Lateral Body Lift - how can I get a natural look? (Photo)

Question

Hi, after losing 150 lbs, at 16 my first procedure was a tummy tuck. Within the last 15 years, i’ve had 4 body procedures including thigh lift, arm lift, lipo 360 and a body lateral lift. This last one done in 2021needs a revision. I am wondering how other surgeons would solve what looks like a double armpit and awful scar work. Please offer your suggested approach to get a natural look. Thank you!

J. Timothy Katzen, MD, FACS · Answer

Hello amanolis,

Thank you for your question regarding revision options for your lateral body lift. Thank you for your history and your pictures.

A lateral body lift, as shown in your pictures, is often described as a vertical torsoplasty. This involves an incision that extends from the armpit down the lateral breast, sometimes reaching the bottom of the rib cage or even connecting with an extended tummy tuck or lower body lift.

To address your concerns about the scars and the "double armpit" appearance, here is a recommended approach:

Scar Revision: The scar from your previous lateral body lift likely spread due to the significant tension on the incision. A surgical excision of the scar followed by re-approximation with longer-lasting sutures is advised. This time, there will be less tension since not as much skin will be moved. The revision should ideally extend to the lower rib cage for a more natural contour.

Armpit Revision: For the excess skin and fat in the armpit or axillary region, a revision of the previous scar is recommended. This may involve excising the prior scar and, if necessary, employing a Z-plasty technique to reduce the excess skin and fat further. Another alternative is converting to a crescent or mini arm lift, where a crescent-shaped area of excess armpit skin and fat is removed.

The exact surgical plan for your armpit and overall revision can only be determined during a thorough consultation and physical examination. An in-person evaluation will provide the necessary insights to tailor the procedure to your specific needs.

These revisions can certainly help in achieving a more natural look. Good luck with your surgery, and I hope my recommendations help guide you toward the desired results.

Sincerely,

J. Timothy Katzen, MD, FASMBS, FICS

Daniel Barrett, MD · Answer

Dear amanolis,
I understand your concern. However, without a proper assessment, it would be difficult to determine what is wrong. It is best that you visit your plastic surgeon for further assessment or ask for a second opinion. Only after a thorough examination, you can get proper recommendations and advice.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Peter D. Geldner, MD · Answer

Congratulations on your spectacular weight loss. Thank you for your photos. The issues that they demonstrate can be improved with careful planning and a procedure combining liposuction and skin removal. One key question is how has your appearance changed from the last procedure. If it looked right and changed recently, that may indicate weight fluctuation. But assuming that your weight has not changed, your issues can be improved with creative planning.

Camille Cash, MD · Answer

The best way to get a smoother contour to the under arms and sides will be through skin excision.  A scar revision can also be performed at that time to improve the appearance of the scars.  I encourage you to visit with a board certified plastic surgeon near you for an evaluation.  I've included a video about plastic surgery after major weight loss that I hope you find helpful.

Daniel P. Markmann, MD · Answer

From what I see in your pictures, I would recommend an Axillaplasty, which is basically a scar across your armpit from back to front, removing excess skin and pulling the skin up tighter.  At the same time, I would revise the upper portion of the vertical scar down your sides.

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