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Cosmetic and Plastic Surgery-SanFrancisco Bay Area|Marin County

Tummy Tuck Surgery, Exparel for Pain Control

October 21st, 2013 Miguel A. Delgado Jr, MD

Before and After Tummy Tuck

This is a 45-year-old resident of Napa County, California who presented to the Novato office in Marin County for evaluation for a tummy tuck. She is 5 feet 5 inches tall and weighs 135 pounds. She is a mother of two children. She underwent a full tummy tuck and tumescent liposuction of her flanks. Her surgery was performed at Marin Cosmetic Surgery Center in Marin County, California. Note the nice, thin, natural appearance of her midsection and the nicely proportioned belly button















San Francisco, CA-Abdominoplasty, also known as a tummy tuck, is one of the most patient pleasing surgeries performed. The long hip to hip resulting scar, for most women, is a small tradeoff for their new flat stomach. The only other downside to the procedure is the discomfort for the first few days. The tummy tuck procedure is not just for women, it is a very popular procedure for men as well, usually after substantial weight loss and many will have the procedure done in conjunction with gynecomastia surgery.

In the past, to ease the pain after surgery, a pain pump was used. At the end of surgery, the surgeon would place; two small catheters through the skin of the upper abdomen. The pump disperses local anesthetic directly into the surgical site and lasts for about three days. The pumps are fed by a supply of local anesthetic that is in a bulb about the size of a tennis ball. The device is kept in bag with a strap that goes around the neck. The pain pump provides relief, but the device is somewhat bulky and freedom of movement is somewhat restricted as the patient is tethered to a machine.

Miguel Delgado, M.D.

Plastic Cosmetic Surgery Specialist,
Dr. Miguel Delgado

Always looking for the best treatment for his patients, Dr. Delgado is now using Exparel for tummy tucks instead of the pain pump. Exparel is not a narcotic but an injectable slow release numbing agent injected at the close of surgery. It is a onetime injection lasting up to 72 hours, which is usually as long as the most intense post-surgical pain.

Exparel is an anesthetic that blocks the nerve impulses that send signals of pain to the brain. Exparel contains bupivacaine which is commonly known as Marcaine, and it is suspended in liposomes, which are a delivery vehicle for pharmaceutical drugs over a period of time.

Most patients tolerate the anesthetic well, but your surgeon will need to know if you have; liver, kidney, or heart disease, heart rhythm disorder or history of seizures, also if you have had a reaction to any type of anesthetic.

Patients who have had surgery using Exparel may still need some narcotic pain relief following surgery, but in clinical trials patients took about a third less narcotic pain relievers than non-Exparel patients and they seem to recuperate faster with a lot less discomfort.

The cost for Exparel is about the same as the cost for a pain pump so it is not deemed worthwhile for less extensive surgeries such as breast augmentation or breast reduction. However, for the patient who has a low pain threshold or is overly anxious about upcoming surgery, a discussion with Dr. Delgado about pain control is recommended.

In keeping abreast of the latest innovations for his patients, in addition to Exparel, Dr. Delgado now has the exciting non-surgical fat reducing “CoolSculpting” available.  See September’s blog for more information and schedule a consultation with Dr. Delgado to see if you may be a candidate.

Haute MD Brings Dr. Miguel Delgado on Board as Their Newest Member of Select Doctors

April 30th, 2013 Miguel A. Delgado Jr, MD


San Francisco, California-Dr. Delgado was selected by Haute MD  to join their prestigious directory of top physicians. Haute MD is an upscale internet publication with informative stories on the latest health and beauty trends. The online publication offers readers access to premiere cosmetic specialists around the country.

Due to his exceptional reputation and skills, Haute MD has featured Dr. Delgado as their newest member as a specialist in plastic surgery for the body, including such procedures as; breast augmentation, breast revision, tummy tuck, mommy makeover and gynecomastia or male breast reduction.

