BODY LIFT / Post Bariatric body lift

About Body Lift / Post Bariatric Body Lift

Many people seek skin-tightening procedures.  Sometimes people develop hanging skin as a result of exercise-induced weight loss or weight loss operations.  Ironically, this hanging skin can also be caused by the amount of exercise in your routine, and unfortunately, these hard-working men and women lose weight and gain muscle mass, but their skin just won’t shrink down to fit their smaller body.  Despite success in achieving their lofty goals in weight loss and living a healthier more active life, some people can be disappointed in the results that they see in the mirror.  This disappointment robs them of the true success that they have accomplished.

For other people, their skin simply loses its natural elasticity as they age, so they become troubled by excess skin hanging from their arms, abdomen, hips, and thighs.  Often people will change their wardrobe to less flattering styles to hide embarrassing areas of their body.

If you are troubled or concerned about extra skin hanging from your arms, abdomen, hips or thighs and have tried just about everything to get rid of it, there are surgical options that you may wish to consider.  Surgery is the best and most permanent way to remove excess, drooping, or hanging skin. Surgical options can be very effective, but surgery is not the right answer for everyone. Your surgeon at Park Meadows Cosmetic Surgery will educate you about skin tightening options for Body Recontouring and help you make the most informed decision. 

 

Is A Body Lift Procedure Right For Me?

ARM LIFT/BRACHIOPLASTY

People who have extra skin under their arms are sometimes bothered by the hanging skin.  Even physically fit individuals can have strong arms and loose skin that is troublesome.  Brachioplasty or an “Arm Lift” is a procedure that surgically removes this hanging skin.  There are several types of procedures depending on the amount of excess fat and skin in the arm.  These can range from a simple liposuction procedure to remove a small amount of fat while tightening mildly loose skin to a “Short Scar Brachioplasty” for moderate amounts of skin to a “Full Brachioplasty” for the most severe cases.  Each procedure has its own benefits and drawbacks.  Each procedure has its limitations.  These will be discussed with you frankly and openly by your surgeon, so you can make the correct choice for you. 

Before Surgery		After Surgery
Before Surgery		After Surgery
Before Surgery		After Surgery

 

ABDOMINOPLASTY/TUMMY TUCK/BELT LIPECTOMY

This is a common procedure for women after bearing several children.  The changes of pregnancy and aging can affect a women’s abdomen severely.  Men can also have extra skin and fat around the waistline that bothers them.  Also, patients with significant weight loss can still have low self-esteem despite their tremendous personal success because of the excess skin that now exists on a thinner body. An Abdominoplasty or Tummy Tuck is designed to remove the excess tissue around the front of the abdomen.  This is described on a dedicated page on Abdominoplasty.  A Belt Lipectomy or Body Lift is a similar procedure designed to tighten the skin all the way around the body.  It is usually reserved for patients with severely loose skin, sagging hips, buttocks, thighs and abdomen.  Removing a “belt” of skin all the way around the body will not only tighten the skin, but will raise the buttocks, hips and thighs to a more youthful position.  The results are long lasting, but the extra scars are not for everyone, so your surgeon at Park Meadows Cosmetic Surgery will help you make the most informed decision. 

Before Surgery Back		After Surgery Back
Before Surgery Front		After Surgery Front

 

THIGH LIFT

Some people joke about their family curse of large, hanging thighs or are discouraged that their leg skin did not shrink down around their legs as they lost weight.  This hanging skin can rub and chafe together as people walk which can cause rashes.  Other people are embarrassed to wear shorts or bathing suits because “nothing ever fits” or they don’t want to show their legs.  Again, Thigh Lifts are procedures that remove excess skin from the thighs (usually the inner thigh) to tighten the skin and improve the contour of the inner thigh.  An Outer Thigh Lift can be achieved by a Belt Lipectomy.  Like the Brachioplasty, there are several distinct techniques with different indications and short-comings.  Your surgeon will help you decide about surgery, describe any scars that would be required, and explain what results could be achieved. 

Before Surgery		After Surgery
Before Surgery		After Surgery

 

All Surgery Carries Some Uncertainty & Risk.

Body Contouring or Skin-Tightening Procedures are not simple operations because the surgeon has to remove skin and fat to recontour the body without removing too much skin which can cause wound healing problems.  However, the operations are normally safe when performed by a qualified surgeon.  Nevertheless, as with any surgery, there is always a risk of complications.  These risks increase slightly if several operations are done at one time such as a “Total Body Lift.”

