Post Bariatric Plastic Surgery – Tummy Tuck (Abdominoplasty): Despite weight loss, abdominal laxity and redundant skin mask the body shaping benefits of weight loss. A tummy tuck makes things right.
What is Post Bariatric Plastic Surgery?
Post Bariatric Plastic Surgery is Plastic Surgery performed after Bariatric Surgery, to reduce the amount of redundant skin left behind after the fat is burned off. To truly understand Post Bariatric Plastic Surgery, it is important to understand Bariatric Surgery.
What is Bariatric Surgery
Bariatric Surgery is surgery designed to cause weight loss in individuals who are morbidly obese. It is not Liposuction. Bariatric Surgery does not remove fat, it causes weight loss by restricting the intake of calories.
How does Bariatric Surgery work?
Bariatric Surgery works through plication, bypass or a combination of the two. Plication reduces the size of the stomach, causing early satiety so less food is eaten. Bypass bypasses a segment of the small intestine causing fewer calories to be absorbed from what is eaten. Since either technique can be “eaten through” without proper dicipline, a combination of the two tends to yield the largest weight loss.
Is Bariatric Surgery Safe?
Bariatric Surgery is more complex than piercing ones ears, and even piercings carry risk. There needs to be a benefit to the surgery that outweighs the risks. This is why Bariatric Surgery is performed only for people who are significantly overweight.
The Benefits of Bariatric Surgery
There are benefits to Bariatric Surgery besides weight loss. Cleveland Clinic researchers recently published the largest review of weight loss surgery to date. They reviewed 73 bariatric surgery and cardiovascular risk factor studies involving nearly 20,000 thousands patients who had weight loss surgery. For the Post Bariatric Surgery Patients, 63% saw their hypertension improve, 73% saw improvement in their diabetes, and 65% had their cholesterol levels fall. The average follow-up was almost five years. The findings were published in the journal Heart.
What happens after Bariatric Plastic Surgery?
The goal of Bariatric Surgery is to cause massive weight loss. It takes about a year for the body to adjust to its new physiology, and for a pateint’s weight and nutrition to stabilize. During this time, adipose tissue is consumed, and the health benefits are produced. Unfortunately, the skin is frequently left deflated and saggy.
That’s where Post Bariatric Plastic Surgery comes in
Post Bariatric Plastic Surgery is designed to remove the excess skin from the body and extremities, and reduce the skin laxity, revealing the new, slimmer body contours and improving the way one looks and feels. Post Bariatric Plastic Surgery Procedures include:
The American Society of Bariatric Plastic Surgery is dedicated to shaping the body after massive weight loss.
Dr. Mele is an Active Member of the American Society of Bariatric Plastic Surgery, a group of Board Certified Plastic Surgeons dedicated to reshaping bodies after massive weight loss. If you have lost a significant amount of weight, or have completed Bariatric Surgery, and are looking to remove loose skin, give my San Francisco Bay Area Plastic Surgery office in Walnut Creek, California, a call at (925) 943-6353, and schedule a personal consultation appointment.
Dr. Mele discusses Abdominoplasty (Tummy Tucks, Mini Tummy Tucks and Liposuction) on the Bay Area's News Station, KRON4.
San Francisco Bay Area Tummy Tuck patients learned the latest in body contouring on Body Beautiful with host Vicki Liviakis. My recent KRON 4 appearance reveals how Tummy Tucks can help after weight loss and childbirth. By removing disproportionate fat and repairing loose abdominal skin and muscle laxity, you can have a rejuvenated belly. This is part four of the video series; however, links to all four parts are available at the bottom of this post. Watch the show on the San Francisco Plastic Surgery Blog, and learn about the latest techniques of Abdominoplasty (Tummy Tuck), Mini Abdominoplasty (Mini Tummy Tucks) and Liposuction.
Abdominoplasty (Tummy Tuck) Video
This is the final of four video segments about procedures for tightening your tummy. The video includes more viewer questions from the live broadcast. If you didn’t have a chance to call in during the broadcast, but you have questions, feel free to call my office directly at (925) 943-6353, or use the contact form at the bottom of the left column. The (415) phone number in the video was for the live broadcast only.
