ABOUT

Also known as post-bariatric surgery or body contouring after massive weight loss

Obese individuals who opt for bariatric surgery experience a dramatic weight loss. Such a sudden loss of weight often leaves behind excess skin and fat.The sagging skin gives a odd look to the body contour. The sagging skin can be prominently noticed around the

  • Face
  • Neck
  • upper arms
  • breasts
  • abdomen
  • buttocks and thighs

This procedure aims to restore the attractive proportions by removing the excess skin and fat. These procedures leaves scars along the incision lines, but most patients take it as a trade off for the improved appearance they are achieving by getting rid of the excess skin and fat.
Many who consider plastic surgery after dramatic weight loss also consider facelift , brow lift and eyelid surgery.

WHERE IS IT DONE

PROCEDURE LOCATION
Panniculectomy Operation Theatre
Lower Body lift
Liposuction
Breast Lift
Upper arm lift
Thigh lift

DURATION

The following procedures (except Panniculecomy & Tummy Tuck) have to be performed over different sittings they cannot be done together.

PROCEDURE DURATION
Panniculectomy 2-4 hours
Lower Body lift 6-8 hours
Tummy tuck 3-4 hours
Liposuction 1-4 hours
Breast Lift 2-3 hours
Upper arm lift 3 hours
Thigh lift 3-4 hours

ANAESTHESIA

PROCEDURE ANAESTHESIA
Panniculectomy General Or Spinal
Lower Body lift General Or Spinal
Tummy tuck General Or Spinal
Liposuction General Or Spinal Or Local
Breast Lift General
Upper arm lift General
Thigh lift General Or Spinal

INCISIONS, STITCHES & SCARS

The surgeon strategically plans and places the incisions and stitches for the surgery in terms of number, size, material, location and technique aiming to keep the resulting scar minimal, hidden and not easily visible eye. Special tissue handling and suture techniques further minimize scars.

Though incision lines are permanent, in most cases they would fade and significantly improve over time. As some of these surgeries can share the same incisions, the Plastic surgeon will be very careful to plan the order of surgeries.

STAY AT CLINIC

PROCEDURE STAY AT CLINIC
Panniculectomy 24-48 hours
Lower Body lift 2-3 days
Tummy tuck 2-3 days
Liposuction 24-48 hours
Breast Lift 36 hours
Upper arm lift 24-48 hours
Thigh lift 24-48 hours

HOW IS IT PERFORMED?

The procedures aim to remove the excess, overhanging skin seen after a dramatic weight loss. The outcome of each one would have an impact on the next procedure. So, these are custom planned and sequenced suiting your cosmetic goals and timeline. Panniculectomy and lower body lift are the most commonly performed procedures.

Panniculectomy

Pannus is the overhanging skin of the lower abdomen, it is seen typically after major weight loss and/or pregnancy. This procedure addresses the hanging skin in the lower abdomen below the belly button.

Lower body lift, tummy tuck and Liposuction are often used for panniculectomy.

Lower Body Lift

Aka Belt Lipectomy
After a dramatic weight loss one can see loose skin overhanging from the buttocks, thighs and hips. This procedure aims to remove this excess skin and the thin layers of fat below the skin by liposuction and excision . An incision passed from the back to the front of the thighs, around the hips. Loose skin is removed from below this incision and the remaining tissue is ‘lifted’ and suspended to the upper border of the incision.

This can be performed along with a tummy tuck.

Some procedure associated with plastic surgery after a dramatic weight loss include, breast augmentation, Breast reduction and gynecomastia (male breast reduction).

Tummy Tuck – also known as Abdominoplasty

What it does
In this surgical procedure, the surgeon removes the loose abdominal skin and tightens the abdominal muscles with sutures.

This is aimed to address the excess skin and stretch marks below the belly button in the lower abdomen.

Liposuction – also known as Lipoplasty

Fat from your body removed by using suction by a cannula(a small, thin, blunt tipped tube) inserted through small incisions made made in the skin.The surgeon moves the cannula under the skin targeting the fat deposits and sucks them out.

Suction-assisted liposuction (SAL), this the most traditional form of, it draws fat out with a vacuum.

It is done in 3 steps – Separation, Aspiration and Fat Equalization.

Dressings will be applied after the procedure and you will be needed to wear compression garments for a specific period of time.

Breast Lift – also known as Mastopexy

Sagging of breasts, stretching of areolas and drooping of nipples can be seen due to weight gain. A breast lift addresses these issues lifting your breasts thus giving a more youthful look.

The excessive breast skin is removed and the nipple and areola are surgically shifted to a higher position.

The sutures are placed deep in the breast tissue, so that the new breast position is supported for a longer period of time.

The nipples and areolas remain attached to underlying mammary tissue, and this placement usually allows for the preservation of sensation and the ability to breast-feed.

Upper Arm Lift – also known as Brachioplasty

The upper arms can become loose and flabby due to ageing or after a dramatic weight loss. The doctor surgically removes the excess skin and removes any fat deposits by liposuction. The incisions are made typically in the medial side or at the back of the arm and they extend from the axilla to the elbow.

