Tag Archives: stomach fat loss

What is a reverse abdominoplasty, and who needs it?

Reshaping the contour of the abdomen is frequently requested in my office consultations. The most common techniques are various forms of liposuction with or without an abdominoplasty. Another tool in our repertoire which can yield effective results is the “Reverse Abdominoplasty.” The classic indications for a regular abdominoplasty is a torso which has loose excess inelastic skin of the lower abdomen, abdominal wall rectus muscle separation (diastasis), and varying degrees of excess fatty tissue. The technique eliminates the excess skin and fatty tissue in the lower abdomen, reconnects the rectus muscle together to tighten the abdominal wall, and excess abdominal fatty tissue can be reshaped with liposuction to provide a pleasing shape. A Reverse Abdominoplasty is chosen for the individual who has loose excess skin in the upper abdomen, who generally does not have a full diastasis which is affecting the lower abdominal contour, and may have excess fatty tissue in the lower abdomen without skin excess. The technique is to start with incisions that follow the lower breast fold then cross the lower sternum to connect both sides of the abdomen. These scars generally hide very well even in two piece bathing suites. The full thickness skin is elevated down the abdomen preserving the vital blood supply on either side of the belly button. If upper rectus muscles need to be tightened this can proceed. Any abdominal fatty excess can also be corrected with liposuction at this time. The elevated released excess abdominal skin can be addressed in several ways depending on the needs of the patient:

1. If a women who has the upper abdominal skin excess and also desires rejuvenation of the breast the excess elevated skin of the abdomen can be utilized as a self-augmentation under the breast to provide added fullness and shape. This is often done in conjunction with a breast lift (Mastopexy) and can avoid the need and expense of an implant. I have even performed this procedure with a woman who many years ago had bilateral mastectomies for breast cancer and we reconstructed her with implants. She had experienced some weight fluctuation and was becoming very active and requested the elimination of her breast implants but still desired a smaller breast to remain. We utilized a reverse abdominoplasty skin excess, removed the outer skin, and placed it in her implant space to fill the void and added tissue volume and shape provided with fat grafting harvested from her back, thighs, and lower abdomen giving her a smaller but still reasonable breast shape.

2. The Reverse Abdominoplasty could be incorporated as part of a treatment plan to tighten the upper abdominal contour. After the incision and elevation of the abdominal excess loose skin, the surgeon can remove the undesirable portion and fixate the remaining tissue to the rib fascia of the lower breast fold to avoid the scars from migrating inferiorly thus preventing the exposure of the scars on the upper abdomen. I have used this as a primary surgical procedure for women with loose skin of the upper abdomen that would not respond favorably to liposuction alone. I have also used this as a secondary procedure on women who have previously had an abdominoplasty with good results but over time the lower abdomen has maintained its results yet the upper abdomen has become loose and has excess as a result of weight changes, sun exposure, and of course gravity. The excess skin can be removed providing a nice tight appearance to the whole abdomen.

3. Another situation for the reverse abdominoplasty is for a women with loose upper abdominal skin combined with previous augmentation mammoplasty in which the implants have become mal-posed and have drifted inferior and lateral to the correct position. In this case the excess elevated tissue can be utilized as a autologous (meaning from your own body) soft tissue sling to help reposition and stabilize the implant similar to an Acellular Dermal Matrix (ADM) graft without the significant added cost of the product to provide long lasting results.

One of the aspects in my profession of plastic surgery I am most proud of is the innovative nature of the field. We take problem sets that patients present to our office and we create unique methods that achieve a sound result with the least amount of surgery and the lowest costs to ensure successful and happy patients. The Reverse abdominoplasty is an example of one of these off shoot procedures which fills a vital niche in my practice.

Jay H. Lucas, MD
Board Certified Plastic Surgery, MOC 2012
The Lucas Center, Plastic Surgery
Knoxville, Tn.
thelucascenter.com

Worried about skin rolls around your bra line?
We got your back.

