Body Plastic Surgery Procedures
Body contouring procedures are becoming more and more popular today. One reason for this is the recent dramatic increase in the number of patients undergoing weight loss surgeries. In addition, patients in general are becoming more concerned about diet, exercise and weight management. Following massive weight loss patients are often left with large amounts of redundant skin, causing moisture, rash and irritation in areas throughout their body. While topical medications can have a temporary effect on these conditions, surgical resection of the redundant tissue is the definitive treatment. It is important to remember that wound healing issues and scarring are result of body contouring. It is unclear as to the cause, but patients who have had weight loss surgery tend to have more challenges with wound healing than patients who have not had weight loss surgery. In order to remove the areas of redundant skin, incisions are necessary which leads to scarring. For our body plastic surgery patients in Charleston SC, we attempt to place the incisions in areas which hide the scar when possible, but ultimately patients are trading redundant skin and fat for scars, which most patients are happy to do.
Resection of hanging redundant skin from the upper arms is referred to as a Brachioplasty. This procedure involves a linear incision on the inside of the upper arm and at times extension of the incision along the lateral chest wall, depending on the amount of skin which is present. The procedure takes approximately 2 hours and is done as an outpatient. Drains are placed for 7-14 days depending on drainage output volume. Often time’s temporary swelling of the lower arm may occur, but this generally subsidize quickly. ACE wraps are used for compression and elevation is very important when trying to minimize swelling. Wounds are generally well healed by three weeks following the procedure.
Breast Reduction (Reduction Mammoplasty)
Women who have larger breasts associated with neck and back pain, shoulder strap grooving and moisture, rashing and irritation under the breasts are referred to as having symptomatic macromastia. If the patient is unable to alleviate such symptoms with anti-inflammatory medication or weight loss then surgery becomes a reasonable option. The surgery takes approximately three hours and is done as an outpatient. There are 2 drains placed which are in place for 3-5 days post operatively. Patients are encouraged to avoid heavy lifting or straining for the first 3 weeks after surgery. By 6 weeks post operatively, most patients can resume a normal unrestricted level of activity. It is not uncommon to experience some degree of wound separation or drainage along the inframmary fold incision. These issues are generally minimal and self-limiting. The use of daily dressing changes are the only type of treatment generally needed.
This procedure is one which most patients feel better almost immediately after surgery. They state that it is easier to breath and that their neck pain is significantly better without the weight of their breast pulling on their upper back and neck. In fact, most wish they had the procedure years earlier.
Gynecomastia, or male breast enlargement is a benign process which may be the result of hormones, certain medications or be idiopathic in nature (unknown). Often times this condition has a psychological impact on teenage boys and can dramatically impact their social and sports activities. The other subset of men who may be a candidate for male breast reduction, would be those men who have undergone massive weight loss and are left with a large amount of redundant skin and tissue causing moisture, rashing and irritation along the lower fold of the breast and chest region.
The male breast reduction may be performed using liposuction with or without the need for an actual surgical incision. The need for an incision is dependent on the amount of redundant skin which is present and the patient’s age. The procedure takes approximately 2 hours to perform as and outpatient with one drain being left on each side for approximately 10 days following surgery.
Abdominoplasty (Tummy Tuck)
Woman who have been pregnant and patients both male and female who have undergone massive weight loss are the two most common indications for an abdominoplasty. When pregnant, the abdominal wall is stretched slowly over time, which may lead to dermal injury to the skin of the abdomen as well as diastasis (separation) of the rectus muscles of the abdomen. The objective of this procedure is to
- Resect redundant, stretched skin of the abdomen
- Plicate the abdominal rectus muscles eliminating the bulging appearance of the abdomen
- Address lipodystrophy of the lateral abdominal wall and flanks
Many of the same finding mentioned above with pregnancy occur with patients who undergo massive weight loss. Therefore the abdominoplasty is also the procedure of choice to address these issues. The surgery takes 2-3 hours and is done as an outpatient procedure. A drain is left in place for approximately 2 weeks based on fluid output. Patients are generally able to return to unlimited activity within 4 weeks following surgery.
Panniculectomy is similar to abdominoplasty, but specifically refers to patients who have had weight loss surgery and are suffering from panniculitis (inflammation of the abdominal wall). Panniculectomy is a procedure often covered by insurance and does not include plication of the rectus muscles or liposuction.
Thigh Lift (Thighplasty)
Surgery of the thighs or upper legs involves an incision along the medial aspect of the upper leg and possibly the use of liposuction for both the inner and outer aspect of the legs. The procedure is tailored to the patient’s specific clinical issues as well as their desired results and expectations. This is often one of the more challenging surgeries in terms of recovery. The lower legs tend to swell following and wound healing can often be slow following this procedure. Ace wraps and constant elevation when possible is crucial to the recovery process. Drains tend to be in place for up to 3 weeks following the surgery.