want me to help you, I'm here to help you. So the ideal tummy tuck patient, you know, really we like BMI, is kind of a it's a tough number to use, because, you know, muscle weighs more than fat, and sometimes that can play into it, and it's really based on physical exam, but we do like the BMI usually to be less than 30, because studies have shown that there's more complications over that somebody who is taking care of themselves, you don't want to go in and do this big surgery, and then they go and do the opposite thing and gain weight or do things afterwards that's going to counteract what we're doing. The other thing too is you really want to be done having kids. If you're planning to have children, and you want to have this type of surgery, you really want to be done having children, because we do do a muscle repair after this, and that what we call a diastasis, so the separation of the muscles from having babies. So you really want to make sure you've honed in, you know you're where you're at, health, diet, exercise wise, but also based on your medical history, that you're safe to have elective surgery. So those are kind of the key things we talk about with our patients, is their health history, their surgical history, and what their goals are, and where they're at in their life, if they're ready to have this surgery done,

Dr. Jason Hall:

what's what is the, what is the big deal with the muscle repair? Why? Why are we, why are we waiting on that, on people to get done having children before doing a muscle repair?

Dr. Jessica Walker:

Yeah. So for me, I think it's less so the muscle more so the fascia, which is the fibrous covering of the muscles. So when you get pregnant, you know your uterus enlarges and it stretches out those muscles in that fascia. Unfortunately, the fascia is not elastic. It doesn't bounce back. So when you're when your uterus goes back to normal size after you're done having children, the fascia does not snap back. You're never going to have that pre baby body like you used to, no matter how hard. You try at the gym, the muscles usually have laxity to them, and that's what we call a diastasis, mainly of the linea alba, which is the fancy term for the fascia that's right in the midline. So when we go in there and we raise the fat and muscle, or excuse me, we raise the skin and fat off of your muscle, we can see the looseness. We can literally tap on your belly, and you see how loose it is. And then we go there and we tighten up, kind of a football shape that closes into a straight line, and then you tap on that belly and it's you, can, we say, bounce a quarter off it. It's nice and tight. And that's what we like to do. That's why I want to make sure you're done having children, because that can get re stretched if you have kids after having a tummy tuck. So that's the big thing, in my opinion. That's the biggest part of a tummy tuck is fixing that muscle laxity.

Dr. Jason Hall:

How difficult is it if, say, if, if somebody thinks they're done having kids and then has has an abdominoplasty and then has an oops baby, how difficult is it to fix that again if it stretches back out?

Dr. Jessica Walker:

So it just depends. Some people actually, after they've had their muscles fixed, do actually go back pretty tight if they have an oops baby. Other things though, that can play into it is, did the skin stretch as much as Do we have enough skin to take out again and redoing a whole tummy tuck, or do we just need to go back in and fix the muscles? So it all really depends on timing. You know, we usually don't recommend doing a tummy tuck until you're a year out from having kids, so the body can bounce back as much as we possibly can get it to, and the scar tissue, what you build up, how far it's been from your last tummy tuck. So it's definitely a little harder than a fresh tummy tuck, but it can be done.

Dr. Jason Hall:

Sounds like there's a lot of variables, a lot of ifs, a lot of ifs in the redo. So just if there's a lot of ifs, if you hear your surgeon saying there's a lot of ifs and a lot of variables, then it's probably redos. We want to avoid those as much as possible. Absolutely, yes. So when we're, you're doing an abdominoplasty, you're, you know, lifting up all that skin to be able to see the muscles, you create a lot of empty space. And that's typically, I've been doing this for a while. That's where the drain goes, and that's why, you know, the tummy tuck is that one procedure where, you know, even though most of them, we don't use drains anymore, I still use a drain. You don't, I don't talk to me brainless surgery, talk to me about

