The Question
With the rising popularity of bariatric, or weight-loss, surgeries of different types, questions about what can be done to address the excess skin these procedures leave is a growing hot topic for Atlantic Coast Aesthetics and other cosmetic surgery providers. One example is the focus of this week’s Ask Dr. Pane segment. The patient, a Facebook follower of ours from the Miami area, asks, “What are my plastic surgery options after having lost 70+ lbs? Will CTT with torsoplasty, round breast implants, arm lift, thigh lift and Brazilian butt lift be applicable for me?”
The Case
The patient forwarded pictures of her current body for Dr. Pane to examine. He noted extreme skin laxity, or flapping, in the torso, back and thigh areas, with moderate laxity around the upper arms. However, patients are reminded that photographs are never a substitute for in-person clinical evaluation. Any recommendation they receive based on photographs should be taken as an initial impression and by no means final or definitive until they have met with a qualified and experienced cosmetic surgeon to fully assess the patient’s overall condition and medical history.
The Answer
In this case, Dr. Pane says the extreme skin laxity caused by the rapid weight loss would make this patient an excellent candidate for an abdominoplasty, and potentially other procedures as well. However, based on the photographs, he is doubtful the patient has sufficient remaining subcutaneous fat deposits to make fat transfer-based procedures such as a Brazilian butt lift feasible.
The patient in this case should expect to undergo the requisite procedures in stages. Some practitioners would advocate doing everything needed in a single session, but Dr. Pane feels this exposes the patient to unnecessary risk of complications, as well as more stress and strain on the body’s healing processes. In Dr. Pane’s opinion, the patient would be best served to undergo the procedures in distinct stages to allow time both for the patient to recover from one series of procedures and to evaluate what else may be required, desired and practical.
Stage one would consist of an extended abdominoplasty, which takes into account both the patient’s front and back. In this patient’s case, the loose skin all around the torso makes this a much more practical method of addressing the issue than a “simple” abdominoplasty. The advantage to this is, some of the tissue from the extended abdominoplasty can be used to augment the buttocks in a modified Brazilian butt lift, since Dr. Pane has concerns about whether enough subsurface fat remains for a traditional BBL. This could also be paired with a breast lift with implants, which is definitely something the patient will want to consider, subject to medical history, healing factor, the condition of the breast tissue at the time of consultation and other considerations.
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The second stage would consist of thigh and arm lift procedures. The thighs are actually the greater concern from Dr. Pane’s perspective, because the arms don’t have as much loose skin as he would typically expect. Nevertheless, there is enough loose skin present to make an arm lift at least worthy of consideration. If the patient is generally in good health and recovers well, a third stage may or may not be required depending on if any “loose ends” remain after the key problem areas are addressed.
ACA does all these procedures on an outpatient basis, and patients normally tolerate the surgery and recovery well with minimal pain. Patients’ compliance with surgical directions before, during and after the procedures help speed the healing time while minimizing discomfort and the risk of complications. Patients can also help the healing process by avoiding habitual and environmental factors such as smoke, sun, indoor and outdoor pollutants and alcohol consumption, which may interfere with the healing process or lead to infections and other postoperative issues.
If you have a question, interest or concern regarding anything to do with cosmetic surgery, the staff of Atlantic Coast Aesthetics welcomes the chance to talk to you! Simply follow us through our social media at Instagram, LinkedIn, Twitter and Facebook; email us through our contact page; or call us at (561) 422-4116. Your question might even be selected as the focus of an upcoming Ask Dr. Pane segment, helping us educate and inform others while giving you actual, honest answers to your questions. Remember, at ACA we believe the only bad question is the one you don’t ask!