A 45 yo woman is shown before and 6 weeks after an abdominoplasty. Her case was made more difficult by having had liposuction of her stomach 10 years previously by a non-plastic surgeon. This did not properly address the looseness of skin and muscle following her babies. She felt that this had made the appearance of her abdomen worse. She had a bulge of fat in her mid abdomen following the liposuction but the majority of the irregular “cellulite” appearance following the liposuction was in her lower abdomen and was able to be corrected with her abdominoplasty, which tightened the skin and muscles which had been loosened by her pregnancies. The fat bulge was also corrected at the same time. This is fairly typical of cases that I see where the diagnosis of loose skin and loose abdominal muscles from pregnancy was not properly made before her initial surgery. The scar from her abdominoplasty is covered by her underwear. The scar around her umbilicus is at its most noticeable at this, her 6 week visit. These scars typically fade over the next 2 years.
A 37 yo woman who underwent gastric bypass in 2005 and has lost over 100 lbs shown before and 5 months after an extended abdominoplasty. Her case is made more difficult because she had undergone a previous gall bladder removal through an incision in her right upper abdomen, and this scar can sometimes complicate the blood supply. Her preoperative height and weight are 5’5″ and 173 lbs. She has maintained this stable weight for 2 years.
46 yo female with one child. 5’2″ and 179 lbs shown before and 5 months after an extended abdominoplasty. An extended abdominoplasty fits in between a standard abdominoplasty and a lower body lift. When a patient has enough laxity on the sides, a standard abdominoplasty leaves excess skin along the flanks. A lower body lift continues the incision completely around the trunk. An extended abdominoplasty “extends” the incision further posteriorly without the added time and expense of a lower body lift. An excision of additional skin along the flanks and back can always be added later, but many patients can meet their goals without this additional surgery. The scars shown at 5 months will typically continue to diminish and fade for up to 2 years.
A woman in her mid to later 50’s who is troubled by excess skin of her upper arms after losing 150 lbs following a gastric bypass. She is currently 5’6″ and 156lbs. She is shown before and again, 4 1/2 months after a bilateral brachioplasty ( “upper arm lift”). In her case she and I chose to place the scar at the groove below the biceps muscle on the inner arm. With a brachioplasty I tell my patients that they are trading a visible and potentially unfavorable scar on the surface of the arm to obtain a better contour. Her photos show that this scar is not visible with her arms at her side from the front or rear. Although her scars will typically continue to fade and improve for 2 years or longer after surgery, she is already thrilled with her new contour and the ability to wear more fitted shirts. The loose skin that she has elsewhere in her body after her weight loss is not as bothersome for her because she is able to hide it with her clothing.
36 yo 5’7 1/2″ Male who reduced his weight from 258 to 174 lbs with diet and exercise. He continued to have loose abdominal skin and muscles despite a vigorous exercise regimen. He is shown before and 10 months after abdominoplasty.
A woman in her early 60’s who has lost 65 lbs after at lap band procedure and is bothered by the appearance of her arms. She is shown before and again, 1 year after a bilateral brachioplasty. She had a posterior scar placement combined with power assisted liposuction of each arm. The posterior incision seems to allow for better tightening of the upper arm skin in patients with significant weight loss, but is visible from behind. The brachioplasty scars typically will continue to improve for 3 years. She is pleased with her early result, and can wear more clothing styles now.
A woman in her early 60’s who has lost 83 lbs with diet and exercise. She is nearly 5 feet tall and is 136 lbs. She had bilateral mastopexy/augmentation (breast lift with implants) with the placement of 300 cc smooth round moderate profile plus silicone gel implants placed in a partial subpectoral (below the muscle) position.She is shown 8 1/2 months after bilateral brachioplasty (“arm lift”) and bilateral mastopexy (breast lift), and then 3 months after extended abdominoplasty. Although scars will continue to improve for up to 2 years, she is already thrilled with her early improvement. The brachioplasty trades a visible scar on the arm for a better contour. I prefer to place the scar on the inside of the arm, where tailors typically put the seam of a suit coat sleeve, as it is not visible with the arms at the side. Some surgeons prefer to place the scar at the back of the arm. The extended abdominoplasty extends the incision around the sides and as far back as we can go without turning the patient over during the abdominoplasty. It gives a better correction of the sides than with a standard abdominoplasty, but is less surgery ( and expense) and an easier recovery than a lower body lift. A posterior excision can be done as a second procedure if the patient wants additional tightening to complete a lower body lift in stages, but many patients, including this one do not need or want this.