Body contouring is any procedure that alters the shape of different areas of the body. Body contouring after massive weight loss refers to a series of procedures that eliminate and/or reduce excess skin and fat that remains after previously obese individuals have lost a significant amount of weight, in a variety of places including the torso, upper arms, chest, and thighs.
Tummy Tuck (Abdominoplasty)
A flat, toned stomach is something that many of us strive for through our diets and exercise. However, for some this may be impossible to achieve due to aging, heredity, pregnancy, weight fluctuations, or a prior surgery. A tummy tuck, otherwise known as an abdominoplasty, removes excess fat and skin around the abdomen, and repairs weakened or separated muscles, creating a tighter and smoother abdominal profile. During this procedure, your belly button may need to be moved or a new belly button may need to be created. In order to achieve the best results, patients should try to reach their ideal body weight before undergoing the procedure. Thinner patients typically see a flatter more defined waistline following their abdominoplasty than those who are still trying to lose weight.
Following the procedure, you will see an immediate improvement in the contouring of your abdomen. The final result can be seen within 2-3 weeks after swelling has subsided. For 3-4 months we recommend wearing a compression bandage to help eliminate chronic swelling just above the scar. Most patients can return to normal daily activities and work in about 2 weeks. However, if muscle tightening is performed no heavy lifting or abdominal exercises are allowed for 6 weeks. Most discomfort following an abdominoplasty occurs in the first 3-4 days. Postoperative pain pumps, which last for three days, may be used to help control pain without narcotic side effects.
Abdominoplasty or Liposuction?
Many women have both an excess of fat and skin in the lower abdomen. Liposuction alone will help decrease the amount of fat of the lower abdomen but the excess loose skin will still be present. Patients who need to remove both would be better served with an abdominoplasty. Liposuction can be performed in conjunction with abdominoplasty to remove fat adjacent to the abdomen. Patients with minimal excess skin and fat would be better candidates for liposuction only as a slight amount of skin tightening can be expected.
Mini Tummy Tuck
Unlike a full tummy tuck where the entire abdomen is considered, a mini tummy tuck focuses on the area of the stomach from the belly button to the pubic area. Patients who are concerned about a minimal amount of excess skin on their lower abdomen may wish to have a limited or mini abdominoplasty that involves no repositioning of the belly button and usually no muscle tightening. A mini-tummy tuck may also be used to address C-section scarring. Recovery time from this procedure is much shorter than with a full abdominoplasty.
Liposuction concentrates on your body’s specific, hard-to-lose areas of excess fat. Even very thin patients who exercise religiously often have problem areas particularly as they get older. These fat bulges are out of proportion to the surrounding areas and can be quite noticeable. In women, the most popular areas for liposuction are the lower abdomen, hips, inner thighs, outer thighs or saddlebags, the back of the thigh below the buttock crease and the inside of the knees. In men, the most common areas treated are the flanks or love handles, abdomen and back. We see many patients in consultation who are at least 20 lbs. overweight but who want liposuction. These patients typically do not see a significant improvement postoperatively because their total body fat is too high and will be disappointed with the result.
The best candidates for liposuction are patients who are close to their ideal body weight and in reasonably good shape. They must be committed to a consistent regimen of diet and exercise to maintain their improvement in body contouring. Although the fat removed will not return in the treated areas, the procedure is not a free ticket to stray from your diet as fat can accumulate in other areas. As with many plastic surgery procedures the better shape you’re in, the better your result.
Tumescent liposuction is the most common technique used today. During this procedure, a large volume of fluid containing a local anesthetic and adrenaline into the tissue. This solution temporarily shrinks capillaries and hardens or “tumesces” fat which is then removed. This technique allows for better postoperative pain control and promotes a faster recovery.
Following their liposuction procedure, patients are placed in a postoperative compression garment or girdle which is to be worn for one week without removing it. Wearing the garment as instructed is critical to keep swelling to a minimum. Limited activity is recommended for the first week. Patients may then resume normal activity but should wait 2 weeks to resume exercise.
Moderate bruising and swelling can be expected the week following the procedure. This will continue to subside for 1-2 weeks. Sutures are removed within 7-10 days. At that time, patients are asked to wear a compressive garment such as spandex shorts or a panty girdle to help eliminate any residual swelling. A final result will be seen in 3-4 months once all swelling has gone down.
Arm Lift (Brachioplasty)
An arm lift, or brachioplasty, is a surgical procedure that reshapes the under portion of the upper arm, from the underarm region to the elbow. The procedure is performed to reduce fat and excess skin in the upper arm region that droops downward, and tighten and smooth the underlying supportive tissue that defines the shape of the upper arm. Sagging or drooping skin on the upper arms can be caused by fluctuations in weight, aging, or heredity. This condition cannot be corrected through exercise.