Besides having a directory for top physicians, Haute MD also gives the readers a detailed profile of the doctor’s with before and after pictures of actual patients, videos the doctors may have produced and patient testimonials.

The exclusive website delivers San Francisco Bay Area men and women intriguing articles like:
•    “Auriculotherapy Beads for Celebrity Wellness”
•    “Cupping Celebrity Health Fad: Groundbreaking or Totally Useless?”
•    “Benefits of Dead Sea Salt”
•    “Power Juice and How it Helps You”

“Haute MD connects the most trusted doctors and specialists with the country’s most discerning affluent audience. The network is an exclusive, invite only membership circle with only one representative per market for each of the nine medical specialties.”

What is the Cost of a Tummy Tuck?

April 15th, 2013 Miguel A. Delgado Jr, MD

This is a 45-year-old woman resident of Marin County who is 5 feet 5 inches tall and weighs 135 pounds. She is a mother of two children. She underwent a full tummy tuck and tumescent liposuction of her flanks.


San Francisco, California – One of the most popular cosmetic surgical procedures for San Francisco Bay Area patients is the tummy tuck. For some patients who have lost a lot of weight, men and women alike, a tummy tuck removes excess skin and fat for a smoother and flatter stomach.

For women who are finished having children, the abdominoplasty is a remarkable procedure to help them achieve their pre-pregnancy figure. In addition to the tummy tuck, a waist enhancement procedure can be added to give more definition to the waist. An extremely popular procedure adds breast surgery to the tummy tuck. This is known as the mommy makeover. The breast surgery could be a breast lift with or without implants and in some cases a breast reduction.

A standard tummy tuck usually takes 4 hours and the fee for Dr. Delgado would be about $6800. The fee for Marin Cosmetic Surgery Center would be $2800. The anesthesiologist fee is $1200. The supplies run about $1050, including a pain pump, surgical garments, VitaMedica vitamins and various other supplies. These fees are just to give an estimate of costs involved; at the time of the initial consultation each patient will be given a personalized quote.

For many it seems no matter how much dieting and exercising are done, it is not possible to get a flat, smooth abdomen that the tummy tuck procedure can provide, thereby making it one of the most patient pleasing procedures available.

New Study Shows Evidence of Lasting Weight Loss After Tummy Tuck Surgery

February 28th, 2013 Miguel A. Delgado Jr, MD

Before and After Tummy Tuck

The February issue of Plastic and Reconstructive Surgery, which is the official medical journal of the American Society of Plastic Surgeons (ASPS), states that a pilot study shows that patients who have had an abdominoplasty (tummy tuck)may have significant lasting weight loss. This is particularly true of those Marin County patients who were overweight or obese prior to surgery.

This may be due to increased satiety, feeling full after eating. The researchers also discuss possible changes in the “neuroendocrine system” by removing fat cells from the abdomen; it may reduce the levels of hormones affecting the appetite which are secreted by fatty tissues. More studies will be needed to confirm this hypothesis.

Patient Satisfaction Determines Surgical Success

May 31st, 2012 Miguel A. Delgado Jr, MD

The Journal of the American Society of Plastic surgeons, “Plastic and Reconstructive Surgery”, recently announced the results of a study of 360 patients treated with liposuction, lipoabdominoplasty, and abdominoplasty.  Lipoabdominoplasty is a term to describe liposuction of the abdomen and flanks combined with a tummy tuck.

This study was done to compare results of liposuction alone for reduction of the tummy compared to the cosmetic plastic surgery patient that had lipoabdominoplasty and just abdominoplasty from the patient’s point of view.

Before liposuction of the tummy

Before liposuction of the tummy

After liposuction of the tummy

After liposuction of the tummy


The results showed that liposuction patients recovered more quickly and had less pain that the lipoabdominoplasty and abdominoplasty patients. However, the levels of satisfaction with the results of surgery were much higher than for liposuction alone. Patients stated they had improved self esteem and improved quality of life, with 97.6% saying they would do it again and 99.2% would recommend the procedures to others.

