In the Media

PLASTIC SURGERY UPDATE:

TOTAL BODY LIFT

BY STEVEN BLOCH, M.D.

Patients who've had massive weight loss due to dieting or gastric bypass often are left with massive amounts of excess skin which will not shrink on its own. This manifests itself as an abdominal apron, laxity of the buttocks and thighs with folds of skin, drooping and deflation of the breasts, and hanging skin on the upper arms. These areas can be approached as separate operations or can now be combined using one surgical event in a total body lift.

A lower body lift combines an abdominoplasty (tummy tuck) with a thigh and buttock lift. The incision is placed in the waistband area and runs around the body, lifting the buttocks and lateral thighs, tightening the abdomen, and defining the waist. The lift is combined with liposuction to remove excess skin and fat. This used to be considered a major operation, but with recent advances and a team approach, the operating time has been cut in half. This has several advantages: With a shorter operation, patients have less bleeding, less chance of infection, and lower complication rates. With these savings, additional procedures can be done safely at the same time, such as arm, medial thigh, and breast lifts.

In the case of a medial thigh lift, an incision is hidden in the groin and under the buttocks. The excess skin is removed and often liposuction is employed to reshape the area. In the case of a breast lift or mastopexy, the nipple is raised and the excess skin is removed. The remaining breast tissue is reshaped into a more conical, youthful appearance. Often, a breast implant is used for additional enhancement.

Recent advances in post-operative pain management and the use of "pain pumps," which slowly infuse long-acting local anesthetics into the wound and numb it up, allow the patient to be up and walking within an hour of surgery. What used to require a lengthy hospital stay can now be done safely on a semi-outpatient basis. The point of a consultation is to address individual needs and come up with a feasible game plan. The important thing to understand is that each patient is unique.