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What is a full body lift / body contouring?
A significant amount of weight loss over a very short period of time, it can happen over an
18 month period, where the remaining skin may not retain its elasticity, and shrink back
down size. Many patients with excessive amounts of hanging skin go through a multitude of
problems, everything from daily hygiene to finding clothes that fit, but also hide what they
don't want seen.
A holistic and comprehensive approach to the bariatric surgery and its outcome is necessary
to achieve your desired figure following the weight loss. Bariatric patients must be treated
uniquely from non-bariatric patients, because the elements of the procedures needed are
basic, but the process is very different. In the past what has worked for many other simply
may not be what is required for this type of patient.
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What are some concerns with the body lift procedure?
Patients who have undergone gastric bypass surgery and the significant weight loss have
numerous but similar concerns. Procedures frequently done to alleviate these concerns are:
- Mastopexy is a procedure to lift the breasts and can be done with or without the addition of implants to improve shape and fullness.
- Facelifting, a procedure for the lifting of the forehead and eyelid surgery may be necessary to achieve complete facial rejuvenation, or you may be a candidate for endoscopic or minimally invasive techniques.
- An abdominoplasty or a lower body lift can contour the abdomen, hips, thighs and buttocks.
- Brachioplasty is a technique to lift the arms and bring shape back to them.
- A medial thigh lift can lift the inner thighs, ridding you of wrinkling or sagginess.
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What approach should I take before making a decision about a body lift?
Your surgeon will help assess your anatomy as well as your own priorities and emotions to
help develop a comprehensive plan. It is not uncommon to combine a tummy tuck with a breast
lift, or a thigh lift with an arm lift, as well as other combinations of procedures.
Although it is not possible to do all the procedures at once, you may have two or three
done in one operation, but your surgeon will help to assess the situation with you.
The cornerstone of a successful approach to body contouring is to individualize treatment
to your specific circumstances and goals and to ensure that you have an adequate
understanding of the issues involved so that you are able to make a fully informed decision.
This will help you achieve the appearance you desire with the least invasive procedure
available, thus creating a mutually rewarding experience.
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What should I expect after the body lift procedure?
Once the procedures are complete, you will notice an improvement in your body immediately.
Your shape will continue to change and improve in the following months as the swelling
subsides. You may be able to be up and walking the day following surgery, be aware that you
will be sore for several days. You will be able to resume your normal daily activities
within several days following surgery, and life will be back to normal within a few weeks.
The body contouring will get you the results you are seeking as long as you work with your
surgeon and map out the best process for you. You should be able to look as good as you feel
and enjoy your new body.
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What does body contouring have to do with gastric bypass surgery?
With the growing popularity of bariatric/ gastric bypass surgery as a treatment for obesity,
body contouring after significant weight loss has become a field of special interest for many
plastic surgeons.
By applying the latest techniques in body sculpting individualized to each patient's specific
needs and priorities, your plastic surgeon can help you realize the new shape that is hidden
beneath the excess skin that remains after your goal weight has been achieved.
With significant weight loss over a relatively short period of time (usually 15-18 months), the
remaining skin often does not retain the elastic qualities necessary to "shrink back down" to
your new underlying shape. This often leaves patients with excessive amounts of hanging skin
that creates a multitude of problems such as daily hygiene and finding clothes that fit properly.
A comprehensive approach to the bariatric patient is necessary to achieve the optimal figure
following weight loss. One of the most important considerations for our surgeons to realize is
that a bariatric patient must be treated differently from non-bariatric body contouring
patients. What has worked well for many years on other patients simply does not provide
adequate shaping and contouring for the bariatric patient.
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What are some conditions that bondy contouring can help alleviate?
-Breast ptosis, or droopiness, as well as a loss of breast volume (Mastopexy is a procedure
to lift the breasts and may be performed with or without the addition of breast implants
to improve shape, fullness and cleavage.)