Before abdominoplasty

Before abdominoplasty

After abdominoplasty

After abdominoplasty

Patient satisfaction is the most important factor of surgical success.


Tummy Tuck Belly Button

April 18th, 2011 Miguel A. Delgado Jr, MD

 Tummy Tuck (Abdominoplasty) is a highly successful surgical procedure with an extremely high satisfaction rate for Dr. Delgado’s San Francisco, Bay Area patients. One of the tell-tale signs of a great surgeon with a wonderful artistic eye is how he reconstructs the belly button. The belly button is an exposed anatomical feature, which is attractive in the female abdomen. The goal for a tummy tuck belly button should be an “inny” opposed to”outy”. It should not be too big, it should not be too small but it should be in proportion to the size of the abdomen and the height of the patient. The scar should be of good quality and if it is not this is something that the surgeon can trim and revise to make look very nice and natural. The major component to make a nice belly button is the amount of fat that surrounds it. If there is a large amount of fatty tissue then the belly button will be deep and have a circular configuration and less attractive in general. During the tummy tuck technique Dr. Delgado does liposuction around the belly button and excises tissue and fat, however a certain amount of fat must remain due to potentially compromising the skins health. Therefore it is easier to get an attractive belly button when there is a thin fatty component around it. A good test to determine if your surgeon does a good job; look at the belly button in before and after pictures of other patients, this is a great indicator if your doctor has an artistic eye, knowledge and patience to construct a nice belly button as Dr. Delgado does.

Tummy Tuck with Waist Enhancement

March 11th, 2011 Miguel A. Delgado Jr, MD

There is almost nothing as joyful as the addition of a child to a family, but many California women are discouraged with the look of their abdomens after childbirth. It is no wonder they turn to their plastic surgeon for help, and the good news is there is a lot of help available. Once a woman has finished having all the children she plans to have, a tummy tuck is a wonderful solution to help her get her pre-pregnancy body back into shape. The tummy tuck is one of the most popular procedures among San Francisco Bay Area women.

Along with the tummy tuck, Marin plastic surgeon, Dr. Delgado offers an additional optional procedure that he calls “the waist enhancement”. This is where he tightens additional muscles, the external oblique fascia, around the waist, giving great definition!! Not only does this pull in the waistline, it improves the shape of the upper buttocks as well. Not all surgeons do this additional procedure but Dr. Delgado has found that this procedure is the “icing on the cake” for most women. For many their result is even more impressive than their pre-pregnancy shape, with the ultimate result of the body of someone who has spent hours at the gym! Compare the photos above that do not have the additional “waist enhancement” procedure, to the photos below that do.

Mommy Makeover: Body Rejuvenation for a Post-Pregnancy Figure

October 11th, 2010 Miguel A. Delgado Jr, MD

The Mommy Makeover is a procedure made popular by many  California celebrities, that entails breast surgery, tummy tuck and some degree of liposuction.  It has been popularized over the past year-and-a-half to two years due to the increasing demand for women wanting to regain their shape, body image and self-esteem.  The technique involves either a breast lift or a breast lift with a breast augmentation.  On some occasions, the patient may require a breast reduction.  However, in most cases women lose a fair amount of volume in their breasts and require either a lift or a lift with breast enhancement using an implant. At your consultation in San Francisco or Marin, Dr. Delgado will help you decide the best procedure for you.

The tummy tuck is a key note of this procedure in which the pregnancy has changed the abdomen, both in the abdominal wall as well as the skin.  For a pre-pregnancy look, the procedure entails tightening the abdominal wall and stretching the skin down to a nice, taut, contoured figure.  Liposuction of the flanks is an added bonus which gives a nice waistline.  The Mommy Makeover is a significant procedure which takes approximately two weeks to recover, but the results are amazing.  Dr. Delgado performs numerous Mommy Makeover procedures at his Marin Cosmetic Surgery Center,with beautiful results and very happy patients. Please click here to view a Mommy Makeover video of Dr. Delgado’s patients.