Surgery After Weight Loss and Body Lift Procedures

In the United States today, approximately 31% of the population (59 million people) is obese, defined as roughly 30 or more pounds over a healthy weight. Nearly 65% of the US population is considered either obese or overweight, defined as weighing 10 to 30 pounds over a healthy weight. Numerous health problems can arise as a result of obesity, including diabetes, heart disease, and many others.  There are a variety of ways to achieve weight loss, all starting with the self commitment to improve how we both look and feel.  A proper balanced, healthful diet combined with regular exercise is the cornerstone of weight loss and achieving health and fitness.  Surgical procedures, known as bariatric surgery, surgery for weight loss, or obesity surgery, can also be performed.  

After the tremendous achievement of weight loss, and particularly massive weight loss, many people are troubled by the excess loose and sagging skin and fat that remains.  The wonderful accomplishment of weight loss is often, and unfortunately, counterbalanced by the excess of the body, arms, and thighs that are both unsightly and symptomatic.  Thankfully, there are treatments that reduce or remove the excess skin and fat after weight loss, allowing people to truly reach their goals of both feeling and looking better.

The “body lift” describes a series of procedures that are tailored to the individual’s needs after massive weight loss. The Lower Body Lift, the Upper Body Lift, and the Thigh Lift are all body lift procedures that can be performed after extreme weight loss.

The Upper Body Lift removes excess skin and fat from the arms, underarms, chest, breast, and back.  Thigh Lifts remove excess skin and fat from inner thighs, and often outer thighs, and knees.  Every individual’s distribution of excess skin and fat, and their particular desires, are unique, and the different body lift “tools” can be tailored with the appropriate body lift procedure to satisfy one’s particular goals.

Lower Body Lift

The Lower Body Lift removes excess skin and fat from the abdomen, thighs, flanks, and back, while also tightening the torso and lifting the buttocks and thighs.  It is also known as a circumferential abdominoplasty, or dermolipectomy.  Liposuction is often performed as well.  Not only can excess skin and fat be removed with this body lift procedure, but the body can be contoured and “sculpted” to improve appearances dramatically.  This body lift surgery often requires an overnight stay in the hospital.

Upper Body Lifts

The Upper Body Lift can incorporate arm lift (brachioplasty), breast lift (mastopexy), and removal of excess skin and fat from the side of the chest wall and back.  Breast enlargement (breast augmentation with breast implants, or augmentation mastopexy) can also be performed should the individual desire. This type of body lift surgery is most often performed as an ambulatory procedure.

Thigh Lifts

Thigh Lifts remove excess skin and fat from inner thighs, and often outer thighs, and knees, and may incorporate the Lower Body Lift incisions. A Lower Body Lift is most often performed before the Thigh Lift.

Is a Body Lift Right For Me?

Body Lift surgery is only performed after you have reached a weight loss “plateau”.  It is important that nutrition and health are optimum prior to body lift surgery.  Once these are achieved, after thorough consultation with your plastic surgeon the specific body lift procedure and combination of techniques will be selected for your particular needs.

Scarring After Breast Lift

The surgical procedure for a breast lift is an interesting one, though its description could make you think it would leave horrible scars. Remarkably, it leaves few scars and even those tend to fade to near invisibility over time. Several breast lift surgical procedures have been developed, and each offers advantages and disadvantages. Each procedure involves different incisions that determine location, extent and prominence of scarring.

Seeing is believing

While written descriptions of the procedures make it difficult to get a realistic picture of the scars that may result (it sounds worse than it is), seeing photos of pre-and post-breast lift surgeries make it clear that scarring ranges from minimal to nearly invisible once completely healed.

After surgery

Considering how they might look immediately after surgery, and for several months following, you might think they’ll never improve. Expect them to be reddish and swollen, initially. In time they will fade to thin white lines. Products, such as cortisone creams or silicone sheeting used during recovery, can help reduce scarring even more effectively.

Good skin care before and after the surgery will help minimize scarring, as will maintaining good health, consistent weight, a good diet, and other breast health measures. Skin care treatments are far superior to those that were available as recently as 10 years ago, and, now, many are medical grade–something that few could afford in the past. Sunscreens, moisturizers, and avoiding exposure to the sun and harsh environments will help maintain the elasticity your skin needs to keep its lovely shape. Increased elasticity reduces stress on the incisions, which, in turn, keep the scars as invisible a possible.

Quit smoking

Smoking is destructive to just about every part of the body, including your breasts, and can impede the healing that would, otherwise, diminish the scars. One of the effects of smoking is vasoconstriction–narrowing of the blood vessels. Vasoconstriction reduces blood flow that is essential to healing, which can result in slower healing and more noticeable scars due to poor circulation. Smoking can also increase your risk of complications from surgery.

Smoking can cause breasts to sag earlier than non-smoker’s breasts, and can cause sagging even after a breast lift. Also, because smoking contributes to sagging, the incision site can stretch, expanding the scar.

Minimal scarring

Those scars that do remain will be in inconspicuous places. The most prominent ones will be under the breast on the lower side and along the bra band line (in the fold where the breast meets the chest) where they are not likely to be seen. Those around the areola will be along the edge where the areola meets the skin, and will blend in with the change in tissue texture. These are completely unnoticeable except to you and only because you know where they are.

