J. Timothy Katzen, MD, FACS

Hi Sarahmee1234. Thank you for your question regarding the fact that you are 8 weeks post op from an arm lift, you are using Contractubex gel, and whether you still need your arm garment. Also, the fact that you still think my arms are big. Contractubex gel contains three active ingredients: Extractum cepae, Heparin sodium, and Allantoin. These ingredients work together to soften scar tissue, reduce inflammation, and promote wound healing. Specifically, Extractum cepae has anti-inflammatory and bactericidal properties and prevents the formation of excessive scar tissue. Most plastic surgeons would suggest you continue to use Contractubex for about two months after an arm lift. After that, most plastic surgeons would suggest you use a silicone-based cream and silicone strips for at least six months after your brachioplasty. If you feel that your arms are still large, please follow up with your plastic surgeon. Your arms are probably still swollen. To get an accurate assessment of what exactly you need, schedule a free virtual consultation. Most plastic surgeons offer free virtual consultations. I hope that I have answered your question regarding the fact that you are 8 weeks post op from an arm lift, you are using Contractubex gel, and whether you still need your arm garment. Since a brachioplasty or arm lift surgery is a difficult procedure, please seek an experienced, board-certified plastic surgeon with significant experience performing these types of arm lifts. Do your research. Make sure your chosen plastic surgeon has performed at least 150 arm lifts. Make sure they have the before and after pictures to prove it. Carefully examine their before and after pictures and check their reviews on RealSelf. Sincerely, Dr. Katzen, MD, MBA. (Plastic Surgeon, President of the American Society of Bariatric Surgeons, certified by the American Board of Plastic Surgery, Fellow of the International Society of Aesthetic Plastic Surgery, American College of Surgery, International College of Surgery, and American Board of Metabolic and Bariatric Surgery, and member of the American Society of Plastic Surgery, American Academy of Cosmetic Surgery, RealSelf Hall of Fame, and RealSelf Doctor Advisory Board for Medical Review and Consumer Panel.)

Hi Pivhvbnvbn, Thank you for your question regarding your abdomen itches 6 months post-op abdominal etching, and whether this is common? Itching after any surgery is common. Itching is due to histamine being released by mast cells during the healing and recovery phase. To treat post-VASER HI DEF abdominal itching, most experienced plastic surgeons would recommend an antihistamine, like Benadryl. Benadryl comes in a topical liquid gel or as pills. Either form will work. Deep tissue massage can also help to break up the scarring after VASER HI DEF lipo. A massage wand like a Theragun will also help to break up scar tissue. I hope that I have answered your question regarding your abdomen itches 6 months post-op abdominal etching and whether this is common? If you have any more questions regarding VASER liposuction or reduction surgery, contact an experienced plastic surgeon. Since VASER HI DEF liposuction is a specialized procedure, please seek an experienced, board-certified plastic surgeon with significant experience in VASER HI DEF liposuction. Do your research. Look at their website. Look at their reviews on RealSelf. If you cannot find an experienced, VASER HI DEF liposuction plastic surgeon in your neighborhood, consider traveling out of state if you must. Sincerely, Dr. Katzen, MD, MBA, FACS, FICS, FASMBS. (Plastic Surgeon, President of the American Society of Bariatric Surgeons, certified by the American Board of Plastic Surgery, Fellow of the International Society of Aesthetic Plastic Surgery, American College of Surgery, and International College of Surgery and member of the American Society of Plastic Surgery, American Academy of Cosmetic Surgery, RealSelf Hall of Fame, and RealSelf Doctor Advisory Board for Medical Review and Consumer Panel.)

Hello Nice692482, Thank you for your question regarding whether it is safe to have a back lift and breast lift at the same time when you are 52 years old and 108 pounds. Thank you for your history and your pictures. First, congrats on your weight loss!! Great job. Second, without a physical examination, let’s analyze your pictures to determine what procedure you need. There are two types of back lifts. Back lifts are also called torsoplasties. There is the vertical torsoplasty, where an incision is made from your armpit, down your sides to the top of the hip. A large elliptical paddle of skin and fat is removed from each side. The other back lift is called a horizontal torsoplasty. The horizontal torsoplasty has several names, including the brastrap lift, braplasty, or even upper body lift. During a horizontal torsoplasty, an incision is made across your back, and a large butterfly-shaped area of back skin and fat is removed. With only a single picture to guess, most plastic surgeons would suggest a horizontal torsoplasty as the best treatment for your upper back. We have no pictures of the breast, so we can only assume you need a breast lift. Also, we do not know what type of breast lift you will require. There is the crescent, doughnut, lollipop, or anchor. Any of the breast lifts (mastopexies) can be combined with your horizontal torsoplasty if you are healthy and have no underlying health conditions. If you have the horizontal back lift and the anchor mastopexy, the incisions connect. These procedures are performed under general anesthesia and take about seven or eight hours to complete. Complications of combined brastraplasty and anchor mastopexy include wound breakdown, infection, hypertrophic scarring, and partial or complete nipple areolar necrosis. Three weeks should be sufficient to recover. Good luck. I hope I’ve answered your question regarding whether it is safe to have a back lift and breast lift at the same time when you are 52 years old and 108 pounds. If you have any more questions regarding back liposuction, back lift, vertical torsoplasty, hour-glassing procedure, horizontal torsoplasty, bra strap plasty, or braplasty, contact an experienced plastic surgeon. Since the torsoplasty is a big procedure, please seek an experienced, board-certified plastic surgeon with significant experience performing the vertical and horizontal torsoplasty. Do your research. Make sure they have performed at least 100 torsoplasty surgeries and have the before and after pictures to prove it. Carefully examine their before and after pictures and check their reviews on RealSelf. If you cannot find an experienced torsoplasty plastic surgeon in your neighborhood, consider traveling out of state if you must. Sincerely, Dr. Katzen. (President of the American Society of Bariatric Plastic Surgeons, certified by the American Board of Plastic Surgery, Fellow of the International Society of Aesthetic Plastic Surgery, American College of Surgery, and International College of Surgery and member of the American Society of Plastic Surgery, American Academy of Cosmetic Surgery RealSelf Hall of Fame, and RealSelf Doctor Advisory Board for Medical Review and Consumer Panel.)

