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:9/2/2014)... San Diego, CA (PRWEB) September 02, 2014 ... guide titled, “Is Group Therapy Right for Me?” The ... joining group therapy or counseling, in addition to common ... in group therapy improve not only from the interventions ... the group and receiving feedback from group members,” says ...
(Date:9/2/2014)... TCG, a leading government technology strategy and IT consultancy, has ... companies in America for the seventh year in a row, ... 2013, 2012, 2011, 2010, 2009, 2008, and the Inc. 500 ... to 2013, ranking the company at position 3,708 on the ... 635 spots from 2013! More information is on TCG's ...
(Date:9/2/2014)... The Wm. Jennings Bryan Dorn Veterans Affairs Medical ... meeting for Veterans and their families on September 24. ... provide Veterans with valuable healthcare and benefit information,” said Medical ... a forum where we can gather important input directly from ... will be held 4:45 p.m. to 5:45 p.m. in the ...
(Date:9/2/2014)... with early-stage breast cancer in California, the percentage undergoing ... although this procedure was not associated with a lower ... to a study in the September 3 issue of ... for the removal of one breast was associated with ... examined in the study. , Randomized trials have demonstrated ...
(Date:9/2/2014)... (PRWEB) September 02, 2014 Medex ... location of their corporate headquarters in Coral Springs, Fla. ... have exceeded our business development objectives for the 2014 ... Neil Herbst. “Our industry has requested a higher level ... utilization reviews. Medex has delivered, and the industry has ...
Breaking Medicine News(10 mins):Health News:TCG One of the Fastest-Growing Companies in America – for the Eighth Time! 2Health News:Increase seen in use of double mastectomy 2Health News:Increase seen in use of double mastectomy 3Health News:Medex Analytic Services Announces New Location for Corporate Headquarters 2
... are at a greater risk of catching bird flu, as the ... ,A study on cats in areas where outbreaks have ... than thought. It raises the chilling prospect that the disease could ... human pandemic. And it shows that should bird flu ever break ...
... have patented a device, which is capable of the ... by various bacteria, notable amongst which are Salmonella, Campylobacter ... due to food poisoning, as well as of other ... the aim of extending the uses of the device ...
... Dengue fever is a viral infection transmitted through the ... patients //never knowing they have been infected. However, in ... tendency triggering the often-fatal Dengue Shock Syndrome. Because some ... the virus from the tropics back to their home ...
... rise in pneumonia, bronchitis and other acute respiratory infections in ... the United Nations health agency is sending antibiotics for thousands ... many more from catching the illnesses. ,“Early ... save lives,” UN spokesman Adrian Edwards told a press briefing ...
... diuretic drugs should not be recommended as a way to ... caused during pregnancy. It is characterized by high blood pressure, ... urine. The high blood pressure can affect the brain, kidneys, ... in the 1960s to women in order to avoid dangerously ...
... of researchers has constructed a model that predicts how ... by airliners. ,The study, "Modeling the Worldwide ... appears in the January issue of the journal PLoS ... the world's largest-scale epidemic simulation of its kind. ...
Cached Medicine News:Health News:Cat Owners at Risk of Bird Flu 2Health News:A Patented Device for Rapid Diagnosis of Diseases 2Health News:Europeans Developing First-Ever Dengue Fever Vaccine 2Health News:UN Sends Medicine to Afghanistan 2Health News:Avoid Diuretic Pills During Pregnancy 2Health News:Scientists Assess Risk of Flu Pandemic Spread Via Global Airlines 2Health News:Scientists Assess Risk of Flu Pandemic Spread Via Global Airlines 3
Other medicine definitionOther Tags