47yr, 5'7, female , VSG patient who has lost 120lbs. What procedures will address the front and back of torso? (photos)

Question

47yr, 5'7, female , VSG patient who has lost 120lbs. I plan to have surgery but I'm not sure what i need. I would like to address my stomach, arms and back fat. Current weight is 210lb

Carmina Cardenas, MD · Answer

It is wonderful what you have achieved after losing all the weight. Your BMI still little high and I will recommend to lose 20-25 lbs more in order to achieve a healthier BMI. 
Your will be candidate in separated stages to: Lower Body Lift which will include 360 skin resection, muscle repair, mons lift, front and outer thigh lifting, real buttocks lift, liposuction to waist and lower back, use that fat to transfer to your buttocks and also Butt flap to add more projection. 
Next stage Upper Body Lift which will include Back lift, lateral vertical torsoplasty, arm lift and lipo to arms, breast Lift. 
Be encouraged!! 
You will look awesome after all. 
Dr. Cárdenas

J. Timothy Katzen, MD, FACS · Answer

Thank you for your question regarding what procedures you need to address the front and back of your torso. Congratulations on your weight loss of 120 pounds. Before you consider reconstructive plastic surgery after massive weight loss, your weight should be stable for approximately 3 to 6 months. Once your weight is stable, then you can consider these procedures. In regards to your stomach, I would suggest an extended tummy tuck. This includes permanent elimination of excess skin of the abdomen and hips, pubic (mons) lift and reduction, recreation of the belly button, and abdominal muscle tightening. For your arms, I would suggest an arm lift, arm reduction, or brachioplasty. This includes arm liposuction as well as removal of excess skin and fat from your elbow to your armpit. For your back fat and back skin rolls, I would suggest a torsoplasty. There are two types of torsoplasties. Your best torsoplasty option would be a horizontal torsoplasty or a bra strap-plasty. During the horizontal torsoplasty procedure, an incision is made across your back, ideally underneath her bra strap line. A butterfly area of excess back skin and fat is eliminated.  Another option is the vertical torsoplasty. During a vertical torsoplasty, an incision is made from the armpit down the side of your torso. Sometimes the incision goes to the bottom portion of the bra, sometimes the bottom of the ribs, and sometimes to the top of the hip. The extent of the vertical torsoplasty incision depends on the individual patient. The main advantage of the vertical torsoplasty over the horizontal torsoplasty is that the vertical torsoplasty scar is hidden. However, in your case your best results would be obtained with the horizontal torsoplasty, rather than the vertical torsoplasty.
Many of these procedures can be combined or they can be done in three stages. Please seek an experienced, board-certified plastic surgeon who has performed hundreds of these surgeries.

Gary M. Horndeski, MD · Answer

At 5'7 and 210 lbs, your BMI is 32.5 which is a little high for surgery. I would begin with your breasts using The Bellesoma Method. This will reshape your breast tissue creating upper pole fullness without implants, elevate them higher on the chest wall and more medial to increase your cleavage. Vertical scars are avoided, nipple sensation (in 95%) and the ability to breast feed are maintained. At the same time, liposuction can be done. After these have been completed, you have consider a tummy tuck, If you are not planning future pregnancies, I recommend abdominoplasty with mesh reinforcement. The mesh creates a more hourglass figure by compressing the abdominal wall resulting in early satiety and helps maintain a reduced weight. You will eventually need a posterior continuation of the abdominoplasty that will create the circumferential lift.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Gianfranco Frojo, MD · Answer

I would recommend a lower body lift followed by an upper body lift and last a thigh lift. I would highly recommend seeing a board eligible or board certified plastic surgeon for a physical exam and accurate analysis with safe recommendations for potential surgical options. Best of luck!

Wess Cohen, MD · Answer

Thank you for your question. Congratulations on your weight loss! The road to body contouring can be long. You will likely need multiple procedures to get the absolute result that you want, especially if you are considering a breast lift, arm lift etc. The first procedure should be a circumferential body lift. This will get rid of the excess abdominal tissue, lift your outer thighs, and take care of most of your back rolls. The benefit of this procedure is that it avoids the large midline abdominal scar of a Fluer de lis abdominoplasty. Good luck

Daniel Barrett, MD · Answer

Dear Nice737431,
it is hard to tell for sure without an examination. Based on your photos, it looks like you would benefit from tummy tuck, breast lift and back lift. If you are considering surgery, I would suggest you consult a board-certified plastic surgeon. Only after a thorough examination, you will get more information and recommendations.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Camille Cash, MD · Answer

Congratulations on your impressive weight loss!  From the front you can consider a breast lift with/without reduction and a tummy tuck with liposuction to contour your curves.  The approach for the tummy tuck could be an extended incision or even a circumferential.  A bra line lift would address excess skin and tissue on the upper back.  I've included a video that I hope you find helpful.

Jose A. Munoz, MD - Account Suspended · Answer

Hi and welcome to our forum!Congratulations on your significant weight loss!From your photos, I note excess fatty tissue and lax skin of the flanks, upper and lower back and a lax abdomen. Without photos of the arms, I cannot comment on them. BMI, or body mass index (weight in kg / square of height in meters) is one criterion to determine the results of a cosmetic surgery. You can find BMI calculators on the internet. If your BMI is greater than 30, the cosmetic result will not be optimal. If your BMI is greater than 35, your operative risk will rise. Your BMI is 32.89, a bit high but not prohibitive. An abdominoplasty / beltectomy (circumferential) will flatten the abdomen and eliminate flank and lower back skin excess. An upper back lift / brachioplasty will address your upper back and axillary skin excess and lax upper arm skin. This most likely will require 2 separate operative procedures. Visit a board certified plastic surgeon for evaluation and discussion.Best wishes...

47yr, 5'7, female , VSG patient who has lost 120lbs. What procedures will address the front and back of torso? (photos)

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