As a plastic surgeon, I see patients who have lost amazing amounts of weight through bariatric surgery and have used this to champion new lifestyles which can eliminate diabetes, hypertension and sleep apnea. Often these patients can discontinue all medications previously taken under a physician’s care. Unfortunately, post-bariatric surgery patients, who are otherwise healthy and active, find themselves prisoners in their own fortresses of hanging flesh.
People feel better, but they don’t look better because of the excess skin on their faces, arms, breasts, abdomens, flanks, buttocks and thighs. Many bariatric surgeons try to provide surgical rejuvenation procedures themselves, leading to less than desirable outcomes and even unnecessary deaths. Plastic surgeons have additional training and expertise and are uniquely qualified to provide patients with a “get- out-of-jail card” from their excess skin. The important principles of body contouring procedures can only be learned in a plastic and reconstructive surgical residency.
What are the procedures that can help you look and feel better?
A total body lift is usually broken up into three distinct procedures, each one taking 6.5 to 7 hours to perform. These are complex and nuanced procedures that necessitate a tremendous amount of skill to remove and reshape the skin. This operation is a life-changing event, and everyone is universally very happy.
1. Circumferential lower body lift with gluteal augmentation: The first procedure I routinely begin with is the circumferential lower body lift with gluteal augmentation with vascularized flaps from the flank region. Upon completion of this surgery, I can make better aesthetic judgments about the breasts and legs. The lower body lift is actually three separate operations performed at the same time: a tummy tuck and flank-plasty with lateral-thigh repositioning and gluteal augmentation utilizing skin from the muffin top and positioning the tissue into the gluteal region to enhance the buttocks.
Despite the long surgical time and the complex number of procedures performed, I almost always send patients home that night. They actually do much better at home than staying in the hospital. All incisions are closed deeply, so no sutures need to be removed. There are four drains, which stay around a week. We utilize a pain pump with a long acting local anesthetic to block pain response. Everyone gets a blood thinner for five days to prevent clots. It generally takes around two weeks to start feeling better.
2. Upper body lift (bilateral brachioplasty with lateral chest wall reshaping and breast rejuvenation): The next procedure is usually a combined upper arm and lateral chest wall contouring (otherwise known as an extended brachioplasty). This surgery is often blended with a breast lift with or without an implant. The brachioplasty is a one-stage procedure with very few complications, and patients love the results. The breast rejuvenation is almost always a two-stage procedure, because the tissues after weight loss are quite complex. If the residual breast tissue is very thin, it may require an implant to help create shape and volume during the second stage.
3. Medial thigh lift: The final surgery is typically the lateral thigh lift. In most cases, we perform aggressive liposuction in the area of the medial thigh, then resect the loose tissue left after the liposuction. The incision spans from the knee to the groin crease on the inner aspect of the leg. This allows us to transversely tighten the skin in this distribution for a much smoother, firmer look. Patients can resume fairly normal activities in a week. It’s a transformative experience to feel comfortable in shorts, dresses and pants by unburdening yourself of loose, hanging skin.
If you have lost significant weight from bariatric surgery or by other means and are experiencing the difficulties of carrying around excess skin that is adversely affecting your quality of life, please contact me at 865.218.6210 or go online to thelucascenter.com to begin your three dimensional rejuvenation today.