Dr. Jessica Walker:

that? Yes, so, and that's a big thing, I think it's definitely up and coming. There's definitely still surgeons who use drains. I don't think it's unreasonable, but in my hands, so when we do a tummy tuck, like I mentioned before, we raise the skin and the fat as one unit off the muscle. So we're cutting all those attachments. So what he mentioned is, we're creating what we call dead space, or where, when we lay the fat back down on top of the muscle, we're not recreating those attachments so there's space for fluid to fill. So traditionally, we usually leave two drains. I know, I believe you only one drain. Now we used to leave two drains and we would take those out. We would take those out, usually three to four weeks after. You know it has to be below a certain amount coming out before we take those out. But what I do in surgery is I recreate those attachments. I do something called progressive tension sutures. So as I'm laying the skin and fat back down on the muscle, I'm placing sutures to reattach it back down. So there's no space, space for fluid to fill. So in my hands, from what I have seen I you know, I did with drains during residency and fellowship, without drains. Now, as an attending, you can still get a seroma, which is what we're trying to prevent, is that fluid buildup in that space after either of these procedures. But what I have noticed is I see less postoperative seromas doing the progressive tension suture technique in my hands. And the other thing too is patients hate drains, and I hate drains, so that way we can avoid that excess having to have a drain after surgery. Now there's definitely times where I do leave drains. I have left drains and tummy tucks when you go in, and there's a little bit of a surprise that you weren't anticipating. You can't place those progressive tension sutures. You definitely still have to leave a drain. But that's kind of the technique that I have worked on, and that's what I've been doing now for over three years.

Dr. Jason Hall:

Does not leaving a drain depend on how much skin you're removing, how long an incision you have to leave, how much liposuction you Is there something that kind of goes into that decision, or is it? Is it everybody?

Dr. Jessica Walker:

I would say for it's not everybody, but it's the majority of patients. For me, I would say the times where I would potentially have a drain is obviously, if I find something that I was not anticipating. And then I would say with high volume liposuction, because to do liposuction, we actually put fluid in to take fluid out, and high volume liposuction does create more swelling. So if you can predict the amount, if it's going to have a lot of swelling, then I do still think there's a role for a drain to help keep the swelling down, because that's going to put tension on your incisions. So there is still a role for a drain, I would say for me, when it's skin work, like the tummy tuck or a body lift, I don't lean towards drains. I lean towards drains. If there's a surprise. Or if I'm doing high volume liposuction with the procedure,

Dr. Jason Hall:

okay, so even with body lift, so like the tummy tuck that goes all the way around, you're not putting drains in

Dr. Jessica Walker:

those. No, I don't. I just make sure that you really close down that space that you've created so there's no space for fluid to fill. So I bet people love that. They do. That's awesome, and it's I my nurses love it too, because they don't have to help me with drains in the office and all those things.

Dr. Jason Hall:

Oh yeah, our office staff really enjoy not having nothing to do with drains and and coach people through the process of getting rid of those things.

Dr. Jessica Walker:

But when I talk to my patients, I you know, I tell them I do drain list, but I always say, if there's something abnormal or I find something I wasn't anticipating, I will leave a drain. I will always do what's safest for you. And if leaving a drain is safer, I will do that. But majority time, no,

Dr. Jason Hall:

you mentioned finding a surprise. What? What? What are? What's an example of a surprise that would make you want to leave a drain.

Dr. Jessica Walker:

Large hernias, if there was a hernia that we weren't anticipating that, you know, hernias pop out like a little balloon, but sometimes they go back in, if we can't feel it on that initial exam. Sometimes, if you find a large hernia that would again, or if I do high volume liposuction, the one patient that I did have to leave drain on, she had kind of almost an incomplete hernia. You know, a hernia by definition, is a defect in the abdominal muscular or abdominal wall. And she had her from previous lower abdominal surgeries like hysterectomy C section, her anterior there's layers of the abdominal wall. The anterior layer was intact, but I could see everything below that, the muscle behind it wasn't intact. So I did not feel comfortable, because with progressive tension sutures, you're placing stitches with needles. I did not feel comfortable doing that for her. So drains it was, and we actually ended up not fixing her muscles either, but she ended up still having a great result. So there's it's just, I would say being a general surgeon first has absolutely helped me in doing abdominal surgery, because I have been inside the abdomen, and I know how to treat things inside the abdomen, or what to predict for things. So I definitely think that has helped me in doing drain and drainless surgery.

