Navigation Links
Body shaping


Body contouring, also known as body lifting and body shaping is a lengthy, expensive procedure plastic surgeons use to remove large amounts of hanging skin from the bodies of men and women who have lost massive amounts of weight, often as much as 45 to 136 kg (100 to 300 pounds). The excess skin interferes with almost all aspects of the patient’s life.

Contents

History

More people are becoming morbidly obese, a condition reached when a person’s Body Mass Index (BMI) reaches 40 or more. In addition, obesity negatively affects the economic health of a society as well as other aspects of adult and child health, often for life.[1][2]Childhood obesity is on the rise in Europe as well.[3]

Bariatric surgery

In response to a serious obesity crisis, medical science has devised a handful of bariatric (obesity treatment) surgeries, including gastric bypass, stomach stapling, lap banding, stomach reduction and other techniques that reduce the amount of food the stomach can hold. For instance, in the United States, the American Society of Bariatric Surgery (ASBS) reports that the year 2000 saw an estimated 37,700 surgeries to restrict the size of a patient’s stomach. But in 2006, the most recent year for which statistics are available, there were 177,600 such operations. Usually, by 18 months after the surgery, patients report having lost anywhere from 45 to 136 kg (100 to 300 pounds).

Body lifting

Food restriction operations to the stomach have several onerous side effects. One such undesirable side effect that is very bothersome and visible is the loose, hanging skin that covers much of a weight loss patient’s body. Because hundreds of pounds have stretched the patient’s skin to the maximum, it has lost its elasticity and the ability to spring back. Instead, the newly slimmed patient must deal with so much extra hanging skin, he or she can actually stumble on an overhanging panniculus, the large apron of skin hanging from the stomach that can cover the pubis and groin areas. Notably, many extra inches (and sometimes, feet) of floppy skin hang from the upper arms, the chest, the stomach, the upper thighs and buttocks. In the most extreme cases, in order to walk, the patient must reach down and gather up the extra skin hanging on the lower body much like an 18th century woman gathering up her skirts to run.

Most women who have lost massive amounts of weight complain about the difficulty of getting their fleshy arms into sleeves and their excess stomach skin tucked into clothing. Many say that sitting on the loose skin is like sitting on Jell-O. Most women in this state condition require a mastopexy, or breast lift, often with breast implants. Men who have body shaping surgery usually undergo male breast reduction surgery to remove the pendulous skin hanging from their chests.

The extra rolls and sheets of skin rub against each other, creating many spots of irritation and leading to hygienic difficulties. The masses of excess skin also make any form of exercise difficult. Many patients become reclusive and are hesitant to enter romantic or social relationships. Said one massive weight loss patient: “After I lost 155 pounds, (70 kg) it was like I had a size 26 skin hanging on my size 8 body.”[4]

While the procedure is expensive, often running in the neighborhood of US$20,000 to US$50,000 for an entire body, it usually leaves long, visible scars on the arms, chest, stomach and legs. Nonetheless, the body lifting procedure is growing in popularity, thanks to a concomitant rise in weight loss surgeries on the stomach. For instance, in the year 2000, 207 lower body lifts took place, according to the American Society of Aesthetic Plastic Surgeons (ASAPS). But in 2006, 10,323 such lift operations took place, an increase of 19 percent over the previous year.[5]Most surgeons break the surgical task into an upper, and a lower, body lift. A lower body lift removes the sagging skin on the back, abdomen, buttocks and thighs while the upper body procedure removes loose skin from the arms, breasts and chest.

Potential risks and side-effects

Body lifting is not lightly undertaken. The process requires a commitment on the part of the patient who must stay with the program through bariatric surgery, during the 18 months required for weight loss, then the body contouring procedures and recovery. Often, beginning to end takes three years.[6]A single body lifting operation can require seven to 10 hours under general anesthesia, blood transfusions and often, another surgeon to assist. Plastic surgeons advise patients that body shaping is not an obesity operation. A patient who is more than 50 percent over his or her ideal weight must first drop as many pounds as possible before proceeding. Other medical considerations the plastic surgeon must take into account include scars already present on the body, current medical conditions like heart disease or bleeding disorders, and if the patient smokes. Other possible risks include infections and reactions and complications due to being under anesthesia for longer than six hours. The patient may also experience seroma, a build up of fluid; dehiscence (wound separation) and deep vein thrombosis (blood clots forming in the legs.) Rare complications include lymphatic injury and major wound dehiscence. The hospital stay for the procedure can require from one to four days while recovery can require about a month for a total body lift. Essentially, the patient trades “skin for scars.” But skin relaxation is always a risk and may not be stopped with a single procedure.[7]Reputable plastic surgeons will explain all the risks and complications in full to their patients and even encourage a second or third consultation visit with other plastic surgeons to get additional views on such a major undertaking.

Body lifting surgical procedures

While body shaping can be done in one marathon session, it is usually broken into one to three surgical stages, with the patient under general anesthesia. But if the patient is a smoker, has a history of deep venous thrombosis or clotting disorders along with a high BMI and other medical risk factors, the surgeon will probably insist on doing several short procedures in a hospital setting to insure maximum safety for the patient.

