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A number of plastic surgical procedures have been developed in order to address body contour issues after massive weight loss. Often after massive weight loss the body does not return to the nice, tight skin envelope that was present prior to weight gain.
Procedures available to address the issues that arise include: body lift, abdominoplasty, mastopexy, brachioplasty, medial thigh lift, upper body lift and face lift. These procedures may be combined with liposuction to optimise body contour. Liposuction alone is rarely suitable for people who have lost a significant amount of weight, since this only increases skin laxity rather than improving it.
At a consultation with Mr Kenton-Smith you can discuss the concerns that you have and prioritise which parts of your body you would most like to be rejuvenated. He will advise you of the likely results of the procedures he discusses, and show examples of results in his own patients
Most people who have undergone significant weight loss will require a body lift to rejuvenate the lower abdomen. A body lift is essentially an extended tummy tuck (abdominoplasty) which meets in the middle of the back. This not only tightens the front of the abdomen but also removes excess skin at the sides and back. It has some effect on tightening the outer thigh laxity which may be present.
Mr Kenton-Smith will advise you of the advantages and disadvantages of an abdominoplasty versus a body lift during a consultation. An abdominoplasty tightens up the loose skin at the front of the tummy and also recontours the abdominal wall, removing of the folds of loose skin at the front of the abdomen. A body lift achieves this along with tightening the sides and the back of the lower trunk as well.
An abdominoplasty usually takes 2 hours and a body lift takes about 5 hours in theatre. Patients generally stay in hospital for 1-2 days after an abdominoplasty and 2-3 days after a body lift. Most people are able to return to sedentary/office type work after 2 weeks for an abdominoplasty and after 3 weeks for a body lift.
Following massive weight loss the skin envelope is often loose and empty. The looseness may extend around the sides of the body towards the back. If the looseness is just isolated to the breast a mastopexy, or breast lift, will lift and reshape the breast. If the looseness extends around to the sides, the incisions will be extended in the form of an upper body lift to tighten this. It is possible to use any excess tissue under the arms to enlarge/augment the breast and avoid the need for a breast implant, this is called autoaugmentation. These possibilities will be discussed with you in full during a consultation. It can be surprising how much larger breasts can appear after having a breast lift or after using autoaugmentation technique.
A thigh lift has an effect on the outside of the thighs. This, combined with liposuction of the outer thigh, lifts and tightens the outer thigh skin. The outer thigh is lifted as part of the lower body lift procedure. This, however, does not address the inner thigh. The inner thigh can be treated with a medial thigh lift.
Liposuction to the inner aspect of the thigh must be performed very carefully in order to reduce the chance of subsequently requiring an inner thigh lift. A consultation with Mr Kenton-Smith will assess your suitability for liposuction to the inner thigh, and advise you if you would be better served with an inner thigh lift. Young, tight skin with no stretch marks is most suitable for liposuction on its own. Following significant weight loss an inner thigh lift is generally required. Both liposuction and an inner thigh lift help to improve the contour of the inside of the thigh and prevent rubbing and chafing.
An inner thigh lift is performed under a general anaesthetic at St Georges or Southern Cross Hospital. Mr Kenton-Smith will see you on the ward and perform preoperative markings prior to theatre. Whilst in theatre, liposuction will be performed to the inner thigh to remove any excessive volume of fat. Following this, an incision will be made in the crease of the groin and the inner thigh will be lifted. Extensive stitching is performed under the skin in order to re-suspend the inner thigh into a tighter position. The skin is then closed. After this operation patients can expect a scar within the groin crease. Most patients can expect to spend one night in hospital after this operation. They are advised to part their legs no further than shoulder width apart for the next two weeks, and avoid vigorous exercise for three weeks.
A Bodylift is performed under general anaesthetic in hospital and costs approximately $21,500 depending on how much time the proceedure will take. This amount includes surgeon's fee, hospital and anaesthetist charges.
Liposuction is performed under general anaesthetic in hospital and costs between approximately $7,500 - $11,300 depening on how large or small the area/areas are. This amount includes surgeon's fee, hospital and anaesthetist charges.
A thigh lift is also performed under general anaesthetic and costs approximately $11,500-$13,000 including hospital, anaesthetic and surgeon's fees.
A more exact price guide will be calculated after your consultation with Mr Kenton-Smith.