-Sagging of the facial skin (Facelifting, forehead lifting and eyelid surgery may be
necessary to achieve complete facial rejuvenation, or you may be a candidate for endoscopic
or minimally invasive techniques)
-Excess abdominal skin and a laxity of the muscles of the abdominal wall, sometimes with
an accompanying hernia. (Abdominoplasty or a lower body lift procedure can contour the
abdomen, hips and buttocks)
-Hanging skin under the arms (Brachioplasty is a technique to lift the arms)
-Wrinkling and excessive bagginess of the thighs (A medial thigh lift can lift the inner thighs)
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Can I take all of these conditions with one body contouring procedure?
Obviously all of these concerns cannot be addressed simultaneously during one operation. However,
two procedures usually can be safely combined. During your consultation, your plastic surgeon
will assess your anatomy as well as your own priorities to help you develop a comprehensive
plan, or blueprint, for your body contouring. It is not uncommon to combine a tummy tuck with
a breast lift (with or without the addition of breast implants), or a thigh lift with an arm
lift, as well as other combinations of procedures.
The cornerstone of a successful approach to body contouring is to individualize treatment
to your specific circumstances and goals and to ensure that you have an adequate understanding
of the issues involved so that you are able to make a fully informed decision. This will help
you achieve the appearance you desire with the least invasive procedure available, thus
creating a mutually rewarding experience.
If you think you might be a good candidate for body contouring following significant weight
loss, this article will give you a basic understanding of the procedures and the results you
can expect.
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What does the body contouring process consist of post bariatric surgery?
The Consultation
During your initial consultation, your plastic surgeon will inquire about your medical
history, prior procedures, medications, allergies, and your motivations for seeking plastic
surgery. It is very important that you be thorough when providing your medical history, as
this information helps to prevent complications during your care. When asked about medications,
be sure to include any vitamin or herbal preparations, as these can affect your blood pressure
and clotting ability. Honesty regarding your use of tobacco and alcohol is also very important,
as these may have a profound impact on your recovery period and your ability to heal following
your procedure.
After reviewing your medical history, your plastic surgeon will discuss your concerns,
priorities and motivations for pursuing plastic surgery, as well as your fears. After examining
you, he or she will be able to offer advice and options to help you achieve the appearance you
desire. He or she will explain the advantages and disadvantages of the different options you
have before you.
At the completion of your consultation, you should be given a written estimate of the cost
of your procedure. At this time, you will also have the option to schedule your procedure if
you so choose. The decision to undergo surgery is a very important one, and the final decision
should be given very careful consideration. You are also encouraged to bring your spouse,
significant other, family member, or a friend to your consultation.
Type(s) of Anesthesia
Anesthesia is an essential part of any surgical procedure and must be performed safely.
General anesthesia is preferred for most of these procedures and is the deepest form of
anesthesia. You are asleep, feel no pain, and will not remember the procedure. This is the
most common type of anesthesia used for body contouring after gastric bypass surgery because
these procedures tend to be lengthy and require full muscle relaxation for maximum tightening
intra-operatively.
Intravenous sedation, called "twilight sleep," is a combination of local anesthetic
administered at the surgical site by the surgeon and intravenous sedation administered
by the anesthesiologist. You breathe for yourself, but you are in a deep sleep throughout
the procedure. You should feel no pain, and you will not remember the procedure. This is
more commonly used for facial rejuvenation procedures.
The prevention of postoperative nausea and vomiting is also an important component of
body contouring. To improve your overall experience and ensure you feel better faster
following your surgery, a new medication has been developed that has resulted in a very
low incidence of postoperative nausea and vomiting. You should be given an intravenous
dose of Zofran at the beginning of your operation. Zofran is a new drug that is currently
the best medication available to prevent nausea and vomiting. This is a very important
consideration to make sure that your experience is as pleasant as possible.
Your surgeon will discuss all of these options with you more thoroughly at the time of
your consultation, and please ask about anything you do not understand.
Details of the Procedures
As mentioned previously, it is important to develop a comprehensive approach to your body
contouring. This has evolved into several specialized techniques meant to optimize your
results. These include:
-Developing a clear overall strategy during the consultation process and reviewing this
plan during the preoperative visit. This plan will be reviewed thoroughly so that you have
a full understanding of the procedures, incisions, and results you can expect.