Hi Amandaboley12, Thank you for your question regarding whether BCBS of GA PPO pays for a body lift or tummy tuck, since you are a 31-year-old female who has lost over 160 pounds. Congratulations on your weight loss! Great accomplishment.Thank you for your history and your pictures. To get an accurate assessment of your specific needs, schedule a free virtual consultation. Most plastic surgeons offer free virtual consultations. Without a physical examination, we should analyze your single picture to determine the best procedures. Given your history of 160-pound weight loss, most plastic surgeons would suggest a 360 circumferential lower body lift. The 360 circumferential lower body lift is an all-encompassing procedure that includes an extended tummy tuck, umbilicoplasty, mons lift and reduction, rectus abdominis plication, hip lift and reduction, and buttock lift and reduction. An extended tummy tuck does not include the hip lift and reduction, or a buttock lift and reduction. Now that we know what procedure you need, we will approach BCBS of GA PPO. Insurance approval for reconstructive plastic surgery after massive weight loss is complex. Factors to consider are BCBS of GA policies. BCBS of GA policies can be found on their website. Usually, insurance companies do not care how much weight you have lost. Insurance companies are usually looking for a BMI less than 30, the abdominal skin needs to cover the mons, and chronic rashes unresponsive to creams and steroids. Sometimes the apnniculectomy is covered, sometimes the abdominoplasty (tummy tuck). Rarely do insurance companies cover the 360 circumferential lower body lift. If you want to try to obtain insurance authorization for a panniculectomy or tummy tuck, you need to document these rashes with pictures and supplemental medical records. You will also need a letter of medical necessity for your abdominoplasty from your plastic surgeon. However, in the end, it is entirely up to your insurance if they are willing to pay for a panniculectomy or tummy tuck. I hope that I have answered your question regarding whether BCBS of GA PPO pays for a body lift or tummy tuck, since you are a 31-year-old female who has lost over 160 pounds. If you have any more questions regarding the lower body lift, 360 circumferential lower body lift, belt lipectomy, belt abdominoplasty, or belt dermolipectomy, please get in touch with an experienced plastic surgeon. Since the body lift is a big procedure, please seek an experienced, board-certified plastic surgeon with significant experience performing the lower body lift. Do your research. Make sure they have performed at least 150 circumferential lower body lift surgeries and have the before and after pictures to prove it. Carefully examine their before and after pictures and check their reviews on RealSelf. If you cannot find an experienced, lower-body lift surgeon in your neighborhood, consider traveling out of state if you must. Sincerely, Dr. Katzen, MD, MBA, FACS, FICS, FASMBS (President of the American Society of Bariatric Plastic Surgeons, certified by the American Board of Plastic Surgery, Fellow of the International Society of Aesthetic Plastic Surgery, American College of Surgery, and International College of Surgery and member of the American Society of Plastic Surgery, American Academy of Cosmetic Surgery RealSelf Hall of Fame, and RealSelf Doctor Advisory Board for Medical Review and Consumer Panel.)

HI Kflores, Thank you for your question regarding what you need to fulfill your goal of having a small waist, flat stomach, and defined abdominal muscles. Thank you for your history and your pictures. First, it would be best to have an in-office consultation so we can pinch your abdominal wall to assess your remaining fat. Without a physical consultation, the best we can do is to analyze your pictures to determine the best procedures. From your pictures, you still have excess fat of your abdomen. That means you need more VASER liposuction, especially the anterior abdomen and your superior iliac crest (love handles). If VASER liposuction is also needed in the lower back, you would need 360 VASER lipo. VASER would be highly suggested over traditional liposuction because the VASER can melt the scar tissue associated with your prior VASER lipo and tummy tuck. Good luck! The VASER procedure takes about two to three hours to complete. VASER HI DEF can be performed under IV sedation or general anesthesia. Most plastic surgeons prefer general anesthesia because more fat can be removed safely. Also, general anesthesia is less painful compared to IV sedation. Plan for a 10-day recovery. If you have any more questions regarding VASER liposuction or reduction surgery, contact an experienced plastic surgeon. Since VASER HI DEF liposuction is a specialized procedure, please seek an experienced, board-certified plastic surgeon with significant experience in VASER HI DEF liposuction. Do your research. VASER Hi-Def liposuction is difficult to perform and achieve excellent results. Revision VASER lipo is even more difficult. Look at their website. Look at their reviews on RealSelf. If you cannot find an experienced, VASER HI DEF liposuction plastic surgeon in your neighborhood, consider traveling out of state if you must. Sincerely, Dr. Katzen, MD, MBA, FACS, FICS, FASMBS. ( Plastic Surgeon, President of the American Society of Bariatric Surgeons, certified by the American Board of Plastic Surgery, Fellow of the International Society of Aesthetic Plastic Surgery, American College of Surgery, and International College of Surgery and member of the American Society of Plastic Surgery, American Academy of Cosmetic Surgery, RealSelf Hall of Fame, and RealSelf Doctor Advisory Board for Medical Review and Consumer Panel.)