The Question

Human anatomy is an incredibly diverse and specialized topic. Humans come in all shapes and sizes, and anatomical models are of only limited help when it comes to getting down to the nuts and bolts of a specific patient’s body. This is important to keep in mind, because what may be the correct or even ideal course of action for this patient may be completely inappropriate for another, even though “on paper” they may appear identical. An example of this is the focus of this week’s Ask Dr. Pane segment, a patient who is interested in having some body work done. The patient asks, “I’ve lost a lot of weight (about 65lbs). Is the best course of action a lower body lift [and] breast lift with implant and BBL?”

The Case

Dr. Pane reviewed the photographs the patient provided to evaluate this case. In the absence of a complete medical and clinical history, and better yet an in-person clinical evaluation with complete history, his best opinion follows below. However, patients should always remember that photographs may augment clinical evaluation, but are never substitutes for hands-on analysis in a clinical setting.

The Answer

In this case, Dr. Pane is skeptical about the necessity of a lower body lift. This may prove to be a far more invasive and extensive procedure than is really warranted based on the photos he studied. The patient has a relatively slender build and while there is some looseness of the skin, there is not enough for him to consider a lower body lift as the go-to treatment for this patient.

The question here is really going to come down to priorities. If the patient really wants the BBL as a top priority, versus for example the breast augmentation, then because of her build the BBL will be the most important, because of the need to harvest as much fat from her body as possible. Likewise, if she would prefer breast augmentation through fat transfer, this would take precedence and the BBL may be relegated to a lower tier of priority, once again based on her overall build and the estimated amount of subcutaneous adipose available to work with.

For this patient, Dr. Pane feels the best results for this patient would be achieved through an abdominoplasty, or “tummy tuck,” versus a lower body lift. There is some looseness of the skin, but again, not the kind or scale of looseness which would be typical of radical weight loss associated with a gastric bypass for a morbidly obese person, for example. Depending on how much loose skin is present on the thighs, he may consider a medial thigh tuck, in which the incisions are placed in the creases of the thighs, but a down-the-leg incision would be unnecessary because there simply isn’t enough loose skin present to justify it.

Concerning the breast augmentation, the patient is probably going to get the most benefit from implants as opposed to fat transfer. The reason for this is because there has been some deflation and loss of volume during her weight loss, and that will need to be replaced to restore the shape and appearance of the breasts to what she considers normal. If the patient does not consider the BBL to be as much of a priority, Dr. Pane says he feels the abdominoplasty and breast augmentation, done in a single procedure, will probably offer the most immediate and obvious improvement to the patient while minimizing the recovery time as much as possible. If she wants the BBL as well, she would probably do best to have the BBL and fat transfer done first and then, in a second procedure, have the abdominoplasty and breast augmentation done after an appropriate length of time for the tissue insult from the initial surgery to resolve itself.

Cosmetic surgery is a fascinating and diverse topic, and we at Atlantic Coast Aesthetics love the opportunity to talk shop with patients who are interested in what cosmetic options are available for them to look and feel their best. Simple follow us on Instagram, Facebook and/or Twitter; contact us through the ACA website; or call us at (561) 422-4116. Your question may even become the focus of an upcoming Ask Dr. Pane segment, answered personally by our founder and Chief Medical Officer, Dr. Thomas A. Pane, live on the air! This is great because it gets you the answers you need and want from someone with experience you can trust, while giving us the chance to educate and inform others at the same time. Remember, at ACA, we believe the only bad question is the one you don’t ask!