The following are the individual components of body contouring:

Arm lift or brachioplasty. The extra flesh on the arms of bariatric patients virtually always appears on the underside of the upper arm and is sometimes referred to as “bat wings.” Surgeons realize they must use long incisions made from the armpit to the elbow to remove the skin and create a more pleasing contour. Consequently, surgeons open the arm on its underside so that the resulting scar is fairly well hidden. A brachioplasty procedure can employ some liposuction after the incision is made. With the arm opened, the surgeon pulls the skin tight and then trims away the excess skin which, depending on the patient, can be a pound of skin per arm or more.

Breast lift or mastopexy. By trimming excess tissue from the upper breast, the surgeon can move breasts which usually droop to the umbillicus to a more upright and full position. The procedure also often requires an implant to make up for lost fat and tissue inside the breast. Scars on women are almost always hidden inside the area covered by the bra. Most men gladly exchange several light, quickly fading horizontal scars across their chest muscles for a sleeker upper trunk that looks good in a T-shirt.

Stomach lift or abdominoplasty. Excess skin hanging down over the pubic region is often the distorting feature that most concerns and bothers patients. The stomach pannus retains moisture, and causes rashes due to skin rubbing against itself which usually leads to poor hygiene. While the surgical procedure to remove it is known as a panniculectomy, there is often more work to be done for patients who suffer from large amounts of hanging skin. To provide improved contours on the waist, back and flanks, surgeons sometimes perform a belt lipectomy, (also known as a torsoplasty or a circumferential lipectomy).[8]The incision goes all the way around the patient’s midsection at the level of the lower waist. The surgeon uses more liposuction on the stomach and flanks while trimming excess skin from the patient’s back and sides as well. The abdominoplasty and belt lipectomy incisions are placed so that the resulting scar is hidden within most underwear and swimsuits, thongs notwithstanding.

Lower body lift trims excess skin on the buttocks and thighs. For an inner thigh lift, the surgeon makes an incision high on the inner leg, starting near the groin and continuing down to the knee. Some fat may be removed with liposuction. The surgeon then removes excess skin and redrapes the remaining skin before closing the long incision, leaving the patient with tighter and more attractive thighs.

The outer thigh and buttock can be lifted through a hip-to-hip incision across the back, above the buttocks.

Usual results

While considered major surgery, the outcome of body shaping is generally extremely satisfying to patients although it can require several months to see the full effects of the procedure. But with a flatter stomach, more curve to the waist and smaller hips, less “back fat” and smaller, better shaped buttocks, patients usually develop more self confidence and become more active. After healing, most patients can buy and fit into easily available clothing, participate in sports and physical fitness activities again and become more involved in social and romantic situations.

When researchers at the University of Pittsburgh enrolled 18 bariatric patients just before the subjects decided to undergo body contouring, their average age was 46, plus or minus ten years. The researchers studied the patients’ body perception, quality of life and mood at three and six months after the body contouring procedures. They found the subjects’ quality of life improved and significantly enhanced their moods which had remained stable at the six-month point.[9] Most body lifting patients return to non-strenuous work in about two to three weeks.

Except for brachioplasty, virtually all body shaping procedures require the patient to wear a support or compression garment for two to six weeks. The garment speeds and aids in healing.

Patients can usually drive again within one to three weeks, depending on the extent of the surgery, their health and general robustness.

Further reading

  • Total Body Lift: Reshaping the Breasts, Chest, Arms, Thighs, Hips. Waist, Abdomen & Knees after Weight Loss, Aging & Pregnancies, Dennis J. Hurwitz, M.D. F.A.C.S., M.D. Publish, NYC
  • Body Contouring Surgery After Weight Loss, Joseph Capella, M.D., Peter Rubin, M.D., and Jeffrey Sebastian, M.D., Addicus Books, Omaha, Nebraska
  • Eating Well After Weight Loss Surgery, Patt Levine, Michele Bontmpo-Saray and William B. Inabnet, Marlowe & Company. Washington, D.C.

References

  1. ^ Dietz; Health Consequences of Obesity in Youth: Childhood Predictors of Adult Disease; PEDIATRICS Vol. 101 No.3 Supplement March 1998, pp 518-525
  2. ^ David Thompson, PhD; John Edelsberg, MD, MPH; Graham A. Colditz, MD, DrPh; Amy P. Bird; Gerry Oster, PhD. Life Health Economic Consequences of Obesity Arch Intern Med. 1999;159:2177-2183
  3. ^ http://www.asbp.org/news_viewer.php?id=115
  4. ^ http://www.cosmeticsurgery.com/articles/archive/an~79/
  5. ^ http://www.plasticsurgery.org/media/Press_Kits/Procedural-Statistics-Press-Kit-Index.cfm
  6. ^ Chandawarkar, RY Body contouring following massive weight loss resulting from bariatric surgery. Adv Psychosom Med. 2006; 27:61-72
  7. ^ Borud, L.J.; Warren, A.G. Body Contouring in the Postbariatric Surgery Patient J Am Coll Surg; 2006 Vol.203 (01) 015 pp 82-93
  8. ^ Aly AS. Cram AE, Heddens C. Truncal body contouring surgery in the massive weight loss patient. Clin Plast Surg 2004;31:611-624,vii.
  9. ^ Song AY, Rubin JP, Thomas V, Dudas JR, Marra KG, Fernstrom, MH. Body image and quality of life in post massive weight loss body contouring patients. Obesity (Silver Spring), 2006 Sep;14(9):1626-36

