 So, just a little anatomy as we go along, you guys can see me cutting with an electric pen, but this white thing is called Scarpus fascia. It's a fascia before we get to the deep fascia, which is on top of the muscle, but it's very well developed in her. That's very good. That's what we use to grab, to close the deep layer. Good morning everyone. We're starting our tummy tuck as usual. We isolate the belly button by going around it, as you know. We talk about this many times. The belly button is on a stalk and it's in a fixed position. It can go up and down a few millimeters, but that's about it. You can't move it from place to place unless you're doing what's called a floating belly button. And it's not a favorite of mine to do a floating. Some people do, but it's not my favorite thing because it can make the belly button come down too low. So, we always isolate it in the place it's supposed to be, but it comes out through a different part of the skin. So, one of the first things we talked about was lifoing the pubic area. It's very important to take this fat out, because if not, you have fat cells here that'll grow at a proportion with the rest of it and you'll get like a little muffin. So, what we do is we blend it in just enough so the number of fat cells is decreased. So, we can see the patient has a scar here. We're just going to go right below it so she'll only have one scar. Her scar is from here to here, but we're going to go about a centimeter and a half below and make it just one scar. So, just in a little anatomy as we go along, you guys can see me cutting with an electric pen, but this white thing is called Scarpa's fascia. It's a fascia before we get to the deep fascia, which is on top of the muscle, but it's very well developed in her. That's very good. That's what we use for to grab, to close the deep layer. So, we have a couple of lessons to learn here today. Number one is although she's very thin and she's very even on both sides, you remember she had an abdomen that looked protruded. You could see it was because of the muscle, as I told you beforehand. She needs that internal plication to tighten her muscle. So, although she's very thin, she looked like she was bigger because the flooring wasn't flat. So, once we make the floor flat, then when we lay the skin on, it's going to be nice and flat. So, we're going to start with the plication. You can see how loose she is, and after we tighten her, then you can see how nice it will be. She did have lipo before, and you've seen us do where ladies are about two inches thick. Look at how thin she is here. She is about 0.7 centimeters. 0.7. Look at that, maybe on this one, maybe a centimeter, but she's no bigger than a centimeter. Look at that, that's how thick she is, 1 centimeter. So it's not that she's thick, it's because of the bottom, it's not flat. So, today we're going to put the internal corset and flatten her out at the bottom. Okay, everyone, so we finished it, look at how much tighter the abdomen is right now. It's not as floppy, and it's flat. There we get all the bleeder, there's the muscle, you see the muscle fasciculate? So you see that, that's the muscle fasciculation. So we're right over the rectus, the six-pack muscle. We did a double layer suture, and look at how nice and smooth and even it looks. So now when we put the skin over, she's not going to have that pregnant look. She's going to be very flat. We've already tagged the belly button, you see it's on the stock. You can't really move it, but only a few millimeters. So we know where it is, and we're going to bring it through the skin. Stay tuned. Okay, so here we are at the point of taking out the skin. We measure twice, right? We have two different ways of measuring. Here's one, we see the length we're taking out. We're taking out this much, which equals to, let's see, that's 15 centimeters and about 17 and a half centimeters, so we're ready to excise the skin. Here we go. Look at how thin this is compared to the one we did last week. Last week ours, our flop was about two inches. Today we're talking about less than a centimeter, because she's had the previous light bulb by yours truly, of course. So here we are measuring the skin on this side. It's about the same size as the other. So she's going to lose part of her tattoo. You can see the stem is going to be partly cut off, but that's part of surgery. That shows you how much we have lowered her skin, so we're going to cut that off. So this is the sternal bone. We talked about the sternal bone, the xiphoid, and here is our incision. Now the rule of the thumb is that I already know where the thumb is, that's where I want it. So the measure of the xiphoid, so she's about 29 centimeters, and two-thirds down the xiphoid should be your abdomen, so it's two-thirds, one-third. So around from here to the xiphoid, we want to be about 18. So here's 15, 16, 17, 18, right at the point. And you want this to be around 8 to 9, perfect. So we're done with the case. Look at how beautiful it looks. Her incision is limited. We put it very low. We took out the other one. As I told you, she lost part of her rose. Now, interesting thing is, you can see the belly button is a little bit different color than the rest of the skin. You might ask why that is. Just remember, we took off the lower skin, and the lower skin because it exposed more to sun, the belly button becomes a little darker than the skin up top when we pull it down. So that's another way you can tell a little bit of a difference is all, usually the belly button is a little bit darker in a tummy tuck patient because of more exposure to sun. So that's it for today's video. Thanks for watching. I'll see you in the next video. Bye.