Dr. Jason Hall:

Yeah, I think, I think the general surgery training is very important to have that first of all, to have the experience before getting into plastic surgery that you've you've had that experience really taking care of sick people, doing big operations, and knowing what could go wrong.

Dr. Jessica Walker:

Well that, and I think for us too, you know, we operate on a lot of massive weight loss patients, and talking about a ruin y versus a sleeve versus, you know, all those different duodenal switch we learned how to do those procedures as a general surgeon, so I know what the deficits are when it comes to their nutrition levels and things like that, and what part of the stomach was removed or what part was skipped and bypassed. So I think that helps us, for us learning the nutrition and what we need to work up before we work on a massive weight loss patient as well. So general surgery has definitely played a huge role in our careers.

Dr. Jason Hall:

No, absolutely thankful for it, even it's five years that was awfully long sometimes, but, but, yeah, I wouldn't, totally wouldn't trade it for the world. No, but getting back to the to your abdominoplasty techniques, how does does not having drains impact patients, a patient's recovery? What does recover? Typical recovery like for your patients?

Dr. Jessica Walker:

So typical recovery, the biggest thing is compression garments. That helps with post operative swelling, to help tension, take tension off of our incisions. Usually you're sitting at about 45 degrees after surgery. That's done by design. That's how a tummy tuck is done. We do that. We sit you up to take off as much skin as we possibly can. So you actually walk a little bit hunched over for a week or two. Eventually the skin will stretch. It always stretches, no matter how tight we make it, and you will stand back upright. So I usually recommend, depending on the type of work that you do, up to three weeks off of work, and then really, six weeks of no heavy lifting, nothing more than 10 pounds, and no core exercises, because we've worked on that muscle. And then with drains. You know, when drains are in, we want the output to be of a certain value for 24 48 hours before we take the drains out with me without doing drains, that's one less thing that we have to worry about. But you know, we always have to watch for seromas. Either way, when you take a drain out, you have to monitor for a seroma. And if I do drain less surgery, you have to monitor for a seroma. If that happens, that's something that you and I both take care of in the office, but you do have an ultrasound in the office to help with that, to help remove those seromas. So recovery, I would say, for a tummy tuck is the longest recovery, just because, mainly of the muscle work and secondary usually, we accompany liposuction with a tummy tuck,

Dr. Jason Hall:

with with abdominoplasty surgery. You know, I kind of think about it like three, three parts of it that we're taking care of, you know, we're taking care of the skin, we're taking care of the fat, we're taking care of the muscle of those three. Me, which one of those three do you think gives most people the biggest result, if you had to pick one, if you can only, only, only get one, if I

Dr. Jessica Walker:

wanted to pick one, I mean, it's really patient based, but I would say a lot of women, not the majority, but a lot of women, and me, I'm in this boat now, have had C sections in the apron belly where the shelf is having that C section where the scar is tethered, it really bothers them. So I would say the biggest thing for the majority of my patients is skin and taking off that overhang in the lower abdomen. Second, I would probably say muscle, the diastasis, the core weakness. A lot of people don't realize that they have it, and you can see it kind of when you turn to the side. To the side and bend forward and don't flex, you can kind of see it hanging down. That's what we tighten. But I would say that C section, and it's me right now I, you know, I have definitely have a diastasis. I can actually feel it, but I hate the C section shelf, and that's what I'm trying to work on. But, yeah, skin for me, for you,

Dr. Jason Hall:

it very, very similar to what you're saying. I think it's very patient dependent. I think the for women who don't, who haven't had C sections, or haven't had any previous surgery, the muscle is actually the biggest, the biggest problem, because you you hear women, even women who have had C sections, complain that they go to the gym and they work out and they work out and they work out and they can't get their stomach flat again because of that muscle laxity. And I think that that, that that's, that's what makes it hurt so bad to fix, but I think it also is kind of restoring that core strength, and that core shape is huge, but it is like, you're right.