Skin

Many women are uncomfortable wearing form-fitting clothes, because the skin either above or below the bra line creates rolls detracting from the aesthetics of the female back. Unfortunately this can occur at any age. Spanx may hide the problem, but who wants to wear tight undergarments during warm weather months?

Causes: The skin of the back and shoulder must accommodate the wide range of motion of the shoulder girdle. When the arms are raised above the head, the skin in the posterior upper armpit region must stretch to avoid restricting this movement. Over time our skin begins to enlarge and increase in surface area, particularly in the posterior-axillary fold region tapering towards the tip of the shoulder blade. The skin lower in the armpit region and sides along the ribs does not require expansion, but a transitional line or fold can develop and become more pronounced with gravity causing a landslide effect of the skin above. The appearance is made worse with a restrictive band of the bra traversing this region thus forming the dreaded “bra strap fat roll.”

Anatomy varies greatly depending on skin type and quality, body mass index (BMI), and age. In some cases, skin folds are very tight without a great deal of excess fat, but the skin excess is the issue. People with greater BMI scores may have a great deal of fat deposited in this region. The other extreme is the massive weight-loss patient who has very little adiposity but has a great deal of inelastic deflated skin, which hangs over the bra. Each of these types of patients requires different treatments to achieve a pleasing result.

Treatment options: If you have slight increases in fat deposits in your back with deep tight folds, the treatment of choice is suction-assisted lipectomy with the added energy source of either VASER-assisted suction lipectomy (ultrasonic energy), power-assisted suction lipectomy (PAL), which is a mechanical rotating blade effect built into the cannula, or HydraSolve, a heat and water pulsing technique that breaks down interstitial fibers surrounding the fat. All these approaches work by breaking down the ligamentous attachments between the back and the dermis of the skin combined with the inflammatory reaction of the surgical cannulas allowing a re-draping/redistribution of skin to tighten over the back and conform to the new contour.

In my opinion, the results of these techniques are superior to liposuction alone. Non-invasive body-contouring procedures such as cryolipolysis (CoolSculpting) have no mechanism to break down the fibrous insertions to the skin from the deeper fascia, thus no elimination of the tight fold lines will occur.

If you have an elevated BMI and increased adiposity of skin folds, you will also benefit from the above-mentioned techniques of added energy sources with liposuction, but a greater degree of fat removal is necessary. Increased fat volume requires a more cell removal. However, discretion must be utilized to prevent over resection that can result in loose hanging skin on the back.

For the massive weight-loss patient or the person who has a large amount of loose-hanging skin with or without added fat volume, a skin resection technique is often incorporated with a brachioplasty to correct hanging skin of the upper arms as well. My incision choice is a vertical resection of skin along the posterior axillary line angle, which is easily concealed.

If bra line skin or fat excess is detracting from the overall aesthetics of your back, you need a board-certified plastic surgeon to thoroughly evaluate your situation to determine the right treatment option to feel more confident in your own skin. Visit thelucascenter.com or call 865.218.6210 to schedule your personal consultation with me.

The bottom line on fat grafting

The buttock area has reached new levels of interest thanks to the influx of the Latin culture from South America and pop culture’s fixation on the shapely, self-absorbed Kardashians. Surgeons on the cutting edge of buttock enhancement choose to use fat grafting instead of buttock implants to avoid some very difficult complications.

Thanks in part due to Dr. Simeon Wall’s concept of tissue equilibration in body sculpting, tissue can be removed from areas of excess and transposed to areas of deficiency. For example, we can take excess areas like the muffin top and the lateral thigh and place that fat into the under-projected gluteal areas creating the idealized shape of the buttock both in terms of the outer framing and the projection.

The breast is another area where fat is very important. Most of the breast volume under the skin is composed of fat with small islands of glandular material dispersed throughout. With aging, volume in the breast is lost by glandular atrophy and some fat loss. Previously breast rejuvenation or enhancement was only thought of with augmentation via implants, with or without tissue repositioning such as a mastopexy. Today fat grafting is critical to achieving superior results. Research suggests that over 60% of breast augmentation procedures could be improved with the addition of fat grafting performed simultaneously.

