If you have lost a significant amount of weight through a diet and exercise program or have gone through the rigors of bariatric surgery to help you lose massive amounts of weight, you have our utmost admiration. Your health will no doubt improve because of your commitment to normal weight, and undoubtedly you feel much better, both physically and emotionally!
The downside of losing significant amounts of weight is that, after much weight has been lost, the skin and tissues often sag. Depending upon your age and the volume of weight you have successfully lost, this may range from just a little bit to an amount of sagging that interferes with normal activities, makes it difficult to exercise and makes it difficult to find clothing that accommodates the sagging. This is when post-weight loss body contouring can be helpful to you.
Post-weight loss body rejuvenation is most often not a single procedure but a combination of procedures performed to restore your body’s contour to as close to normal as possible.
If you are physically healthy, psychologically stable, and have realistic expectations, you will be a good candidate. Age is not as big a consideration as are medical problems such as diabetes, heart or lung disease. Any surgery is a particularly poor choice for smokers, as smoking diminishes the blood supply. If you’re a smoker and wish to undergo post-weight loss body sculpting, you’ll need to quit smoking for at least two weeks prior to the procedure and for at least two weeks afterwards. (Better yet, quit smoking for good and enjoy the many health rewards!)
At your consultation, your surgeon will explain all the body-contouring methods available and suggest the best method for your particular needs. If you want liposuction in the abdominal area, for example, you may learn that an abdominoplasty, usually called a tummy tuck, might create better results, or that a combination of traditional liposuction with UAL or VASER would be the best choice. Rest assured, our surgeons have performed thousands of post-weight loss sculpting procedures and are up to date on the latest technology in this area.
How the Procedure is Performed
As mentioned above, there are several procedures that can be considered for post-weight loss body sculpting and rejuvenation. Among them are:
- Brachioplasty (arm lift)
- Breast Lift
- Thigh lift
- Abdominoplasty (tummy tuck)
- Body Lift
Liposuction is used to treat areas of stubborn fat that are unresponsive to weight loss and exercise. Although liposuction can be used after one has lost a massive amount of weight, most patients find that liposuction alone is limited to smaller trouble spots, ie, liposuction may be a used in a body sculpting or body contouring procedure, but liposuction would not be the “main event”.
Liposuction continues to become more refined, resulting in more precise results and a quicker recovery. Ultrasound-assisted lipoplasty (called UAL and VASER), the tumescent technique and a technique called “super-wet” have revolutionized liposuction as a body sculpting procedure.
Liposuction procedures are performed in our Boca Raton accredited in-office surgery suite on an outpatient basis. If only a small area is to be treated, local anesthesia may be used along with IV sedation to keep you relaxed during the procedure. If a large area is to be treated, such as the abdomen, you may choose to have a regional, or epidural, anesthesia instead of general anesthesia. The choice of anesthesia depends upon which body sculpting procedure is being done along with liposuction. Therefore, if liposuction is combined with another procedure, such as an abdominoplasty (tummy tuck), or body lift, general anesthesia is recommended.
There are several types of liposuction performed here at Sanctuary Plastic Surgery
Tumescent liposuction is typically performed on patients needing only a local anesthetic. Large volumes of fluid, up to 3 times the amount of fat to be removed, are injected into the area to be treated. This fluid is a combination of saline and local anesthetic. The word “tumescent” refers to the swollen and firm (tumesced) state of the fatty tissues when they are filled with the solution. Tumescent liposuction does take longer than traditional liposuction.
Super-Wet liposuction is similar to the tumescent method but less fluid is used, generally the same amount of fluid as fat to be removed. This technique is often best used with IV sedation or general anesthesia and is used in larger areas.
In both the tumescent and super-wet techniques, great care is taken to make sure that the anesthetic fluid that is injected is the correct amount to avoid lidocaine toxicity (if the solution’s lidocaine content is too high), or collection of fluid in the lungs (if too much fluid is administered).
Ultrasound-Assisted Lipoplasty (UAL) and VASER liposuction requires the use of a special cannula that produces ultrasonic energy. As it passes through the areas of fat, the ultrasonic energy literally explodes the walls of the fat cells, liquefying the fat, which is then removed with the traditional liposuction technique.
There are things to consider with the newer techniques. For example, in UAL, the heat from the ultrasound device used to liquefy the fat cells may injure the skin or deeper tissues. Also, you should be aware that even though UAL has been performed successfully on several thousand people worldwide, the long-term effects of ultrasound energy on the body are not yet known.