Dr. Jessica Walker:

Yeah, there's plenty of women who don't have a ton of skin laxity, they bounced back really nice, didn't have a ton of stretch marks. And I like to call those a skinny tummy tuck, because they still need a tummy tuck because they need their muscles fixed, even if they don't have a ton of skin to remove the muscle is absolutely has to be done. And I wish I could explain that to everyone over and over, even though you've lost the weight, you look thin, but the gym is just not going to do it, that fascia stretches and it just does not bounce

Dr. Jason Hall:

back. Yeah, and the thing that the conversation that I find to be the most difficult with those patients, the patients that don't have a lot of extra skin, but we're doing mostly muscle work. Is that extra scar? Could you explain that for people, I see

Dr. Jessica Walker:

you're holding your hands up and down, so you're talking about the vertical scar. So the what happens when we do a tummy tuck is we keep your belly button where the stalk is, or the inner part of your belly button stays attached. We make an incision around it, and we pull the skin down and cut off the excess, make a new hole, because the upper abdominal skin gets pulled down and bring that stalk back up through a new hole. Now in someone who doesn't have a ton of lower skin excess. When we pull it down, that hole that we made is going to move down, but it may not come all the way out, so you may end up with a small vertical incision, which is the old umbilical site. So in my patients, who I can try to predict that on, I always try to mention that beforehand, because you don't want it to be a surprise. They're like, Oh, why do I have an extra incision? And usually we can kind of tell who is and who isn't going to have that extra

Dr. Jason Hall:

scar. Do you find they heal pretty well? Yes,

Dr. Jessica Walker:

and no. You think it would heal really well because it's very small, but you're turning a circle into a into a straight line. So they tend to have a little bit of dog ears, I see. And then it's also kind of the tough part of the abdomen is what we when we talk about, you know, wound healing issues. And skin healing issues is between the belly button and the pubic area. That's the least. That's the skin that's getting the least amount of blood supply. So sometimes I do think people have a little bit more wound healing issues

Dr. Jason Hall:

with that incision the I think that's one of the things with with plastic surgery, that is, it's important for patients to understand is that all of the stuff that we're doing it, we're really pushing skin to its absolute limits. Yes, and there are there tips and tricks that you can you have for your patients to kind of get them ready for surgery. So we can get, we can kind of push that limit a little bit more

Dr. Jessica Walker:

Absolutely. You know, obviously it's always great if you work out and being in your healthiest form. Secondly, absolutely. And I can say this over until I'm blue in the face, and you've seen it on my social media a million times. No smoking, no nicotine, specifically, nicotine it causes so that includes, like, nicotine products. So Nicorette, anything like people think vaping is safe, but it still has, if it still has nicotine in it, nicotine is the issue. I'll let your primary care doctor talk to you about all the other bad things. But for us, nicotine causes vasoconstriction. So vaso means vessel constriction, means to narrow. So you have these nice, big, healthy blood vessels that go down. Down to about 1/8 the size, so you're not getting good blood flow to heal those incisions. So smokers, and even if you pick smoking up after surgery, I've seen patients in residency and fellowship training who have healed their incisions have healed, they pick back up smoking incision breaks down, and it's 100% the nicotine. So that's one big thing. And then optimizing nutrition, I would say, you know, increasing your protein intake and just mentally getting ready for surgery. But I would say smoking is the biggest thing.

Dr. Jason Hall:

So let's talk briefly. The the subject no one wants to talk about with any plastic surgery is complications. Yes. So what we talked you've mentioned seromas. Talk a little bit about tummy tuck complications?