Thigh lift – also known as Thighplasty

This procedure addresses the extra skin and fat in the thigh areas. The skin is excised and any fat would be removed by liposuction.
This can be performed along with a lower body lift. Some of the types of thigh lift are

  • Inner (medial) thigh lift
  • Vertical thighlift
  • Outer thigh lift

Panniculectomy

The incision extends from one corner of the hip to the other and can be concealed in the bikini area.

Lower Body Lift

The incision extends around the circumference of your body in a bikini-line pattern, designed to be hidden in your underwear.

Abdominoplasty

The incisions extend from one corner of the hip to the other just above the pubic area. They will leave a scar, but the incision is strategically placed such that it falls along the natural crease within the bikini line. The length and visibility of the scar varies from person to person.

Breast Lift

There are types of breast lifts, each one with its unique incision and scarring patterns. The surgeon will strategically place the incisions to hide them in natural breast contours, but some incisions have to placed on the breast surface and they would leave a visible mark.

Arm Lift

Incisions are generally placed on the inside of the arm or the back of the arm and may extend from the underarm (axilla) to just above the elbow. In cases with only a small amount of extra skin,a mini-brachioplasty can be performed , and here the incision would be limited to the underarm area.

Thigh Lift

The inner thigh lift incisions are made in the groin fold. In cases of vertical thighplasty, starting from the groin crease a vertical incision is made which extends to the inner knee. In outer thigh lift cases, the incision is made from the groin around the hip. In cases of spiral thighplasty , starting below the buttock fold, the incision is made which continues over the groin crease.

Liposuction

Incisions are very small.

REST AT HOME BEFORE RESUMING OFFICE WORK

PROCEDURE REST AT HOME
Panniculectomy 2-3 weeks
Lower Body lift 2-3 weeks
Tummy tuck 2-3 weeks
Liposuction 1 week
Breast Lift 1 week
Upper arm lift 1 week
Thigh lift 2 weeks

AFTER CARE AND RECOVERY

Healing is a gradual process and you should be patient. You will be able to appreciate the results of the procedure, accurately within 3 months.

Refrain from sports, jogging and other strenuous physical activity for at least 6 weeks.

Driving a Car: within 2-3 weeks, by this time, the drains and sutures would have been removed.

First follow up: after 5 days.

Swelling: It should subside within 5 weeks.

Scars: They fade and flatten over a period of 3 months to 2 years as the skin heals gradually.

Have someone to care of you at home for at least 2 weeks.

You may follow the advice of the surgeon on placing the pillows around you to provide adequate support and to minimize the tension around the operated areas

If you had underwent a breast lift or reduction, the surgeon may prescribe a surgical bra which will help in reducing the swelling.

If you had underwent a tummy tuck or any other abdominal surgery, you should use an abdominal binder which will provide additional support and will help in reducing the swelling.

Maintain proper wound hygiene, take a sponge bath initially and after 2-3 days you may shower like before. Pat dry the suture sites after bath.

FOLLOW UP VISITS

PROCEDURE FOLLOW UP VISITS
Panniculectomy 7-10 days after the surgery
Lower Body lift 1 week after the surgery
Tummy tuck 1-2 weeks after the surgery
Liposuction 1 week after the surgery
Breast Lift On the 7th day after surgery and after 1 month
Upper arm lift 1 week after the surgery
Thigh lift 1 week after the surgery

HOW LONG WILL MY RESULTS LAST?

If you don’t go through another pregnancy or a significant weight gain, your results should be permanent.

It is important to note that plastic surgery cannot stop the normal aging process. If you have undergone a breast lift along with implant insertion in conjunction with a body lift or tummy tuck, please note that, there might likely come a time when you have to replace the inserted breast implants. Ask the surgeon for more information regarding the various implants and situations where one might need an implant removal.

Maintain good communication with the aesthetic plastic surgeon

Keeping safety in mind as well as for the most beautiful outcome of the procedure, we advise that you visit the clinic for post procedure review and evaluation at prescribed times. Also do not hesitate to contact the doctor if you notice any changes in the treatment areas or when you have any concerns and queries.

ASSOCIATED COSTS

Click here for the cost for procedures done in the plastic surgeries after a dramatic weight loss.

LIMITATIONS & RISKS

Significant complications from plastic surgery after a dramatic weight loss, fortunately, are infrequent. Every year, thousands of people undergo this procedure successfully and are glad with the results. The risks specific to your health will be discussed during your consultation.

Some degree of risk will be present with every surgery. Some of the potential complications involved in all surgeries are

  • Allergies
  • Infection and bleeding
  • Adverse response to the specific med
  • Damage to the underlying structures during the procedure
  • Scarring
  • Hematoma or seroma (an aggregation of blood or liquid under the skin that might require removal)
  • Changes in sensation
  • Unsatisfactory results that might necessitate additional procedures

You can minimize certain risks and for the optimal results it is crucial that you follow the instructions given by the doctor both before and after the surgery.
Some situations which might lead to slow healing include heavy stress and nutritional deficiencies.

For the optimal results and to minimize certain risks and it is crucial that you follow the instructions given by the doctor both before and after the post bariatric surgery.