-Precise preoperative skin marking prior to surgery. While you are standing, your plastic
surgeon will make marks on the skin identifying certain landmarks as well as the intended
incisions. Not only does this provide information necessary during the operation, but it
also allows you to review the operative plan one more time with your surgeon before
undergoing the procedure.
-Using various positioning techniques on the operating room table to optimize visualization
intra-operatively that enables him to provide smooth, natural contouring from one body
region to the next.
-Precise cutting, redraping and sculpting techniques
-Careful but considerable suture techniques to provide support to the incisions during
the healing process. By using multiple layers of strong sutures beginning deep in the
tissues and finishing superficially, the resulting scar is optimized and heals into an
acceptable thin line. Even with this suture technique, your plastic surgeon should be able
to use sutures beneath the surface of the skin that do not require removal. Not having to
undergo suture removal has greatly improved patient comfort and satisfaction postoperatively.
Depending on the combination of procedures you choose, surgery will probably last
between four and eight hours. After you are properly anesthetized, your plastic surgeon
will make the incisions necessary for removal of excess skin and fat. After the incision
has been made, he or she gently elevates the skin and fat off of the underlying structures.
For a tummy tuck, the muscles of the abdominal wall are usually tightened using strong,
permanent internal sutures. Some patients have hernias in the abdominal wall, and these may
also be repaired during a tummy tuck.
After removing the excess skin and fat, your plastic surgeon will redrape the skin over
the underlying structures. One or more drains may be placed beneath the incisions. These
slender, rubber tubes assist in draining any fluid that may accumulate beneath the incisions
and delay your healing. Your plastic surgeon may also choose to use a new product called
Tissue Glue. This product helps your body heal and minimizes the fluid that may empty into
your drains, allowing the drains to be removed earlier.
At the completion of the operation, a sterile dressing is applied to the incisions, and
a compression garment is applied to the region of the body being treated. This compression
garment helps support your incisions during healing, decreases postoperative swelling, and
helps decrease any bruising that may occur.
After Your Procedure
If you are staying overnight in the hospital, you will be transported from the recovery
room to your own room. You will have a PCA pump (Patient Controlled Analgesia) available so
that you will only need to push a button to self-administer pain medications when needed.
Your plastic surgeon will visit you in your room the evening following surgery to check
and make sure everything is going well and that you are comfortable. He or she will also
visit you again the morning after surgery to change the dressings and discharge you from
the hospital. You will also be provided with thorough postoperative instructions and a
phone number so that you may reach your plastic surgeon directly at any time with any
questions or concerns you might have.
Alternatively, if you decide to go home in the company of a private duty nurse, you
will be discharged after spending one to two hours in the recovery room.
Most patients find that they are able to transition to Tylenol after four to five days.
You should not take Tylenol AND your pain medicine, because the pain medicine also contains
Tylenol and this excessive dosing of Tylenol has been known to cause liver damage. It is
not safe to drive a car within twenty-four hours of taking pain medication, as your reflexes
and alertness may be altered.
You should plan to take it easy following your surgery. No strenuous activities, heavy
lifting (over 20 pounds), aerobic exercises, swimming, contact sports, tennis, or golf
should be planned for the first three weeks. As your plastic surgeon monitors your recovery,
he or she will advise you when it is safe to resume specific activities.
You should plan to wear the compression garment for three weeks following surgery. Your
plastic surgeon will remove the drainage tubes within several days following surgery as the
drainage decreases to an acceptable level.
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What results from body contouring can I expect?
You will notice an improvement in your body contour immediately. However, your shape
will continue to improve in the following weeks as the mild swelling subsides. You should
be up and walking the day following surgery, although you will be sore for several days.
You should be able to resume your normal daily activities within several days following
surgery, and you should be able to resume all of your physical activities within three
to four weeks of surgery.
As a result of your body contouring, you should be able to look as good as you feel and enjoy your new body.
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Cosmetic/Plastic Surgery
