​The Three Most Common Body Contouring Procedures after a Major Weight Loss and After Multiple Pregnancies

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There is no substitute for staying fit through exercise and eating healthy. But what about those stubborn spots that won’t budge (but do bulge?) Few of us are born with a perfectly proportional body. Even fewer are able to keep it once pregnancy and the 30’s are in the rear view mirror. A variety of surgical procedures can help remove fat or tighten sagging skin. While the tummy and waist seem to get the most attention, body contouring can also address the chin/jowls, upper arms, chest, breast, trunk, hips, thighs, inner knees, calves and ankles. 

      
The best candidates are those close to their ideal weight. Treatment options are dictated by the elasticity of the skin. Liposuction is perfect for patients with skin that “rebounds.” If the skin is loose or weak, liposuction is not the best course. Once fat is removed, if the skin doesn’t retract, you are left with sagging, dimpled skin which is not aesthetically acceptable. Skin must shrink proportionately to amount of fat removed so typically the younger you are, the less chance of risking ripples and waves.


Liposuction can get rid of stubborn fat deposits and prevent fat from coming back in these areas but it cannot address skin texture, firmness, underlying muscles or erase cellulite completely. Additional procedures that tighten skin, remove excess skin or lift the area might be indicated to achieve the appearance you desire.  



Let’s look at the most common body contouring procedures:


  Men and women alike can benefit from body contouring procedures. Post pregnancy, after major weight loss or simply due to aging, proportions can change. All the procedures below take approximately two hours and can often be done on an outpatient basis.


Breast Lift/Breast Reduction
              When you look at your breasts, you most likely evaluate them on size. Am I too big? Not big enough? Simply increasing or decreasing the size of your breasts will do nothing for the positioning of the nipple or the degree of sag. Perhaps you will recognize yourself as being in one of three categories of patients who do well to consider a breast lift.

1.           You have had two or more children, started as a B cup, but went up to a D while nursing. You have stretch marks and your nipples have dropped, cleavage has disappeared and your breasts look “long.”

2.           You always were a C cup, but have lost significant weight. Your breasts have lost mass, but the envelope stayed the same leaving you with empty pockets and enlarged areola.

3.           You are older and notice the elasticity of your breasts gives them the appearance of drooping.



Most patients that are interested in the breast lift procedure are motivated by the following results:

•            Breasts look balanced when wearing a bra

•            A younger breast contour is gained

•            The size of the nipple areola is reduced to fit the smaller breast size

•            The overall breast size is reduced so the associated symptoms are reduced and the breast is proportional to the rest of the body




Breast reduction is one of the most rewarding procedures both aesthetically and functionally. If you have been self-conscious about having large breasts since high school, are sensitive to unwanted attention, or have had to adjust your activity level and clothing to accommodate your chest, you may want to consider a breast reduction. Enlarged breasts also can cause medical problems because of the excessive weight.   The most common complaints secondary to excessive breast size are:

•            Back and neck pain

•            Skin irritation beneath the breast

•            Skeletal deformities

•            Bra strap irritation



In some cases, insurance will cover breast reduction procedures.


Recovery: 2-4 weeks.  

Tummy tuck
Pregnancy or major weight loss can leave you with loose, sagging or projecting lower abdominal wall tissue. A tummy tuck (abdominoplasty) restores the abdominal wall appearance by removing excess tissue and tightening the waist and abdomen. Any scars are hidden beneath the panty line. For women, it not only flattens and tightens the area but eliminates the appearance of white stretch marks and can improve C section scars. Mini tummy tucks are done in the office. The more extended procedure involving the muscle repair beneath requires a general anesthetic in a surgical facility. If muscles have separated (usually due to pregnancy) and are not reconstructed, the final result will be rounded versus a flat abdominal appearance. This is why Dr. Rucker may discuss simulating an internal girdle through reconstruction during your consultation.


Liposuction is often done in conjunction with a tummy tuck to refine contour results.


Liposuction
Liposuction is done to remove excess fat from spot areas of the body, most commonly love handles, tummy and waist. Many types of liposuction methods are on the market but Dr. Rucker prefers the tumescent technique. Fluid is injected into the area to be treated to avoid excessive blood loss. Unwanted tissue is removed through a small hollow tube through ultrasound and a vacuum. For small areas, this is an office procedure. For more holistic treatment a general anesthetic is used, but it is still an outpatient procedure. 


Thigh Lift, Arm Lift
Most often the procedure of choice for someone with significant weight loss, a thigh or arm lift can also deliver beautiful results to those with excess skin due to aging or genetics. Inner thigh skin can be treated by placing the incisions along the inner groin crease. Upper arm lifts are one of the most requested procedures after weight loss. In some cases a modified lift will hide the scar in the arm pit. For more pronounced results, the scar will be on the inner side of the upper arm.  These are outpatient procedures. A thigh lift requires an overnight stay in a surgical facility. Those with extra fat on the inner thigh commonly have extra fat on their knees as well. Both these areas can be further contoured with liposuction for a uniform look.


Noninvasive treatment is always worthy of your consideration, however for permanent improvement in body contour and proportion, these procedures offer lasting and satisfying results.


As with all aesthetic procedures, great outcomes are technique dependent.  Take the time to seek out the best surgeon. 
Article by
Eau Claire Plastic Surgeon