Body Contouring Surgery

Sometimes, as a result of child bearing, weight loss or just the general age process, exercise and a good healthy diet may not be enough to change the body shape and image. Significant improvement can be achieved in many areas with surgery. At the time of your consultation, discuss with your surgery what areas of the body you are unhappy with and what you hope you will achieve with a surgical correction of your problem areas. Sometimes, more than one procedure can be safely done, meaning there will only be a single recovery period.

Body Contouring

Liposuction
Adominoplasty (tummy tuck)
Belt Lipectomy
Brachioplasty
Thighplasty
Chest Redundacy

Liposuction

Liposuction is a surgical procedure whereby localized fatty deposits that are resistant to dieting and exercise can be removed with minimal scarring. A narrow, hollow instrument, called a cannula, is inserted under the skin through a very small incision. A powerful vacuum then removes the fat cells as the cannula is moved back and forth underneath the skin. The ideal patient for a liposuction procedure is a person at their ideal body weight, firm skin tone, and with one or two regions of their body that need reducing. In women, these areas most commonly are the upper lateral aspect of the thigh ("saddle bag" area), and just below the waist ("love handles"). Men most commonly complain of excess fatty tissue around their midriff ("spare-tire"). Other areas that can be treated with liposuction are the medial thigh, knee area, abdomen, calves and the chin area. Some cases of excess breast development in men can be treated with liposuction. Less common areas that can be treated with varying degrees of success are the ankles, arms, and cheeks.

Once the fatty tissue is removed, the skin must shrink down to accommodate the smaller and altered contours. In people with loose skin tone, this contraction of the skin may be incomplete. People tend to develop loose skin with age, but heredity is perhaps the most important factor. Some people at age 45 have excellent skin tone; others at 20 are borderline candidates for liposuction. If the skin tone is less than ideal, the benefit of a smoother contour will still be achieved, but there may be some rippling of the skin. Some patients are prepared to accept this; others may opt for an excision of the excess skin at the time of surgery, or as a second operation. These alternatives will be discussed with you at the time of your consultation.

Most liposuction is done under a general anaesthetic, which means the patient is asleep during the entire operation. Small areas, such as the chin, can be done under a local anaesthetic with sedation to help the patient relax. Most surgery is done on an outpatient basis, but some patients having large areas treated may be kept overnight. Very extensive liposuction may necessitate a blood transfusion. Under these rare circumstances, arrangements are made for you to donate your own blood prior to surgery.

After surgery compression garment (a special type of girdle) or supportive tapes will be used. These must be maintained for six weeks after the surgery to allow the skin the best opportunity to contract down and achieve a good result. The areas treated by liposuction will be bruised and tender, but most people experience very little pain. Any routine postoperative pain can easily be relieved with mild pain medication. Depending on the type of work you do and the number of areas being treated, you may return to work 3-7 days after surgery. Mild exercises and sports may be resumed after three weeks.

However, more strenuous exercises should not be started before six weeks.

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Adominoplasty (tummy tuck)

TempPic1 Frequently following weight loss, the abdomen sags and in some   cases the skin hangs down over the thighs. This causes discomfort and hygienic problems.   There is also an embarrassment as far as dressing is concerned.   This component is dealt with by freeing the skin up to the mid portion of the chest and bringing it down, excising all the skin from the umbilicus to the mons pubis. Sometimes the skin cannot come all the way down and the patient will have a little vertical closure in the midline above the mons pubis as well as the transverse scar.

  Because of the laxity of the abdominal wall, most commonly the surgeon will tighten up the muscle container and give the patient a flatter tummy.  

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Belt Lipectomy

Most weight loss patients have a sag of the skin above and including the upper part of the buttocks.   This loose skin can be removed at the same time as the abdominoplasty.   This is referred to as a belt lipectomy.  

For this procedure, the patient requires to wear a garment support for a period of five weeks after the surgery.  

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Brachioplasty

Following massive weight loss, there is a gross redundancy of the upper arm and sometimes the upper portion of the forearm.   While suction can remove some of the remaining fat, nevertheless, the skin needs to be removed by excision.   Here the surgeon carefully measures the skin so that the same amount is removed on both sides.   It is important that the arm not be excessively tightened for if it is, it will interfer with emphatic drainage of the forearm and the hand leaving to swelling in these areas.  

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Thighplasty

Following massive weight loss, the thighs become loose especially on the inside.   It is generally always some residual fat around the thighs which can be removed at surgery.   Here the surgeon makes an incision in the groin posteriorly and carries it along the inside and then up onto the anterior aspect of the thigh sometimes joining the scars from the belt lipectomy.   After removing the excess fat, the surgeon then removes the excess skin which commences on the posterior aspect of the thighs, on the inside of the thigh and up onto the anterior thigh.  

This skin flap is then carefully sutures up into the groin area, securing it to the deeper structures, so that the scar will not migrate down the thigh.   In this procedure, the patients will need to wear a garment support for period of five weeks.  

The wearing of garments following this aspect of surgery is to hold the skin and the skin flaps into position of election so that the cells can grow together.  

Occasionally, the skin is so loose on the inside of the thigh that a vertical incision is required in order to remove the redundant skin. Your surgeon will discuss this aspect with you.

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Chest Redundancy

Mastopexy, in massive weight loss, the breast have lost a great deal of weight and hang down. They can be tightened by a procedure called a mastopexy. In this procedure, the breast remains the same volume but in tightening it, it will stand up more on the chest wall.

TempPic1On the sides of the chest and sometimes on the front of the chest, a fold of skin hangs down which is referred to the thoracic fold.   This can be disturbing and bothersome to a patient.   It can be excised but does leave a scar across the chest.   However, most patients prefer to have the scar rather than having a fold of skin.   In some men, the nipple/areolar complex hangs so low that it needs to be repositioned higher up onto the chest to reach normalcy.  

How many of these various procedures that can be done at one time varies according to what needs to be done and the general physical condition of the patient.    Generally, two or three of them can be done at the same time.   If a lot of surgery is done at the same time, it will generally be done by a team of plastic surgeons and done at a General Hospital where blood is available for transfusion.   However, if the surgery is less involved, most commonly it is done at a free standing surgical facilities.  

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