Brachioplasty (Arm Lift)

BRACHIOPLASTY or arm reduction is another common area treated. The main negative of this surgery are the scars which can be quite ugly-raised off the surface, red and spread-ropey like. These do usually fade after a long time and can be treated with revisions/lasers/compression/cortisone injections. The incision ends up either in the crease on the inside of the arm or can be placed at the back of the arm. Usually this is combined with liposuction.

It is done under general anesthesia and can be combined with other procedures. Drains may be placed as well as ace wraps and/or gauntlet type support for up to several weeks, followed by wound support like paper tape for several months.

Thighplasty

Thighplasty is a large procedure and usually just reserved for the weight loss patient. The incisions vary depending on where the excess skin is, but usually at least down next to the pubis and around the thigh onto the buttock. This usually is not combined with a Tummy Tuck for the incisions for each are too close together. This procedure can be done as either an outpatient or inpatient under general anesthesia, and may take up to three plus hours depending on how extensive.

Complications besides infection/bad scars/asymmetry/numbness are the wound separating in different parts/necrosis and not being able to remove all the excess skin and tissue. The recovery is between two and three weeks with showering after about one week, but this can vary for every patient. Supportive garments are worn for about the same length of time.

These procedures may be unusually covered by insurance for in most cases they are purely cosmetic in nature.



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Abdominoplasty

The "tummy tuck" is done as an outpatient at hospital outpatient surgery center with a general anesthetic administered by an MD anesthesiologist.

Normally, all the skin/fat between the cut, which is just above the pubic hair and from one hip to the other, and the belly button can be removed. Also, the muscles are tightened (repair and re-approximation of the rectus abdominis muscles) that have separated usually after childbirth. Other more limited cuts or operations may be done, depending on the patient's situation and the improvement they desire. Also, other procedures, like liposuction, breast/face surgery, can usually be combined.

After the surgery which usually takes about two hours, the patient is placed into a supportive binder/girdle which they wear for about two weeks. This not only provides support, but also prevents fluid or a seroma from developing. A tube or drain is also placed to help prevent this, and it is usually removed in about ten days, after which the patient may shower.

Usually, the person can do light activity within several days and even drive in about a week, but heavy activity only after two/three weeks.

Complications like infection, wound separation, and bleeding are uncommon, while seroma and scarring are more common. The most feared is a pulmonary embolus or blood clot going to the lungs which may even cause death. Precautions against this are used during surgery, like compressive alternating pressure stockings, and the patient is strongly encouraged to at least move their lower extremities every half hour while awake as well as deep breathe and cough while holding in their stomachs. Also, if fluid does collect, it may cause more scarring and a fullness above the incision which can be helped with liposuction performed many months after the procedure. Dog ears or uneven healing can also be easily corrected.

Body Lift

A BODY LIFT is actually a combination of an abdominoplasty(Tummy Tuck), and BUTTOCK LIFT procedure, where the cut is across the abdomen, extends around the sides, and then across the buttock. It removes by pulling down the excess abdominal skin, and pulls up the buttock and removes the excess skin and tissue there also.

It can sometimes be performed as an outpatient, but usually an overnight stay and under a general anesthetic. After the surgery which may take several hours, the patient is placed into an abdominal girdle/binder for about two weeks. Initially, they are in a semi-sitting position and able to fully straighten in about ten days. Limited activity is possible within the first week, and unlimited usually after three weeks.

Some of the complications are bad scars, fluid or seroma collections, infection, wound separation,pulmonary embolus and asymmetry.

Back Lipectomy

A back lipectomy involves removal of excess skin of the upper or lower back or flank areas, and is usually of both sides. This procedure can be done as an outpatient under a general anesthetic, and can be part of a breast skin reduction extended to the back, or an abdominolplasty(Tummy tuck) extended to or across the flanks(Body lift).

The excess skin is marked and then removed at surgery with liposuction used as necessary to tailor the area further. Drains may be placed as well as an elastic type support is used after the surgery. Limited activity is possible within a few days and full activity as early as two weeks.

Bruising, prolonged swelling,seroma formation, infection and separation of the wound is possible. Numbness invariably occurs as well as some asymmetry. The main negative are the scars which are extensive and depend on how much tissue is removed. In the majority of patients, the scars heal with acceptable scars-flat, not too wide and white, but in about 20% of patients, they may be red, spread and ropey, and raised off the surface of the skin.