kathy s WLS Journey - Beginning the Plastic Surgery Journey!
Jul 24, 2005
Body ContouringAfter a person has stomach stapling or gastric bypass, she loses tremendous amounts of weight, usually after having carried many excess pounds for decades. Once the patient has lost the excess and has returned to a more normal weight, she finds the skin on her body has become so stretched, it can be like wearing extra garments. So loose skin hangs on legs, arms, stomachs and chests. Body shaping and contouring is the surgical process that removes the extra skin.
Another option is surgically tightening the skin around the entire body in one stage - a body lift. This is much more extensive surgery, has greater risks, and requires extended hospitalization. Body lifts are often completed in two or three operations.
With the increasing popularity of various cosmetic surgery procedures, including body shaping and contouring, it is important that the prospective patient research and understand different issues like what the procedure can and cannot treat, inherent risks, costs, and other factors. Keep in mind, cosmetic surgery is just that - a surgical procedure whose results cannot simply be erased. While the information contained in this website will provide you with a good introduction to body shaping, when considering this or any other cosmetic procedure, we recommend that you consult a qualified provider with significant experience.
Some important elements you should understand regarding skin removal include the following:
How is Body Contouring Performed?
Depending on how much skin is going to be removed, the operation usually requires two to five hours and is done under general anesthesia. Surgeons may do one operation or may schedule two to four to complete the work. For a total body lift, the surgeon does a tummy tuck (abdominoplasty,) a breast lift or reduction, upper arm lift, middle thigh lift and lower body lift. While doing the tummy tuck, the surgeon will also tighten the muscles along the abdominal wall which helps create a flatter stomach.
The overall effect is smoother, flatter tummy and far less baggy skin on arms, chest, buttocks and legs.
The operation usually starts with a horizontal incision just above the pubic area. Surgeons incise a circle around the belly button (the umbilicus) so it stays attached to the body. They then tighten the abdominal muscles by stitching the overlying sheet of tissue and that allows the muscles to grow back together again. (Pregnancy can also force the stomach muscles to part.) Physicians trim away excess skin and fat, perhaps do some liposuction and then pull the sheet of skin toward the rib cage, trim it and create a new hole for the belly button. Doctors insert small plastic drains - which stay in place for 12 to 18 hours - and then stitch the incision close. Finally, a tight elastic dressing is applied to the stomach.
In an arm lift (brachioplasty,) excessive skin and fat hanging down from an extended arm (known as a "bat wing) is removed by first doing liposuction to remove excess fat. During the procedure, an incision is made on the inside of the arm - where it is less visible -- from above the elbow to the armpit. Sometimes, depending on the amount of skin to be removed, an incision can be made just within the armpit. The excess skin is removed and - if needed - more fat is suctioned away.
The procedure is much the same for removing loose, hanging skin on the upper leg. A thigh lift is performed through incisions placed in the natural groin crease. The excess skin is removed and the tissues are lifted to improve the contour and smooth the skin of the entire area below it extending to the knees. The time for the procedure varies - the average is three to four hours -- based on your body and the extent of lift required. It is usually performed as a day surgery in an accredited facility, although it may require an overnight stay depending on your overall health.
A breast lift restores a youthful shape and position to sagging, deflated breasts that happens with aging, pregnancy, the effects of gravity and weight change. It improves both your self-confidence and appearance. Because many weight loss patients also have had a loss of breast volume, breast implants may be inserted in conjunction with the lift to recreate a fuller appearance. The procedure removes some of the stretched skin to create an uplifted, shapely form. The location and length of the incision will vary depending on the amount of lift required. Doctors make every effort to limit the length of the scar and place it in the most inconspicuous location possible. Fortunately, the beast incisions can be easily covered by bras and bathing suits.
Where do I begin?
Those considering body shaping should first find a qualified cosmetic surgeon to perform the procedure. CosmeticSurgery.com has created an easy and effective way for patients to find a cosmetic surgeon online.
After finding a qualified practitioner, the patient should schedule a consultation appointment with the doctor. This visit allows the doctor to examine the current state of the patient's body. The doctor will also ask about the patient's medical history, medications taken, or other conditions that could prohibit treatment. During this consultation, the doctor will explain the procedure in detail, risk, benefits, costs, length of treatment and other factors. This visit also gives the patient a chance to ask the doctor any questions or voice any concerns about the treatment
How Much Pain is Associated with Body Contouring?
Moderate amounts of temporary pain, swelling, numbness of abdominal skin and bruising are encountered after a body contouring procedure. Patients can expect redness for several weeks or months. The patient undergoes general anesthesia during the operation and often uses a device known as a pain pump while recuperating during the hospital stay -- which ranges from one to eight days. The pain pump is a tube laid across the patient's incision and dispenses pain killers onto the skin at the patient's discretion. Studies have shown the pump reduces post operative pain by about 50 percent. Some swelling may be present just above the line of the scar but will disappear in several months. Also, sensation in the lower portion of the stomach, just above the pubic area, will be reduced and may be permanent.
