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“You look great!” After losing large amounts of weight through bariatric surgery, many patients hear compliments like this from friends and family. However, patients may not feel like they look “great” because they still have extra skin left over, especially in the abdomen. Due to typical fat distribution before bariatric surgery, the abdomen is usually the area of the body with the most excess skin. Tightening and removal of this extra skin is essential for the patient to be able to wear proportionally-sized clothing and to avoid getting rashes. Skin tightening is an excellent way for bariatric surgery patients to take another step towards leading a happier, healthier life.
Dr. Heistein understands how intimidating skin tightening and bariatric surgery can be. He will make sure that you understand every step of the process and that all of your questions are answered.
Abdominal skin tightening after massive weight loss is done in one of three ways: panniculectomy, tummy tuck, or belt lipectomy. There are also varying degrees of skin removal that can be done on the arms, thighs, chest, back, and breasts. The choice of method will depend on your health, as well as the amount of loose skin you have following bariatric surgery. Dr. Heistein will also base his decision on your postoperative aesthetic goals.
During your Body Contouring After Weight Loss consultation with Jonathan Heistein, M.D., he will answer questions you may have about the procedure or treatment and will discuss any safety concerns related to the surgery.
Panniculectomy is the skin tightening procedure that is most often covered by medical insurance. An incision is made from hip to hip, and the excess skin that is hanging over your pubic area is trimmed. Unlike other methods, a panniculectomy will not tighten any muscles or affect the overall contour of the abdomen; the excess skin is simply removed in order to prevent rashes. This procedure is frequently combined with the other options for abdominal or truncal contouring.
A tummy tuck, or abdominoplasty, is the most commonly requested procedure by patients who have undergone bariatric surgery. Dr. Heistein recommends this method of skin tightening to patients who have lost a great deal of weight, and would like to show off a fit new figure. A tummy tuck differs from the other methods of post-bariatric surgery skin removal in that both the muscle and the skin are tightened. In doing so, Dr. Heistein can give you a more flat, firm belly and a beautiful hourglass figure.
The third option for abdominal skin tightening is called a belt lipectomy, so named because of the incision used. It can also be called a lower body lift since it helps to “lift” the outer thighs and buttocks too. Dr. Heistein makes an incision that extends all the way around the abdomen, at approximately the same height where you would wear a belt; sometimes this is supplemented by an additional incision down the front of the belly to the pubic area. Belt lipectomies are excellent options for patients who have excess skin in large amounts around the abdomen, hips, and back. As one of the few plastic surgeons providing this kind of post-bariatric surgery in the area, Dr. Heistein is proud to work toward restoring a natural and attractive figure for every patient.
An arm lift, or brachioplasty, reshapes the upper arm, by removing excess fat and skin, from the underarm area to the elbow. If the amount of excess is minimal, short or “hidden” scar techniques can be employed to confine the scars to the armpit area only.
In many ways, this is similar to gynecomastia excisions (male breast reduction), but sometimes factors such as massive weight loss necessitate skin removal for restoring a proper form to the chest. This may be confined to the front of the chest or it may extend to the side or back.
A thigh lift is directed either at the outer part or the inner part of the thigh—most commonly the inner thigh. The scar may either be confined to the upper thigh that would be covered by a bathing suit, or it may require skin excision from the groin down to the inner knee. Shorter scar techniques can sometimes be used to keep the scars “hidden” in the groin area only. You should expect a smoother contour soon after your thigh lift.
Medial (inner) thigh lift procedure is aimed at tightening, smoothing and lifting the inner thighs. In a medial thigh lift the incision is in the groin area. In many situations, the incision also runs vertically down the inner thigh toward the knee to remove more of the excess.
The outer thigh lift is aimed at tightening, lifting and smoothing the outer thighs. In an outer thigh lift, incisions are sometimes required from the groin and around the hip, but this depends on individual patient’s needs.
A buttock lift by involves a scar across the low back and can be done either alone or following a previous abdominoplasty. A buttock lift can correct low, flat or unevenly shaped buttocks.
The total cost of body contouring surgery is determined based on factors like your medical examinations, surgeon’s fee, hospital charges, post-surgery garments, and anesthesia. The exact techniques used will also impact cost, as will the total time needed to perform the surgery.
Your Body Contouring After Weight Loss will be performed in Jonathan Heistein, M.D.'s surgery center located in Fort Worth, TX.
My only regret is that I didn’t do it sooner!
by AR
It is common to be overwhelmed after reading about so many possible procedures. Dr. Heistein is an experienced plastic surgeon. During your private consultation and examination he will answer all of your questions and together you will arrive at the appropriate course of action for you.
Yes, a buttock lift is aimed at removing excess skin from the buttocks and then lifting and shaping the buttocks. A thigh lift is performed to lift and shape the thigh area as well as to remove excess skin. These procedures are commonly performed following weight loss with or without weight loss surgery.
The results of thigh lift/buttock lift surgery are permanent in some patients. The patients who see the best long-term results from thigh lifts/buttock lifts (as well as other cosmetic surgeries) are those who maintain a stable weight, refrain from smoking and are in good overall health.
In most cases, yes. For many patients it is much more convenient have multiple procedures performed at one time. However, not all patients are good candidates for combined plastic surgeries. It depends on the health of the patient, the length and difficulty of the surgery, and other factors. Dr. Heistein evaluates each patient on an individual basis. If you are interested in multiple plastic surgery procedures, please be sure to talk Dr. Heistein about this during your consultation.
You will be required to quit smoking several weeks before and also after your surgery to reduce post operative complications caused by smoking. This includes use of nicotine in any form (tobacco, nicotine patches or gum.) Skin loss is 8 to 10 times more likely in smokers. Smoking may cause poor or delayed healing – even death of skin (gangrene) in addition to lung complications and bleeding.
Other procedures which are common following significant weight loss include breast-augmentation, breast-lift, thighlift, buttocklift, tummytuck, abdominoplasty, chest contouring for men, and facial procedures such as facelift, browlift, face and neck lifts.
Definitely! After you heal, you will be able to exercise as much as you like.
Dr. Heistein performs a large number of body contouring procedures and skin excision surgeries each year, and is experienced and skilled in the latest techniques. Many other plastic surgeons only perform a few of these procedures each year. Because of this, they lack the vital experience an expert surgeon needs to provide optimal results.
This is important because a surgeon who does not have privileges at a hospital (that is, the right to use the hospital’s facilities) may not be adequately trained. A hospital will always thoroughly check the credentials of a surgeon. Sometimes, when a surgeon operates in his or her own facility, there is no guarantee that the surgeon is adequately trained.
If you have considered body contouring or skin excision surgery, you can rest assured that Dr. Heistein has been credentialed by and has privileges at most of the major hospitals in and around Fort Worth and Southlake, Texas.
Photos from before and after body contouring and skin excision surgery will allow you to assess a surgeon’s work and determine what look you would like to achieve for yourself. However, there are two considerations that are important above all others: you must be comfortable with your surgeon and your surgeon must listen to your needs. Making sure that these occur will help to ensure that you get exactly the results you want!
Dr. Heistein has many patients who travel from outside the Fort Worth or Southlake areas to have this type of surgery as well as other plastic surgery procedures. Because of this we have several options available to meet your individual needs. Feel free to ask about this at your consultation.
The best source of information is a consultation with a board certified plastic surgeon. To schedule an appointment for a consultation, contact our office at 817.820.0000.
Our offices are located in Fort Worth and Southlake, Texas. In addition to body contouring procedures and skin excision surgery, Dr. Heistein provides breast augmentation, breast lifts, liposuction, facelifts, and more.
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