Total Body Surgical Blog

What's the point???  Well, there are several.  This week I would like to summarize the past several weeks.  As obesity becomes a growing world wide problem, obesity surgery is becoming a common thing.  The common procedures are the Lap Band, the gastric sleeve, and the Roux en Y bypass.  They all have their place in the treatment of obesity.  As the procedures and massive weight loss occur, the desire and need for body contouring increase.  If you did not see the previous installments, go check them out to see what procedures are most common and in greater detail.  This installment will cover some of the high points of more detailed discussions of weeks past.

1.  Your weight should be stable for a minimum of 12 months.  Lose the weight, get where you want to be and stay there for at least 12 months before having surgery.  Doing it this way gives better results and leads to fewer repeats.

2.  You must be healthy.  Cosmetic surgery is not "minor" surgery.  People can have complications and even death from this type of surgery.  Make sure you have a healthy heart, lungs, kidneys, and that diabetes and hypertension are controlled prior to your surgery.

3.  You cannot have it all done at once.  These surgeries can be very taxing on the surgeon and you.  Sit down and figure out, in order, what bothers you the most.  Then discuss with your surgeon a strategy to attack the areas in a planned way that makes sense and is safe.  Sometimes procedures can be combined but don't get in too big of a hurry, be safe.

4.  Know what is available.  The most common procedures I see, in order, are:

-Tummy tuck

-Breast lift

-Arm reduction

-Butt lift

-Face lift

-Thigh lift

-Back lift

5.  Seek out a safe and well trained professional....nuff said.

Hope this helps.  New topic next week.  If there is anything you would like to hear about, drop me a line, jeffswetnam@yahoo.com and I will try to address it.

Thanks for tuning in and don't miss our specials.  New ones coming for the fall to so keep looking here.

For the last installment on massive weight loss, we will look at the face. Massive weight gain can cause unrecognizable changes in the face.  The neck, cheeks, and chin become stretched with fatty deposits and cause skin changes that may be permanent even after weight loss.

For the lucky few, facial skin will shrink back to its near normal state.  In these cases, nothing is needed.  For the most part, however, what we see is skin that sags in the neck area and jowl formation in the lower face.  Wrinkles may also appear in the cheek area and in the mid face we see volume loss that creates that "tired" look.  In people that lose massive amounts of weight, these changes can occur regardless of age.  When weight loss patients present, they usually have numerous areas of concern and I try to help them prioritize because we cannot do all procedures at once.  Some want their face fixed first, some don't, again, it is a matter of priority.

The only way to gain long term results in recovering a youthful face are lifting procedures.  We devide the face into three main areas. 1. The lower face and neck. 2. The mid face. 3. The brow.  A fourth area would be the eyelid that I will talk about in a later blog.  

The lower face and neck lift.  This procedure addresses the excess neck skin, jowling, and wrinkling in the cheek area.  Sagging skin in these areas can be very pronounced after massive weight loss.  Incisions for this procedure are placed around the ear   and a small incision under the chin.  The arrows show the direction of pull on the skin and the underlying muscle.  If the neck is not lax, a mini face lift (s-lift, lifestyle lift, day lift, etc.) can be done which shortens the incision to the front of the ear and only partially up the back of the ear.

The brow, when sagging, can cause visual problems and most notably can cause wrinkling in the forehead because of continuous muscle contraction as your brain lifts the brow.  For the most part, I use the endoscopic approach to lifting the brow.  This is done through small incisions in the hair that are essentially invisible.  The brow is lifted and anchored.  After doing this procedure, the forehead becomes smooth and the hooding over the eye is gone.

The face lift and brow lift can be done simultaneously if desired.

For the mid face, the problem is usually loss of volume and a hollow appearance develops.  I feel the best way to remedy this problem is by replacing this volume.  This can be done in several ways.  The shortest lasting way to do this is with a filler product.  The volume is placed over the cheek area.  The second best product is fat.  The fat is harvested from the hip or abdominal area and transplanted back into the face rejuvenating the mid face.  The longest lasting way is with implants.  These are solid silicone, pre-formed devices that replace the lost volume in the area.

These three procedures are the ones most commonly used to treat and rejuvenate the face after weight loss.  Not everyone fits the usual mode however, and consultation to figure out the best treatment for you is essential.  Come see us at INTEGRIS Total Body Surgical for a complimentary cosmetic consultation.

Don't forget our breast and lap band specials that are still going on. Act now to take advantage of great savings!! 

To continue the conversation about body contouring after weight loss surgery, this installment will address the thighs and knees.  After the weight loss, the tummy tuck, the arm reduction, the breast lift, and the butt lift, many people are ready to address the thighs.  You may not need all of these procedures, you may only need one or two.  If more than one procedure is required, I usually save the thighs for last.  Why??  Well, to be honest, it is a difficult recovery because of where the incisions must be placed.  Do you need a thigh lift, or will liposuction cure the problem?  It depends on the amount of extra skin that is present.  Too much sagging skin will not contract with liposuction and will need to be removed.  A problem area of fat depostion can be liposuctioned. 

Incisions for a thigh lift are in the groin, following the contour of the upper thigh.  To lift the knee, the incision travels down the inner thigh, making a kind of "T".  Removing this skin allows us to make the thigh tighter and removing the skin in the groin allows us to pull the skin up getting rid of the sagging and re-shaping the thighs.  The incisions are placed in a high motion area that stays moist and is close to areas that can be difficult to keep clean.  These factors can make wound healing a challenge in the best of circumstances.....thigh lifts are not for the faint of heart.  They can, however, make a huge difference in appearance and wardrobe. 

Come see us at Total Body Surgical for all of your body contouring needs.  Time is running out to take advantage of the Breast and lap band specials so don't miss them!!

More next week.