Plastic surgery is as much an art as a science. Choosing a plastic surgeon is vital to a successful breast lift. Be sure to look for a plastic surgeon who has training and credentials specific to plastic surgery, and verify these.

Breast Enlargement: Reduce the Risk of Rippling

Rippling, or wrinkling as it is often referred to by cosmetic surgery professionals, is a fairly common side effect of breast augmentation surgery. Unfortunately, this side effect ruins the appearance of augmented breasts as the skin can appear “wrinkled” or “rippled” much like water rippling on a river or pond. These creases of wrinkled skin are actually a result of the implant beneath the skin taking on a rippled appearance. Whichever way one looks at it, the last thing any woman wants is to have her new implants ruined by unsightly ripples.

There are numerous factors that do contribute to the rippling of breast implants, and there are most definitely ways to ensure you reduce the risk of rippling.

Firstly, saline implants are much more likely to ripple than silicone implants. The wrinkling is most likely to occur due to under-filling the saline implant, and although surgeons often lean towards over-filling as a way to avoid this, it is by no means a practice which is supported by manufacturers as this could lead to deflated implants in the longer term.

Thinner women are also more likely to experience rippling as they tend to have less of their own breast tissue to cover the implants. Again, even thin women are much less likely to suffer from wrinkling and rippling if they opt for silicone implants.

In addition to all of this, the placement and texture of the implants can also contribute to the risk/ reduced risk of rippling. For instance, implants placed beneath the muscle run a much lower risk of rippling along the upper and inner side of the breast, than those placed above the muscle. However, this does not mean that they can’t ripple along the outside and under regions as these are not covered by the muscle. In terms of texture, smooth implants run a much lower risk of wrinkling, whilst textured implants may be more likely to ripple.

Lastly there is profile and natural breast tissue to consider. For whatever reason, high profile implants tend to ripple less than low profile implants, although the choice between the different profiles is usually dependent on the size and shape of your body and not always in the control of the patient. Whilst we are speaking of factors out of control of the patient, it is important to speak about natural breast tissue.

When it comes to breast enlargement and rippling, the bottom line is the patient’s natural breast tissue. The less you have in terms of your own breast tissue, the higher the risk of wrinkling. No matter what precautions you end up taking, if you have little or no breast tissue, you will be more likely to develop wrinkles than a person with a fair amount of their own breast tissue.

The good news for women that have already had breast enlargement surgery that has resulted in a rippled or wrinkled outcome is that it is possible to rectify with a corrective surgery and possibly new implants. This is by no means an ideal however it is possible with a credible and reputable cosmetic surgery provider.

To Best Offer You Options, A Surgeon Must Be Familiar With Various Breast Implant Approaches

There are many different surgical options within breast enhancement. To be able to offer you options, a surgeon must be familiar with different approaches and implants and have the experience and skill to apply those options confidently. There is no specific set of surgical options that is best for every breast surgery patient. If you are offered only one set of options, that may be the only options a breast surgeon can offer – consult other plastic surgeons.

Every patient tends to think that the options she chose are also the best options for someone else, that isn’t true because no two women are exactly alike. Your tissues are definitely different. No surgical option is perfect. No cosmetic breast surgery option is without trade-offs. The question is whether you know the relative benefits and trade-offs and pick the options that best maximize the benefits and minimize the trade-offs. If you and your plastic surgeon don’t discuss your tissues and how your tissues influence the best choice of breast implant for you, you will need to blame something or someone for the consequences. You will probably blame the breast implant or the cosmetic surgeon, when it’s really you who’s largely responsible.

The most important priority in selecting a pocket for the implant is to assure optimal tissue coverage over your implant for your entire lifetime. Optimal tissue coverage means assuring that all portions and edges of your implant are covered by the most tissue available, given your body characteristics.

If your tissues are thin in the areas that cover your breast implant (and we will show you how to measure later), you may need to put the breast implant partially behind muscle, especially in the upper and middle areas of the breast, to assure adequate tissue cover over the breast implant. If you don’t, you run more risks of seeing the edges of your implant and seeing visible traction rippling later, both of which are usually uncorrectable. But there is much more to making the decision.

Breast implants in the past have been placed in one of two locations: Behind your breast tissue but in front of your pectoralis muscle – behind your pectoralis muscle or retro-mammary placement – partial retropectoral placement.

Now there is a new and frequently better option: dual plane1 – behind muscle in the upper breast and behind breast tissue in the lower breast – the best of both worlds above, while minimizing the trade-offs of each!

When silicone-gel-filled implants were available and widely used in the United States, surgeons began placing implants partially behind the pectoralis muscle because silicone-gel implants had a lower risk of capsular contracture (excessive firmness) when they were placed partially behind the pectoralis. With today’s saline-filled implants, the risk of capsular contracture is about the same whether the breast implant is placed in front of the muscle or behind the muscle. So how do you choose, and what difference does it make? The choice is based on the thickness of your tissues – how much thickness you have to cover your brast implants.