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Body Procedures
Liposuction The Best Candidates for Liposuction The best candidates for liposuction are normal-weight people with firm, elastic skin who have pockets of excess fat in certain areas. You should be physically healthy, psychologically stable and realistic in your expectations. Your age is not a major consideration; however, older patients may have diminished skin elasticity and may not achieve the same results as a younger patient with tighter skin. All Surgery Carries Some Uncertainty and Risk Liposuction is normally safe. Though they are rare, complications can and do occur. Risks increase if a greater number of areas are treated at the same time, or if the operative sites are larger in size. Removal of a large amount of fat and fluid may require longer operating times than may be required for smaller operations. The scars from liposuction are small and strategically placed to be hidden from view. However, imperfections in the final appearance are not uncommon after lipoplasty. The skin surface may be irregular, asymmetric or even "baggy," especially in the older patient. Numbness and pigmentation changes may occur. The Surgery In your initial consultation, Dr. Ebert will evaluate your health, determine where your fat deposits lie and assess the condition of your skin. Dr. Ebert will explain the body-contouring methods that may be most appropriate for you. The time required to perform liposuction may vary considerably, depending on the size of the area, the amount of fat being removed, the type of anesthesia and the technique used. Liposuction is a procedure in which localized deposits of fat are removed to re contour one or more areas of the body. Through a tiny incision, a narrow tube or cannula is inserted and used to vacuum the fat layer that lies deep beneath the skin. The cannula is pushed then pulled through the fat layer, breaking up the fat cells and suctioning them out. The suction action is provided by a vacuum pump or a large syringe, depending on the surgeon's preference. Fluid is lost along with the fat, and it's crucial that this fluid be replaced during the procedure to prevent shock. For this reason, patients need to be carefully monitored and receive intravenous fluids during and immediately after surgery. Technique Dr. Ebert most commonly uses the "super-wet" technique. Fluid — a mixture of intravenous salt solution, lidocaine (a local anesthetic) and epinephrine (a drug that contracts blood vessels) — is injected into the tissue before liposuction to help the fat be removed more easily, reduce blood loss and provide anesthesia during and after surgery. Fluid injection also helps to reduce the amount of bruising after surgery. Usually the amount of fluid injected is equal to the amount of fat to be removed. This technique often requires IV sedation or general anesthesia and typically takes one to two hours of surgery time. Small areas may be done under local anesthesia only. You will see a noticeable difference in the shape of your body quite soon after surgery. However, improvement will become even more apparent after about four to six weeks, when most of the swelling has subsided. After about three months, any persistent mild swelling usually disappears and the final contour will be visible. Content courtesy of PlasticSurgery.org
Tummy Tuck The Best Candidates for Abdominoplasty The best candidates for abdominoplasty are men or women who are in relatively good shape but are bothered by a large fat deposit or loose abdominal skin that won't respond to diet or exercise. The surgery is particularly helpful to women who, through multiple pregnancies, have stretched their abdominal muscles and skin beyond the point where they can return to normal. Loss of skin elasticity in older patients, which frequently occurs with slight obesity, can also be improved. Patients who intend to lose a lot of weight should postpone the surgery. Also, women who plan future pregnancies should wait, as vertical muscles in the abdomen that are tightened during surgery can separate again during pregnancy. All Surgery Carries Some Uncertainty and Risk Thousands of abdominoplasties are performed successfully each year and the results are generally quite positive. Nevertheless, there are always risks associated with surgery and specific complications associated with this procedure. Post-operative complications such as infection and blood clots are rare, but can occur. Infection can be treated with drainage and antibiotics, but will prolong your hospital stay. You can minimize the risk of blood clots by moving around as soon after the surgery as possible. Planning Your Surgery In your initial consultation, Dr. Ebert will evaluate your health, determine the extent of fat deposits in your abdominal region, and carefully assess your skin tone. Be sure to tell him if you smoke, and if you're taking any medications, vitamins, or other drugs. Be frank in discussing your expectations with Dr. Ebert. He will be equally frank with you, describing your alternatives and the risks and limitations of each. If, your fat deposits are limited to the area below the navel, you may require a less complex procedure called a partial abdominoplasty, also know as a mini-tummy tuck, which can often be performed on an outpatient basis. You may, on the other hand, benefit more from partial or complete abdominoplasty done in conjunction with liposuction to remove fat deposits from the hips, for a better body contour. Or maybe liposuction alone would create the best result. The Surgery Most commonly, the surgeon will make a long incision from hipbone to hipbone, just above the pubic area. A second incision is made to free the navel from surrounding tissue. With partial abdominoplasty, the incision is much shorter and the navel may not be moved, although it may be pulled into an unnatural shape as the skin is tightened and stitched. Next, the surgeon separates the skin from the abdominal wall all the way up to your ribs and lifts a large skin flap to reveal the vertical muscles in your abdomen. These muscles are tightened by pulling them close together and stitching them into their new position. This provides a firmer abdominal wall and narrows the waistline. The skin flap is then stretched down and the extra skin is removed. A new hole is cut for your navel, which is then stitched in place. Finally, the incisions will be stitched, dressings will be applied, and a temporary tube may be inserted to drain excess fluid from the surgical site. Content courtesy of PlasticSurgery.org