Dr. Jessica Walker:

Yeah, absolutely. And I actually just did a whole obviously, on social media. It's short videos, but a short series on complications, because I don't think people talk about it enough. And obviously I always caution my patients, when you're looking at befores and afters online, every surgeon, myself included, is always gonna we're gonna we're gonna want to show our best work. So we're not going to show those patients who have had issues. But with tummy tucks, you know, any surgery that you have, there's always a risk of bleeding. Bleeding, I find, is less than 2% of the time in cosmetic surgery, because, again, we're optimizing our patients. They're younger, they're healthier. We're not going to operate on somebody who it's unsafe to operate on. So bleeding less than 2% of the time. But it does happen. Wound healing problems, wound infection, I usually mention it's higher in smokers and diabetics, but it technically can happen to anyone. So that's something I always mention with my patients. You mentioned pushing skin to the limit, we can always have what we call this, the scary word necrosis, which is skin death, and the skin can die. Or when we're doing breast surgery, the nipple can die, nipple necrosis. The good thing about being a plastic surgeon is we are, especially when you're board certified, you've done the formal training, you know how to fix all those complications, or at least help the patients get through them, do the wound healing, and we have options to correct what has happened. Other things with the tummy tuck, if you're doing liposuction, you can have contour regularities or asymmetries. Incisions can have asymmetries. No matter how hard we try to keep the incision perfectly symmetric on both sides, nobody is symmetric. Every time somebody stands up, I'll point out and be like, Did you know your right shoulder is a little bit higher than the other one? And people don't notice these things until we point them out. But you can always have asymmetry. After surgery, you're going to have numbness to the abdominal wall that is going to take a long time to heal. Nerves only grow about a millimeter a day, and so sometimes that can actually be permanent between the belly button and the pubic area, that's the furthest place the nerve has to travel to, and sometimes it doesn't make it all the way back. And then the big, scary complication that I always mention, because, again, I think it's better to be informed than to be not informed is with liposuction, there is a small chance that the cannula can go into the abdomen and into the chest and it can injure an internal organ, which can require a hospital stay, and it can require a much bigger surgery. It's extremely rare that that happens, but it can happen, it can happen to the best of us. So I don't mean to scare my patients, but it's a big surgery, and I think that they should be informed on what they're making a decision

Dr. Jason Hall:

on. Oh, absolutely, absolutely. And I think that that brings up something that I think we need to, we need to sit down and do one of these, just about liposuction, because that is, that's one of the things that isn't talked about much, but is def definitely happens. Well, you you made it to the end of your first show. So we're, we're here at the point where we're wrapping up. So tell everybody where they can learn more about you and our practice.

Dr. Jessica Walker:

Yeah, absolutely. So obviously, I am on social media. I my Instagram. Instagram is kind of my primary I do also do TikTok, but everything that's on TikTok is on my Instagram. So my Instagram is Dr dot Jessica underscore Walker, and then you can always obviously check us out on our website at trilliumplasticsurgery.com, so or drjasonhall.com and both of them will take you there. All the links will be, it will be in the show notes. Yeah, absolutely. And, and then on TikTok, I'm Dr. Jessica Walker, there's no underscore, but we like to have fun. I somewhat make the girls at the office do it with me. I don't force you to do it with me, because he always says, He always says, but we like to have fun. But it's amazing that I did all this training just to make fun TikTok. But the biggest thing is I try to educate. That's that's my primary goal. I do the fun videos to help fill the gaps, to something to have something to post every day. But education is really what I like to do. So if you have any questions or anything you'd like me to talk about that I can do a short video on just shoot me a message on Instagram, and I try to try to do respond to people, and do as many videos as I can when people ask questions. Yeah,

Dr. Jason Hall:

absolutely. And her content is fantastic. So thank you very much. We appreciate you making it this far as always. If you got any questions, you. You got any comments? If you've got any ideas for future shows, shoot me an email info@drjasonhall.com, shoot me a DM @drjasonhall, we'll put all the links in the show notes. Thanks again. We'll see you next time you.