A woman in her early 70’s who is bothered by laxity of the back skin. She asked about liposuction but this does not tighten loose skin and as we age the skin becomes less elastic. The most reliable way to tighten loose skin is to remove a piece. She is shown before and again, just 6 weeks after a bra-line back lift. With a bra line back lift, the back skin is lifted and the scar is hidden under the bra line. The skin in the flank area is pulled up as well.
A mother of 4 in her later 40’s who is bothered by bulging and laxity of her stomach in clothing and in a two-piece bathing suit. She is shown before and again, nearly 6 months after an abdominoplasty. EXPAREL was used to limit her pain and need for narcotics after surgery.
Her case illustrates the importance of proper scar placement, putting the scar in a “thong” position even if it means a vertical slit scar is needed in the lower abdomen from the opening that is made around the umbilicus as the skin is pulled down. The alternative would be to put the entire scar higher where it would be visible on the abdomen. Scars typically become redder and thicker for 6 weeks and then begin to fade and improve over the next 2 years or longer. At nearly 6 months the scar still has some redness but is improving with topical silicone.
A woman in early 40’s who has lost 130 lbs with a gastric bypass, reducing her weight from 280 lbs to 152 lbs She is 5’ 3 ½” tall. She is bothered by looseness of the upper arm skin and back skin. She is shown just before and again, just 4 months after a bilateral “L” brachioplasty ( “arm lift)” done at the same time as a bra-line back lift. A posterior arm incision placement was chosen. Scars from a brachioplasty will typically get redder and thicker for 6 weeks and then slowly improve over the following 3 years. At must 4 months her scars are starting to fade. She is thrilled and told me about being thilled to be able to wear a sleeveless dress to a wedding recently and being able to dance without loose skin on her arms shaking and jiggling.
An RN mother of 4 in her later 50’S who was bothered by a roll of her abdomen in clothes as well as in a one-piece bathing suit. She was 5’2 and 166 lbs, In addition to bulging of the muscle wall from pregnancy she fatty layer was thicker as well with a caliper pinch of 5 cm ( 3 cm or less is ideal). She elected for a lipo-abdominoplasty which combined liposuction with and a abdominoplasty. She is shown before and again, 6 ½ years after the removal of 1850 cc of fat with liposuction and the excision of skin and fat weighing 1488 grams ( 3 1/3 lbs). She actually feels comfortable wearing a 2-piece bathing suit now! Scars typically get redder and thicker for 6 weeks and then fade and improve over the next 2-3 years. A close-up of her scar is shown at 6 ½ years.
A mother of 2 in her mid 50’s who is bothered by rolls of skin in her abdomen which are difficult to hide in fitted clothing. She is 5’4 ½ and 147 lbs and is shown before and again, 4 months after an extended abdominoplasty. Her scar is low, in a thong position, and a periumbilical hollow and “champagne groove” above the umbilicus were sculpted at the time of her surgery. Exparel was used to decrease her need for narcotics after surgery.
Although swelling will continue to improve for 6 months after abdominoplasty she is already thrilled with her improvement.
A mother of 3 in her early to mid 30’s who is bothered by the appearance of her bulging and excess skin of her abdomen after pregnancies. She is 5’ 4 ½ “ and 148 lbs. She is shown before and again, 4 months after an abdominoplasty. Her scars are hidden in a “thong” position and will continue to improve over the next 18 months. There is typically still a little swelling in the lower abdomen that will resolve by 6 months after surgery. She is absolutely thrilled with her result and is looking forward to wearing a two piece bathing suit again. And she tells me that she is wearing fitted clothes again that she has not been able to wear for years.
Update: Our patient is now seen 1 year after her surgery. The scars have continued to fade and she has an excellent contour.
A mother of 3 in her early 30’s who is bothered by the appearance of her abdomen. She had hyper emesis through her pregnancy which caused her to develop a large umbilical hernia She would like to be able to wear a 2 piece bathing suit again, as well as fitting better in fitted clothing. She is shown before and again, 2 1/1 months after surgery. She is already wearing a 2 piece bathing suit. Scars are at their reddest and thickest at 6 weeks after surgery and then typically fade and improve over the next 2 years. Her scar has been hidden in a “thong” position where is can be hidden by most clothing styles. Patients typically have swelling of the abdomen after surgery that continues to improve for the first 6 momths. She is already thrilled with her early result.
A mother of 3 and a medical professional who is in her mid 40’s and who was bothered by skin hanging over her pants and the stretch marks of the skin. She had a painful umbilical hernia as well. She is shown before and again, 3 years after an extended abdominoplasty with a correction of her umbilical hernia by general surgery at the same time. She is 5’5” and was 150 lbs before her surgery. 1089 gms of skin were removed at the time of surgery (454 gms in a pound, so 2.4 lbs).
Since that time she has become active in fitness competitions and has lost additional weight, now being 136 lbs. She shared some photos from her recent competition and gave us permission to share these. She told us that she received many compliments from her fellow contestants on her abdomen and also on the placement of her abdominoplasty scar. They were amazed that it was low enough to be able to hide it with a thong!. I feel it is important to place the abdominoplasty scar in a thong position where it is low enough to be hidden by yoga pants or hip hugger pants, but high enough on the sides to still be hidden by a French-cut bathing suit. The umbilical stalk is kept short to try and keep the scar around the umbilicus hidden on the inside.
A 39 yo mother of 3 who was bothered by a “roll” of abdominal skin as well as by the appearance of the abdominal skin and bulging of the abdomen after pregnancies. She is shown before and again, 2 years after an extended abdominoplasty. A hernia of her umbilicus was repaired by general surgery at the same time. EXPAREL was used to decrease her need for narcotics after surgery. Progressive tension sutures were used to decrease her risk of seroma formation. Her scar is placed low, in a “thong” position. She is thrilled with the dramatic improvement of her stomach, and is happily wearing a 2-piece bathing suit again!
A mother of 2 in her early 50’s who is bothered by laxity and rolls of the back around her bra area. She had a breast augmentation/ lift elsewhere 20 years before, and an abdominoplasty elsewhere 10 years before. She was seen by another plastic surgeon who had recommended liposuction but I did not feel that this was likely to be helpful in her specific case as the skin calipers showed just 3 cm of pinch in her back, the same as the skin thickness in her abdomen. This is a normal pinch and because this grasps a double layer of skin shows that the actual thickness of the skin and fat is just ½ that or 1.5 cm. Her issue is laxity of the skin, not excess fat and can be demonstrated by a “lift” maneuver. When the skin is manually lifted the rolls go away. The only way we know to reliably tighten loose skin is to take out a piece- in this case the incision is carefully hidden under the bra strap. A “bra-line back lift”. The results as seen here at just 6 week after surgery are dramatic. The scar will continue to fade over the next 2 years but is hidden under the bra. She is already thrilled with her new contour. EXPAREL was used at her request and she did need to take any narcotics after surgery. Tattoos are blurred for her privacy.