Furthermore, fat that is harvested contains peripheral stem cells. The presence of stem cells in harvested fat has implications for rejuvenation medicine and the potential growth of tissue such as bone, skin, solid organs and bone marrow cells. Unfortunately, the art of marketing has outpaced science, and many clinicians are calling fat grafting to the face a “stem cell face lift.” This is a misleading statement. Much energy has been directed toward the understanding of the stem cell, but it’s not ready for prime time yet.

Plastic surgeons employ biologic tissue as our medium to create beautiful forms of living art. Fat is a wonderful way to sculpt the human body. It is truly like airbrushing imperfections in three dimensions.

Regardless of the Kardashians over-developed assets, fat grafting is worth the hype. Call 865.218.6210 today or go online to thelucascenter.com to schedule your consultation. I look forward to discussing with you the myriad of options for face, breast and buttock enhancement via fat grafting.

Plan your abdominal rejuvenation before swimsuit season starts

After a very difficult wintery month of February, we’ve finally arrived in March with the anticipation of spring and nice weather to follow. During this time in East Tennessee, people are thinking of getting their boats and pools ready for enjoyment. Are you dreading the idea of putting on your bathing suit or, even worse, shopping for a new one, because you hate the way your stomach looks? Boost your self-confidence by calling The Lucas Center Plastic Surgery for a private consultation to improve or rejuvenate your abdomen.

Giving birth to children, weight loss or weight gain, or even previous surgeries on the belly can be a significant detriment to your appearance. Don’t fret. Take control of the situation. Come see me for a thorough evaluation of your problem areas. I’ll provide you with a detailed plan to address your particular situation.

If your problem is loose skin with poor elasticity then a tummy tuck (abdominoplasty) may just be the right approach. The goal of this surgery is to remove the loose skin, tighten the abdominal wall to provide a tighter, sleeker appearance and remove excess fat at the same time. The initial recovery takes around two weeks, but you’ll need four to six weeks to be at your best again.

I’ve handpicked a dream team of warm, caring staff that will welcome you and walk you through the consultation without causing you to feel judged or intimidated. We understand how frightening it can be to come to a place and discuss what makes you feel uncomfortable and even get undressed and show a complete stranger your most-hated body parts. Trust us, nobody is perfect. Our goal is to ease your mind and provide you with a plan that will improve your look and your self-esteem in a proven fashion that is safe and effective.

So what are you waiting for? Call 865.218.6210 today or contact us online to get ready for summer!

A Lift That Gives You a Lift

At The Lucas Center, we think of cosmetic surgery as more than just a procedure. It’s a lift that gives you a lift! Boosting your confidence is our goal, from the first phone call to your outpatient care. Dr. Lucas is known for his precision and will prioritize your wants and needs each step of the journey.

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Get your confidence back! If you feel good, you are going to shine in every aspect of your life. Plastic surgery will give you a lift in multiple ways. A study revealed that 87% of patients were satisfied with their surgical improvements, including an overall boost in confidence and positive experience with the specific procedure. To learn more about how Dr. Lucas can help you feel and look your best, watch this abdominalplasty testimonial:

[Source:  http://www.surgery.org/consumers/plastic-surgery-news-briefs/plastic-surgery–lift-give-lift-infographic-1051301

Body Lift Testimonial

It is our goal to help you become your best self yet. We love nothing more than to hear customers come back and say how their lives have changed for the better since working with us.

Peggy is a body lift customer who lost more than 150 pounds and came to us to tighten up all the loose skin. She is a fabulously confident and happy woman now that she feels comfortable in her own skin. We couldn’t be more thrilled to have been a part of her journey.

Watch her testimonial:

If you have any questions about a body lift, or any procedure, please give us a call today at 865-218-6210. We want to be a party of your journey!