Body Contouring

Many people who have lost a substantial amount of weight find their skin and tissue lack the elasticity to conform to the smaller body size. In these cases the skin that has been severely stretched is now unsupported.

Surgical body contouring following your major weight loss can improve the shape and tone of your underlying tissue that supports fat and skin. In addition excess fat and skin are removed at the same time. Body contouring results in a more normal appearance with smoother contours.

About The Procedure

Before you decide to undergo body contouring following major weight loss, your weight loss must be stabilized.

  • If you continue to lose weight, sagging pockets will redevelop
  • If you rapidly regain the weight, you will traumatically stress your already weakened and thinned skin, causing further stress to the skin, visible stretch marks and wide scars
  • If you had weight reduction surgery, your plastic surgeon will work closely with your physician to determine when it is appropriate for you to begin body contouring

Good candidates for body contouring are:

  • Adults of any age whose weight loss has stabilized
  • Healthy individuals who do not have medical conditions that can impair healing or increase risk of surgery
  • Non-smokers
  • Individuals with a positive outlook and realistic goals for what body contouring can accomplish
  • Individuals committed to leading a healthy lifestyle including proper nutrition and fitness

Consultation

Your consultation is your time to ask the doctor about the procedure you’re considering, how he thinks it will work for you and any concerns you may have. We suggest you come prepared with your questions on paper so you’re sure not to forget to ask the questions that are important to you.

Questions to consider:

  • What is the simplest and safest surgery to help me achieve my goals?
  • How is the surgery performed?
  • What is the expected length of operation?
  • Are other options available?
  • What results can I expect, and how long do the typical results last?
  • Where will scars be located, and how noticeable will they be?
  • Will scars fade over time, and how long will this take?

When you arrive at the office, you will be asked to fill out a few pieces of paperwork. It is very important when asked about medications to put down all medications you take, including any supplements or aspirin-type regimens, since these items can impact your blood clotting and pressure. In addition, you need to be truthful about your use of tobacco and alcohol since this will affect your recovery and incision healing.

Before you see the doctor, a nurse or nurse practitioner will do an initial exam. You may be able to get a number of your questions answered while with the nurse.

Your surgeon will discuss several factors regarding surgery during your initial consultation, including your procedure, location, anesthesia and recovery. In addition, the surgeon will inquire about your concerns, priorities and motivations for pursuing surgery, as well as your fears.

The doctors are sure to address reasonable expectations for the outcome of your desired procedure, and they should explain what is possible and what is not possible.

After your consultation with the physician, you will meet with the practice manager to discuss procedure costs. Download the Body Contouring Consent Form and bring in for your consultation.

Pre-Procedure

There are a number of things to do prior to your procedure that will make your recovery as smooth as possible and ease your pre-procedure anxiety.

Your surgeon will give you instructions on what medications to stop taking and when prior to your surgery to prevent any unwanted side effects. Medications you shouldn’t take up to two weeks prior to your surgery include, but are not limited to, aspirin and products containing aspirin, alcohol and herbal supplements. Your surgeon may advise you to take Arnica Montana, Bromelain or vitamins A or K for swelling, bruising and to promote general healing.

It is important to remember to only take a supplement or herbal remedy if your surgeon advises it.

Your Pre-Op Checklist

  • Take pictures and make notes to discuss with your doctor. You know what you want, and he knows how to make it possible.
  • Make a list of post-op projects and gather what you need. Stop taking blood-thinning medications and supplements two weeks prior to surgery (aspirin, Motrin, fish oils, vitamin E) and don’t take them two weeks after surgery.
  • Start using anti-bacterial soap in the shower a few days before surgery and following surgery.
  • Remove all fingernail and toenail polish.
  • Fill prescriptions you’ll need, including antibiotics and pain medications.
  • Purchase over-the-counter eye drops and eye gel for overnight (GenTeal seems best and it is found at major drug stores like Walgreens)
  • Pick up Bacitracin for incision areas and Colace to keep your bowels moving during recovery.
  • Clear your calendar for a month post-op.
  • Arrange for caretakers: you, kids, plants and pets need to be taken care of during your recovery. You will not be able to lift, reach, bend over or be too active for some time.
  • Prepare your recovery area so your head is elevated. A recliner works wonders for this. Also stock your recovery area with blankets, water, phone, lotion, tissues, remote control, reading material, laptop, etc.
  • Make a to-do list of things you want to get done prior to surgery and start! You won’t be able to accomplish as much post-surgery. Some items you may want to get done include:
    • Stock up on groceries and easy to prepare meals
    • Clean the house
    • Catch up on gardening
    • Laundry
    • Give the dog a bath
    • Clean the litter box
    • Wash your car
  • Stock up on ice packs, frozen peas and frozen gel packs. You’ll want to use them early and often on your face, neck and ears. It will definitely feel good and keep the swelling down.
  • Pack a receptacle with a lid and towel in your car for the ride home from the hospital just in case you feel nauseous. You may want to add a pillow and blanket, but be sure to set up on the ride home to help with the nausea and swelling.
  • Get your hair and nails done since it will be a while before you can do either.
  • Prepare Power of Attorney for Medical Care and Advance Directives, just in case. Give copies to your doctor and/or surgical center.
  • Breathe and relax! Stress can adversely affect your recovery. Try to remember that you will heal, the soreness will subside and you will look great.