Thigh Lift The procedure is performed under general anesthesia on an outpatient basis unless otherwise advised by the surgeon. Wide variations in the design of the incisions to meet clothing or personal desires are possible. Lifting the inner thighs requires only short incisions extending from the anterior part of the thigh/groin crease around to the buttock crease. Lateral or anterior thigh lifts can be performed as separate procedures if desired. The buttocks can be lifted with upper or lower scars. The doctor will show you what specific procedures are available to solve your particular problem. The patient is placed in a compression garment (similar to a long-line elastic support girdle) at the end of surgery to reduce swelling and assist in the natural shrinking and tightening of the skin. With smaller thigh lifts, initial discomfort is usually easily controlled with prescription pain medication. With larger thigh lifts, one or two nights care in a skilled nursing facility or hospital are usually required. This allows for pain injections, intravenous catheters, etc. Bruising and swelling usually subside within a month, strenuous activities are usually possible in 6 weeks and almost all symptoms are gone in 4-6 months. Additional procedures that may enhance the result include Liposuction, Breast Enlargement and Tummy Tuck. This procedure is considered cosmetic and therefore is not covered by insurance. The patient is responsible for payment. The specific risks and the suitability of this procedure for a given individual can be determined only at the time of consultation. All surgical procedures have some degree of risk. Minor complications that do not affect the outcome occur occasionally. Major complications are unusual. Content courtesy of LookingYourBest.com
Arm Lift Content courtesy of PlasticSurgery.org
Body Contouring after Having successfully battled obesity, these people are now faced with a new challenge- excessive and hanging skin folds of the abdomen, arms, thighs, breasts, and face. Thinking that once they loose their massive weight they will be attractive again, men and women are disappointed and frustrated with unsightly folds of skin which cover their groin like an apron, hang off their arms like bat wings, and wiggles from their legs when trying to jog. It also creates a problem for personal hygiene. This challenge has led to the development of new ways of Body Contouring, designed specifically for after massive weight loss. In 2005, 68,000 men and women underwent Body Contouring after Massive Weight Loss. After weight loss, almost all patients face multiple problem areas which require multiple surgeries. Before surgery, the patient's health needs to be optimized since many develop anemia or vitamin deficiency after bariatric surgery. Next, the sequence of multiple surgeries needs to be wisely devised with the help of an experienced plastic surgeon who specializes in Body Contouring Following Massive Weight Loss. The most common post-bariatric body contouring surgery is a tummy tuck or abdominoplasty. These are not standard tummy tucks, but rather extensive or "High Tension" tummy tucks designed to also lift the sagging hips and thighs; while tightening the loose abdominal wall muscles. A more extensive form of this tummy tuck is call a Body Lift or Belt Lipectomy which removes the excess skin of the abdominal fold, as well as that from the back, resulting in a greater lift of the sagging buttocks and the thighs. Panniculectomy is a more specific form of a tummy tuck selected for those with an extremely large, heavy, and hanging abdominal pannus. Often, obesity results in the over-stretching and the weakening of the abdominal wall, which produces a Ventral Hernia. This and other types of hernias can also be repaired at the time of a tummy tuck or body lift. The second most common body contouring procedure after massive weight loss is Breast Lift or Breast Reduction surgery. These procedures are not limited to women, since men also develop hanging breast/chest folds after weight loss. In women an Inverted-T or Anchor Mastopexy is used. Often breast implants are added to replenish the lost breast volume. This procedure is at times combined with an Upper Body Lift which removes the excess skin folds of the upper torso which extends to the upper back. Breast reduction surgery after massive weight loss in men has a different aim and design. Its goal is to create a flat and masculine chest. The third most common body contouring surgery following massive weight loss is Brachioplasty. Brachioplasty or Arm Tuck removes excess hanging skin of the upper arms. In its extended form, it also removes the redundant skin folds of the outer chest and the axilla or the armpit. The fourth most prevalent post-bariatric plastic surgery procedure is a Thigh Lift. Thigh Lifts address the excess skin folds of the inner or medial thighs, that of the outer or lateral thighs, or that of the entire thigh. It can rather be extensive, extending along the entire length of the thighs and legs. Finally, the least common plastic surgery procedure performed as a result of massive weight loss is a facelift. This is due to the fact that people gain relatively far less weight in their face than their body. Therefore, after massive weight loss there is relatively less loose skin of the face, as there would be on the other areas of the body. Never the less, patients can face, hanging neck folds, jowls, and cheeks after weight loss. A variety of facial cosmetic surgeries including neck lift, facelift, mid-face lift, or a forehead lift can address problems associated with sagging facial skin. In planning for body contouring procedures after massive weight loss special attention has to be given for optimizing safety and minimizing potential complications for these types of procedures that are rather lengthy, complicated, and performed on patients that might have other associated risk factors such as sleep apnea, obesity, diabetes, heart disease, venous insufficiency, malnutrition, etc. Therefore, these patients need to be medically optimized and cleared by an internist, pulmonologist, or a cardiologist prior to surgery. Furthermore, the surgery facility must be equipped and staffed to provide specialized care for such surgeries, as well as to provide extended post-surgical monitored care. Content courtesy of LookingYourBest.com |
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