Operative risks include, but are not limited to, excess bleeding, infection, poor skin healing, poor breast healing.  Because it is necessary to make incisions, all patients will have scars.  Most scars heal well, but some can be red, raised, itchy, and unsightly.  It is impossible to tell how your scars will heal prior to surgery.  Smokers are at higher risk for many of these complications.  It is important to stop smoking at least 1 month before surgery.

Additional Surgeries: In the some cases, your body can be reshaped in 1 surgery.  However, some patients will be better advised to have more than 1 operation after a period of healing.  A planned staged approach can be safer in some patients.  Healing can be unpredictable resulting in asymmetry.  In some cases a second smaller “touch up” surgery is required to give you the best result possible.

Delayed Wound Healing And Dehiscence: In some instances, the incision site takes longer to heal than normal. Cigarette smoking, poor nutritional status and a compromised immune system can all cause delayed wound healing or wound separation.

Scars: A surgeon cannot reshape your body with out making incisions.  Any incision will produce a permanent scar.  Your surgeon will discuss with you the options depending on your body and reshaping goals.  However, most scars heal well and almost all patients are happy to trade these incisions for an improved self-confidence.  In the rare incidence, a scar will be thick and unattractive.  If this is the case with your scars, your surgeon will provide several options to fix or improve them.

Asymmetry: Your surgeon will endeavor to correct any natural differences in your body to make your arms and thighs match as closely as possible and put incisions in similar locations. However, some differences are due to underlying skeletal differences that can not be fully corrected.  Also, healing can be impossible to predict in some patients which can lead to differences in final scar location and contour.  If large differences occur after surgery, your surgeon is committed to provide you with the most pleasing result he thinks he can provide.

Sensation: Skin sensation can be changed by any surgery.  Some patients experience reduced skin sensation because the nerves to the skin can be cut or damaged during surgery. These changes are usually temporary, but can be permanent.

Pain: If you experience severe pain not relieved by pain medicine, notify your surgeon immediately. Some discomfort is expected after surgery and you will receive a prescription for pain medication. The intensity and duration of pain after Body Lifting will vary among patients. Prolonged or intense pain can be due to scarring around a nerve and fortunately is very rare.

Infection: A small number of patients develop an infection. This typically can occur several days to several weeks after the procedure. If an infection does not respond to antibiotic pills, a patient may need intravenous antibiotics in the hospital.  Fortunately, hospitalization is very rare.

Hematoma And Seroma: A hematoma is a collection of blood under the skin, and a seroma is a collection of the watery portion of the blood under the skin. Hematomas or seromas typically develop within the first few days after surgery. However, they may occur at any time after surgery. The body can reabsorb small hematomas or seromas. Larger ones require the placement of a drain for proper healing. A small scar can develop at the surgical drain site.

Blood Transfusion: Some Body Contouring procedures are large operations, especially when done in combination. Despite the size of these operations, significant bleeding requiring a blood transfusion is NOT common, but can occur during or after surgery.  This uncommon issue is more important in operations for Massive Weight Loss patients who tend to have nutritional deficiencies.  It is important to contact your surgeon quickly if you develop new bruising or pain or sudden swelling after surgery even if you have been at home for 1 week or 2 doing well.  It is possible that your surgeon will recommend that you donate your own blood prior to surgery to have some available if you need it.

After Your Body Lift / Post Bariatric Body Lift

You will be given a comprehensive set of post-operative instructions prior to your surgery.  You will have steri-strips covering your incisions. You will be given a post-surgical garment to wear for approximately 6 weeks.

Most patients will need drains for a short time.  If you have drains, you and your family will be instructed on how to care for them. Most patients are able to return to work 10 to 14 days after surgery if they do not have a very active job that requires heavy physical lifting or activity. However, every patient is individual and your surgeon will help you decide when to go back to work.

Patients can experience random, shooting, discomforts or pain after surgery.  This is normal and typically improves within several months. Some patients will notice changes in their skin sensation after surgery.  These sensations tend to even out over time, but in a few cases can be permanent.

Preparing For Surgery

At least 1 month before surgery
Stop smoking at least 1 month prior to your procedure. Smoking reduces circulation to the skin, impedes healing, and can lead to major postoperative complications.

2 weeks prior to surgery
Stop all medications that can thin the blood 2 weeks prior to surgery. These include drugs such as aspirin, Coumadin, Lovenox, Ibuprofen, Vitamin E, and multiple herbal preparations. These medications may cause bleeding during and after surgery.

Report any signs of a cold or infection that appear the week prior to your surgery. You may need to postpone your procedure to avoid unnecessary complications.