During Your Procedure

The procedures necessary to achieve your goals will be defined along with a plan for the timing of these procedures. Plastic surgery procedures that may be recommended by your physician include:

  • Lower body lift to correct sagging of the abdomen, buttocks, groin and outer thighs
  • Breast lift to correct sagging, flattened breasts
  • Arm lift to correct sagging of the upper arms
  • Thigh lift to correct sagging of the inner, outer and mid thigh

Anesthesia: Medications are administered for your comfort during the surgical procedures. The choices include intravenous sedation and general anesthesia. Your doctor will recommend the best choice for you.

The incision: All body contouring procedures require incisions to remove excess skin. In many cases, these incisions may be extensive.

Incision length and pattern depend on the amount and location of excess skin to be removed, as well as personal preference and your doctor’s surgical judgment.

Advanced techniques usually allow incisions to be placed in strategic locations where they can be hidden by most types of clothing, but this is not always the case.

Body contouring is often performed in stages. Your particular condition and goals, as well as your plastic surgeon’s best judgment, will all influence how your doctor defines a surgical plan. While it may have taken you two years or more to lose all the excess weight, it may take equally as long for the results of your body contouring to be complete.

Body Lift

A complete lower body lift treats sagging buttocks, abdomen, waist, hips and outer thighs in one procedure or in staged procedures. Incision patterns vary, and may include a circumferential incision around the body to remove the “belt” of excess skin and fat.

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Breast Lift

The incision patterns for lifting a woman’s sagging breasts will be determined based on the amount of excess skin to be removed.

These may include one or a combination of incisions in a circular pattern around the areola, in a line extending from the areola to the breast crease, and horizontally along the breast crease.

A breast implant also may be recommended to enhance breast shape and size.

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Arm Lift

Sagging skin in the upper arms is treated with an incision from the underarm area extending along the inside or back of the upper arm. Additional incisions on the arms may be necessary anywhere excess skin has formed sagging pockets.

The smoother, tighter contours that result from upper arm contouring are apparent almost immediately, although initially obscured by swelling and bruising. In addition, skin quality is dramatically improved in both appearance and texture.

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Thigh Lift

Reshaping of the thighs is achieved through incisions in the groin that can extend downward to the knee along the inner portion of the thigh.

Improving contours of the outer thigh may require an incision extending from the groin around the hip. Through these incisions your plastic surgeon will tighten tissues for a smoother, better toned thigh.

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Results

The results of a body contouring following aggressive weight loss are visible almost immediately.
However, it may take as many as one to two years or more for the final results of all the recommended body contouring procedures to fully develop. Visible scars will remain, but the overall results are long lasting, provided that you maintain a stable weight and general fitness.

As your body ages, it is natural to lose some firmness. However, most of your initial improvement should be relatively permanent.

Recovery

After your body contouring procedure is completed, dressings or bandages will be applied to the incisions. A small, thin tube may be temporarily placed under the skin to drain any excess blood or fluid that may collect.

Recovery is an important part of any surgery, and you must take the doctor’s orders to heart if you want to heal as quickly as possible.

You will be given specific instructions that may include: how to care for the surgical site, medications to apply or take orally to aid healing and reduce the potential for infection, specific concerns to look for at the surgical site or in overall health, and when to follow up with your plastic surgeon.

Be sure to ask your plastic surgeon specific questions about what you can expect during your individual recovery period.

Where will I be taken after my surgery is complete?
What medication will I be given or prescribed after surgery?
Will I have dressings/bandages after surgery? When will they be removed?
Are stitches removed? When?
When can I resume normal activity and exercise?
When do I return for follow-up care?

Risks

Risks are associated with every surgical procedure. Feel free to bring up any questions you may have about the risks involved with your surgeon. Risks include:

  • Unfavorable scarring
  • Bleeding (hematoma)
  • Infection
  • Fluid accumulation
  • Poor wound healing
  • Skin loss
  • Blood clots
  • Numbness or other changes in skin sensation
  • Anesthesia risks
  • Skin discoloration and/or prolonged swelling
  • Fatty tissue found deep in the skin might die (fat necrosis)
  • Major wound separation
  • Asymmetry
  • Recurrent looseness of skin
  • Pain, which may persist
  • Deep vein thrombosis, cardiac and pulmonary complications
  • Persistent swelling in the legs
  • Possibility of revisional surgery

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