UAL has been proven to work very well in fibrous areas of the body such as the upper back or the enlarged male breast. It is also commonly used in secondary procedures, when enhanced precision is needed. In general, UAL takes longer to perform than traditional liposuction.
VASER is a specific type of ultrasonic liposuction – also called liposelection. The cannulas are smaller and solid and are more gentle to the tissues that regular UAL.
During any liposuction procedure, tiny incisions are made through which a narrow cannula or tube is inserted to vacuum the fat layer that lies deep beneath the skin. The cannula is used to break up the fat cells and suction them out. Our surgeons will keep your incisions as inconspicuous as possible, though there will be tiny scars where the incisions were made. These will fade with time. Fluid is lost along with the fat and is replaced during the procedure.
The length of a liposuction procedure ranges from a few minutes for liposuction of the chin area to several hours, depending on the extent of liposuction performed. The length of your procedure and the anesthesia to be used will be covered in your consultation.
Brachioplasty or Arm Lift
Brachioplasty, or arm lift, is performed to eliminate the excess fat and skin that sometimes occurs under the upper arms following weight loss. While you may lose additional weight through a brachioplasty, this procedure is not meant as a weight-loss tool, but aspost-weight-loss sculpting under the upper arm. The resulting scar is generally from elbow to armpit. It will fade with time but will never disappear completely, though most patients prefer this thin scar to underarms that “wave” each time they lift the upper arm area and, of course, the scar can be hidden completely with an elbow-length sleeve.
A breast lift, with or without implants, is a cosmetic surgery procedure that will lift your breasts to a more attractive position. After significant weight loss, you may find that your breasts lack volume and have a significant droop. A breast lift, called mastopexy by physicians, is an excellent remedy for droopy breasts. A mastopexy can also reduce the size of the areola, the darker skin surrounding your nipples. If your breasts lack volume or firmness, a saline or silicone implant can be inserted during the breast lift procedure, resulting in perkier, firmer breasts.
A thigh lift is a surgical procedure performed to eliminate excess fat and skin around the thighs as post-weight-loss sculpting. It is often combined with a body lift, to lift the sagging skin on the buttocks and abdomen after a great deal of weight has been lost, though a thigh lift can certainly be done as a single procedure.
Abdominoplasty and Tummy Tuck
A tummy tuck, called abdominoplasty in the medical field, is a cosmetic surgical procedure performed on adult men and women that removes excess skin and fat from the middle and lower abdominal area and tightens the muscles in the abdominal wall. A tummy tuck can dramatically reduce the appearance of a protruding abdomen. It will create a permanent scar in the bikini line, however. This scar will fade over time but will never completely disappear. Although a tummy tuck may be done after weight loss, bear in mind that if you have lost a great deal of weight, you may benefit more from a body lift which will not only take care of the tummy area but the hips and buttocks as well.
A body lift is a surgical procedure performed to eliminate the excess fat and skin around the hips, abdomen and buttock that occurs following the loss of a great deal of weight. A body lift is similar to an abdominoplasty (tummy tuck) but it goes beyond the abdominal area to include the buttocks and hips. This is a rather large and complex procedure, requiring several drains to be inserted after the operation (these are removed in a few days) and often requires a hospital stay.
With post-weight loss body sculpting, we tell our patients not to expect to look or feel great right after surgery. Even though the newer techniques are believed to reduce some post-operative discomforts, you may still experience some pain, burning, swelling, bleeding and temporary numbness. Pain can be controlled with medications prescribed by your surgeon, though you may still feel stiff and sore for a few days.
Any drains inserted during your procedure will stay in place from 2-4 days, depending on the amount of fluid that needs to be released.
Your surgeon will give you instructions for showering and changing the dressing(s), and you’ll be seen in the office in a few days post surgery. Healing is a gradual process. We recommend that you start walking around as soon as possible to reduce swelling and to help prevent blood clots from forming in your legs. You will begin to feel better after about a week or two and you should be back at work within a few days or weeks depending upon which procedure(s) you choose to undertake. If stitches are used they are removed or dissolve on their own within the first week to 10 days.
Activity that is more strenuous than sitting at a desk, working around the home, shopping or dinner out should be avoided for about 6 weeks as your body continues to heal. Although most of the bruising and swelling usually disappears within three weeks, some swelling may remain for six months or more. If you have any concerns whatsoever, come back to the office and we’ll examine you to make certain your recovery is proceeding as it should.