A mother of 2 in her later 50’s who had a lap band in 2007, that was removed in 2014 and then had an endoscopic gastric sleeve in 2014. She has lost 100 lbs and been at a stable weight for the last 2 years. She is bothered by fullness and laxity of the abdominal skin and would like to be able to wear fitted clothing.
She is shown before and again, nearly 7 months after an extended abdominoplasty with the removal of nearly 5 lbs of skin. She was 5 feet tall and 139 lbs before her surgery. She is thrilled with the improvement of her abdomen and loves catching sight of herself in a mirror now when she walks by in her fitted clothing. Exparel was used to limit her need for narcotics after surgery, and progressive tension sutures were uses to decrease her risk of seroma formation. Her scar is placed low, in a thong position, where it is most easily hidden by clothing.
As is typical in a patient with significant weight loss she continues to have some looseness of the skin of the
upper abdomen, but not enough in her mind to trade it for a vertical scar ( Fleur de Lis abdominoplasty)
A mother of 3 in her early 60’s who has lost significant weight after an endoscopic gastric sleeve 2 years before. She is bothered by the “pouch” of her abdomen that makes it difficult to wear fitted clothes. She is shown before and again, 6 months after an extended abdominoplasty.
A woman in her late 30’s who has lost more than 120 lbs with diet and exercise and is bothered by the appearance of her abdomen, She is currently 5’ 7” and 200 lbs, giving her a BMI of 31.32, She is shown just before and again, 17 months after an extended abdominoplasty with the removal of more than 5 ½ lbs of skin. We could provide additional tightening of the upper abdomen with a midline excision ( a fleur de lis pattern) but she does not wish to have a visible scar in this area. She is thrilled now to fit better in her clothes.
A woman in her mid 50’s who has lost 148 lbs after a gastric bypass more than 15 years before through an open upper abdominal midline incision. She had had Coolsculpting treatment of the abdomen 3 months before coming to see me, but didn’t report any improvement. Of course cryolipolysis is s treatment for fat, and her problem is excess skin, so the lack of improvement is not a surprise. It is always important to make the diagnosis before selecting a treatment.
Our patient is now seen 18 months after her abdominoplasty. The scars have continued to fade.
A mother of 2 in her late 30’s who has had a gastric bypass and has lost 85 lbs. Her case is complicated by having been a recent smoker. She is 5’ tall and 155 lbs, giving her a BMI of 30.27. She was encouraged to not smoke for 2 months before and after her surgery. She is shown before and again, 7 months after an extended abdominoplasty. She had some initial problems with healing in the lower abdomen, but responded to dressing changes and protein supplementation. She is thrilled with her the new shape of her stomach and can now wear normal clothing.
A woman in her mid 30’s who has lost 128 lbs with diet and exercise. She is bothered by the appearance of her abdomen.
She is 5’7” and 200 lbs, giving her a BMI of 31.3.
She is shown before and again, 6 months after an extended abdominoplasty, with the removal of more than 5 ½ lbs of skin. She is thrilled with her improvement, and no longer worries about how to hide her loose abdominal skin in clothing. As is typical after this much weight loss, her skin is not as elastic and her abdomen is not as “tight” in the upper portion. When patients are significantly heavier there is a horizontal excess of skin in the upper abdomen that could be improved further with a vertical excision, known as a Fleur de Lis abdominoplasty. This trades a vertical scar which would be visible in a two piece bathing suit for a tighter appearance. She is pleased with her contour improvement and does not wish the additional scar in this area.
A mother of 2 in her early 30’s who has lost 180 lbs after a gastric bypass. She is bothered by a drooping and deflated appearance of her breasts. She is shown before and again, 8 ½ months after bilateral augmentation mastopexy. She had Sientra 355 cc round textured moderate profile implants placed in a partial subpectoral position along with a “J” mastopexy on her right side and a vertical mastopexy “lollipop” incision on her left.
Texture was chosen to decrease lateral shifting of the implants and the thicker more “form stable” gel of the Sientra implant was chosen to help keep more fullness in the upper breast. Scars will typically continue to fade and improve for 2 years after surgery.