In the first week to ten days after surgery, some fluid may collect beneath the skin on the stomach. If so, surgeons will use an instrument to draw it out (aspiration).
What are the Long-Term Effects of Body Contouring?
Body contouring, although considered major surgery, is generally very satisfying to patients. When excess skin is surgically removed, clothes fit better; hygiene is easier and more complete while almost all movement is made easier because loose hanging skin no longer rubs against other parts of the body or bulges through clothing. Many patients are able to resume the athletic activities they once enjoyed. Moreover, because the patient will have a more attractive figure and can again wear a wider selection of clothes like short sleeve dresses, sun dresses, shorts, shorter skirts and bathing suits, self-esteem and confidence pick up tremendously.
Who Would best Represent an Ideal Candidate for Body Shaping?
The best candidates are people with good overall health and have had a stable weight for 12 to 16 months after losing massive amounts of weight. Patients who are considerably overweight may be advised to first lose weight before body contouring surgery. If the patient has had a gastric bypass or stomach banding, and has lost at least 100 pounds, then she may be a candidate for body shaping. Surgeons usually advise women who are pregnant, or who plan to become pregnant, to wait until they have returned to their normal weight.
Additionally, doctors advise avoiding overexposure to the sun; avoiding stringent diets; aspirin, Advil or other aspirin containing products for two week before surgery. If you smoke, stopping will aid in healing.
What Are the Risks and Limitations of Body Shaping?
Risks include blood clots, infection and bleeding under the skin flap. In a few cases, poor healing results in conspicuous scarring or skin loss and creates the need for a second operation. If patients gain significant weight after excess skin is removed, the skin will stretch again. Patients can return to work in two to four weeks and must avoid strenuous activity for another four to six weeks. The fading of scars can require three months to two years; scars may lighten after six to nine months. Returning to work usually occurs after two to four weeks.
What Are The Typical Costs Associated With Body Shaping?
The procedure is time consuming for surgeons, anesthesiologists and attending help, uses a lot of operating room and hospital resources and incurs many other fees. So the cost ranges from $20,000 to $55,000 and is usually not covered by health insurance, with few exceptions. Many patients take second mortgages on their homes or forego buying a new car to pay for the operation.
Ten Questions Body Shaping Patients Should Ask Their Surgeon
Prior to any body shaping procedures, a consultation will occur between the prospective patient and the providing surgeon. During this consultation, the surgeon and patient will discuss the treatment plan like the desired outcome, various options that are available to achieve it, the procedure itself as well as various risks and limitations. The surgeon will also provide information regarding anesthesia options, the location and description of where the procedure will be performed (i.e., hospital vs. office surgical suite) and associated costs. A discussion regarding the patient's medical history, as well as a physical examination of the area to be treated will also take place during the consultation.
To better educate the patient about body shaping, as well as assist in formulating realistic expectations, it is recommended that the patient look at before and after photographs, speak with previous body shaping patients, (you are always welcome to ask your doctor for referrals to previous patients and where to contact them) and get answers to the following questions:
1. Are the desired results I described realistic?
2. Where is the body shaping procedure performed and how long will it take?
3. In my case, what technique and which shaping technique are most appropriate?
4. What kind of anesthesia will the surgeon use during the surgery?
5. How much does body shaping cost and what other elements factor into that cost (i.e., hospital fee, anesthesia, etc)?
6. What is the surgeon's level of experience in performing body shaping?
7. What percentage of patients experience complications with body shaping?
8. What is the surgeon's policy in regards to correcting or repeating the procedure if the body shaping does not meet agreed upon goals?
9. What should I expect, post-operatively, in terms of soreness, scaring, activity level and so on?
10. Have you ever had your malpractice insurance coverage denied, revoked or suspended?
Before and after photos may be supplemented with additional valuable information by requesting the names and contact information for several of the surgeon's body shaping patients.
In addition to the previously mentioned questions, it is imperative that body shaping patients relay to their surgeon information regarding any allergies and serious medical conditions they may have. Furthermore, patients should inform the surgeon of any medications they are taking.
This site provides information about plastic/cosmetic surgery and is designed to help users make decisions regarding their own treatment options. But medical information is not the same as medical advice--the application of medical treatment to a person's specific cir****tances. Although we go to great lengths to make sure our information is accurate and useful, we recommend you consult a qualified medical practitioner if you want professional assurance that our information, and your interpretation of it, is appropriate to your particular situation.
Updated thoughts - Do your research, see more than 1 surgeon and take your time. I was turned down by the insurance company for my surgery until they saw the color photos of all the sores and bleeding rashes. They changed their minds and I was so lucky! That was over 10 years ago and while I think it's even harder today fight and don't give up. Document and take photos! PS was just as important to my success and keeping the weight off as the WLS.
HW:330 - GW:150 - MW:118-125
RW:190 - CW:130
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