1 week prior to surgery
Do not eat or drink anything after midnight before your surgery. This includes water, ice, or hard candy. The only exception is that you may take your blood pressure or heart medication with a sip of water the morning of surgery.

The day before surgery
Plan to wear comfortable loose fitting clothes to the procedure.

Do not wear jewelry or bring valuables with you on the day of surgery.

You must arrange to have a responsible adult drive you home after your procedure.

What To Expect On The Day Of Surgery.

When you arrive, you will be escorted to a preoperative evaluation area where you will be asked to change into a gown and will be given foot covers. Your surgeon and the anesthesiologist will meet with you before you enter the operating room suite. During this time, the surgical consent form will be reviewed with you in detail and special markings may be made on your skin at the surgical site. You will have the opportunity to ask any last minute questions.

Once in the operating room, you will be transferred to our padded operating room table. A nurse will start an intravenous drip in your arm and connect you to monitoring devices. The anesthesiologist will give you medication through your intravenous drip to make you feel drowsy.

When your surgery is completed and your dressings are in place, you will be moved to the recovery room. During this period a recovery room nurse will assure your comfort and continue to monitor you closely.

Your stay in the recovery room will last approximately I to 1 1/2 hours. Most patients are fully awake within 30 to 60 minutes after their surgery, but they may not remember much about their time in the recovery room due to some of the anesthesia medication. Once you are ready for discharge, a postoperative appointment will be scheduled and your discharge instructions will be reviewed.

Patients who wish to stay overnight in the surgical center for 23 hours of post-operative observation and care are invited to take advantage of the comfortable room and our overnight nursing staff the night of surgery.

You must have a responsible adult drive you home from the surgery center. This individual should have your prescription filled at the hospital pharmacy prior to taking you home. A responsible adult must stay with you the first night after your surgery if you decide to go home because you have been sedated.

Post-operative Instructions

Diet: Start with clear liquids and toast or crackers. If those are well tolerated, progress to a regular diet.

Driving: No driving for at least 48 hours after your procedure or while taking pain medicine.  For more extensive of combined procedures, you may not be able to drive for a week or more. 

Activity: You may walk and gently climb stairs immediately after surgery. After 4 weeks you may resume light activity such as brisk walking. During the first 4 weeks do not lift anything heavier than a gallon of milk. After 6 weeks you may resume more strenuous aerobic work and lifting activities as tolerated.

Work: Depending on your career and your rate of healing you should be able to return to work within 2 weeks of surgery. Your surgeon will be able to give you a better estimate depending on your physical and professional profile.

Wound Care: Keep your dressings clean, dry, and intact for the first 48 hours. Then remove the top dressing, and leave the paper tapes in place; these will fall off in approximately 1 week. If you go home with a drain, empty and record its daily output. Keep a sterile dry dressing over the site where the drain enters the body. Change this dressing daily. Once the drain is removed, you need to keep a dressing over the drain site for 1 to 2 days or until the drain site heals over.

Swelling: Moderate swelling and bruising should be expected during the first 2 to 3 weeks after surgery. During this period wear a post-operative garment provided (except when showering) to minimize swelling and discomfort. Mild swelling will continue for 2 to 3 months.

Bathing: If you do not have a drain you may shower 48 hours after you remove your dressing. If you go home with a drain, you may shower once it is removed. Your surgeon will typically remove your drain several days after surgery.  However, larger procedures or combined procedures may necessitate you having a drain in for 1 week or more. When you do shower do not direct the water spray over your incision site. Do not submerge the incision in a bath or swimming pool for 4 to 6 weeks.

Medications: Ask your surgeon when you should resume your blood thinning medications. All other prescription medications may be resumed immediately as usual while you are taking pain medicine, you are encouraged to follow a high fiber diet or take a stool softener such as Colace (available over the counter), as pain medications tend to cause constipation. Take the full course of antibiotics given by your surgeon, to help prevent infection.

Smoking and Alcohol: Do not smoke for the first month after surgery as it impedes wound healing and can lead to serious wound complications. Alcohol consumption is dangerous while taking pain medicine. It has a tendency to worsen bleeding.

Post-operative Appointment: Your surgeon wi1l schedule follow-up visits at appropriate intervals. Please keep all these appointments so that your progress may be followed closely.

Special Considerations: Call your surgeon immediately if you experience any of the following: excessive pain, bleeding, redness at the incision site, or fever over 101° F.

Final Results: You will see dramatic improvements immediately after surgery with which you will be quite pleased.  However, it may take up to 6 months to a year until the breasts reach their final contour and shape.