External links


'"/>


(Date:4/14/2014)... treat children with uncomplicated acute appendicitis is a reasonable ... fewer missed school days, according to a pilot study. ... Hospital and published online April 12 in the ... the first prospective study on nonoperative management of acute ... , Researchers enrolled 77 patients age 7 to 17 ...
(Date:4/14/2014)... 2014, Perth, Australia. Drug discovery company Proteomics International ... of a companion diagnostic (CDx) test with the ... The research team authenticated the panel of biomarkers ... samples. Seven biomarkers were validated at high stringency ... The mass spectrometry data was then cross-validated using ...
(Date:4/14/2014)... 2014) When it comes to the cost and ... Patients get the best care when they are treated ... extensive experience in their current job, according to a ... and Columbia Business School. The study was published in ... Applied Economics . , The review of more ...
(Date:4/13/2014)... STANFORD, Calif. A low-cost empowerment program for ... and sexual harassment of these girls, who live ... and are frequently attacked, a large new study ... Stanford University School of Medicine, Lucile Packard Children,s ... No Worldwide, validated the program,s effectiveness in combating ...
(Date:4/11/2014)... the processes that control brain cell production could pave ... brain-related disorders. , Scientists have gained new understanding of ... how and when nerve and brain cells are formed ... and keeps it healthy. Their findings could help explain ... which is a fundamental characteristic of many diseases including ...
Breaking Medicine News(10 mins):Health News:Antibiotics alone are a successful treatment for uncomplicated acute appendicitis in kids 2Health News:Antibiotics alone are a successful treatment for uncomplicated acute appendicitis in kids 3Health News:Longer nurse tenure on hospital units leads to higher quality care 2Health News:Empowerment program greatly decreases incidence of rape, Stanford/Packard-led study finds 2Health News:Empowerment program greatly decreases incidence of rape, Stanford/Packard-led study finds 3Health News:Empowerment program greatly decreases incidence of rape, Stanford/Packard-led study finds 4
... THURSDAY, March 29 (HealthDay News) -- Doctors may fail ... cleansed before having a colonoscopy, a new study warns. ... instructed to stop eating solid food and to consume ... empty the colon. However, previous research suggests that ...
... Reporter , THURSDAY, March 29 (HealthDay News) -- ... transmit information about a person,s vital health statistics, ... electrodes of electroencephalograms (EEGs) and electrocardiogram (EKGs). ... like a temporary tattoo than a medical patch, ...
... (March 27, 2012)Beatrice Mintz, Ph.D., professor and Jack Schultz chair ... will receive the Ninth Annual AACR Award for Lifetime Achievement ... Annual Meeting 2012, held Sunday, April 1, at 8:15 a.m. ... AACR Award for Lifetime Achievement in Cancer Research was established ...
... Lisa Esposito HealthDay Reporter , THURSDAY, March ... more healthy properties of flavanols -- the antioxidants found ... including investigations of how cocoa might affect blood pressure, ... were to be presented Wednesday at the American Chemical ...
... THURSDAY, March 29 (HealthDay News) -- Although eight states boosted ... that,s a decline in the number of such increases by ... Centers for Disease Control and Prevention shows. One thing ... smoking rates decline as cigarette prices go up, the CDC ...
... researchers have identified a new population of intestinal stem cells ... , This new stem cell population, reported March 30 in ... (inactive) in contrast to the recent discovery of intestinal ... a protein, Lrig1, that may act as a "brake" on ...
Cached Medicine News:Health News:Inadequate Bowel Prep May Invalidate Colonoscopy 2Health News:Wireless Skin Patch Developed to Transmit Medical Info 2Health News:Wireless Skin Patch Developed to Transmit Medical Info 3Health News:Beatrice Mintz, Ph.D., receives ninth annual AACR Award for Lifetime Achievement in Cancer Research 2Health News:Beatrice Mintz, Ph.D., receives ninth annual AACR Award for Lifetime Achievement in Cancer Research 3Health News:Chocolate a Sweet Remedy for Many Ills? 2Health News:Chocolate a Sweet Remedy for Many Ills? 3Health News:Chocolate a Sweet Remedy for Many Ills? 4Health News:States' Efforts to Boost Cigarette Taxes Slows: CDC 2Health News:Newly identified stem cells may hold clues to colon cancer 2
Other medicine definitionOther Tags