Tummy Tuck (Abdominoplasty) Video Part 4
Tummy Tuck (Abdominoplasty) Information
This Tummy Tuck (Abdominoplasty) Video includes:
How much does a Tummy Tuck cost?
Does insurance cover Abdominoplasty costs?
What type of Tummy Tuck is best for you?
Modifications of Abdominoplasty (Fleur-de-Lis Tummy Tuck) for skin tightening after massive weight loss and after bariatric surgery?
How long is the Tummy Tuck recovery?
Can an Abdominoplasty be performed safely with Diabetes?
Finding the Right Abdominoplasty (Tummy Tuck) Surgeon
If you are considering cosmetic plastic surgery to improve the appearance of your tummy, or any body part, be certain to review the benefits, and the risks, with a Board Certified Plastic Surgeon like myself, as part of your personalized consultation appointment.
Additional Information on Abdominoplasty (Tummy Tuck)
This is part 4 of 4 in a video series on Abdominoplasty (Tummy Tuck) in the San Francisco Bay Area. Additional segments can be found here:
Additional information on Abdominoplasty, Tummy Tucks, Mini Abdominoplasty, Mini Tummy Tucks, Liposuction and many other procedures is available on my main Walnut Creek Plastic Surgery website and information on breast implants and breast augmentation is available on my specialty breast site: San Francisco Breast. Information on procedures frequently combined with Tummy Tuck procedures, like Breast Augmentation or Liposuction, with a Tummy Tuck is also available. The combination of Tummy Tuck and Breast Enhancement (Breast Augmentation, Breast Lift, etc…) is often called a Mommy Makeover.
Dr. Mele discusses Abdominoplasty (Tummy Tucks, Mini Tummy Tucks and Liposuction) on the Bay Area's News Station, KRON4.
I recently appeared on Body Beautiful, and San Francisco Bay Area Tummy Tuck patients learned what’s new in body contouring. If you have lost weight, had a baby or have stubborn bulges of fat, cosmetic plastic surgery may be right for you. Hear the latest about Abdominoplasty (Tummy Tuck), Mini Abdominoplasty (Mini Tummy Tucks) and Liposuction on the San Francisco Plastic Surgery Blog.
Abdominoplasty (Tummy Tuck) Video
Below is the second of four video segments about abdominal rejuvenation. This video includes before and after pictures of tummy tucks both large and small. Comparisons between liposuction and tummy tuck are made. Please note, the (415) phone number in the video was for the live broadcast only. If you have questions about abdominoplasty, feel free to call my office directly at (925) 943-6353, or use the contact form at the bottom of the left column.
Tummy Tuck (Abdominoplasty) Video Part 2
Tummy Tuck (Abdominoplasty) Information
This Tummy Tuck (Abdominoplasty) Video includes:
Abdominoplasty Before and After Pictures after massive weight loss (post-bariatric surgery)
Tummy Tuck Before and After Pictures after childbirth with stretch mark removal
Abdominoplasty Before and After Pictures with muscle tightening
Tummy Tuck Before and After Pictures with removal of lower abdominal fat and muscle tightening
What is the difference between a Mini Tummy Tuck and a Full Tummy Tuck?
Where does Liposuction fit into abdominal rejuvenation?
Where is the scar located for a Tummy Tuck?
Is the Mini Tummy Tuck scar really shorter than the traditional Abdominoplasty scar?
What can be done to minimize the Tummy Tuck scar?
Massage
Topical Silicone
Laser treatments
Finding the Right Abdominoplasty (Tummy Tuck) Surgeon
If you are considering cosmetic plastic surgery to improve the appearance of your tummy, or any body part, be certain to review the benefits, and the risks, with a Board Certified Plastic Surgeon like myself, as part of your personalized consultation appointment.
Additional Information on Abdominoplasty (Tummy Tuck)
This is part 2 of 4 in a video series on Abdominoplasty (Tummy Tuck) in the San Francisco Bay Area. Additional segments can be found here:
Abdominoplasty San Francisco Bay Area (Tummy Tuck) – Part 4 of 4 (Coming Soon)
Additional information on Abdominoplasty, Tummy Tucks, Mini Abdominoplasty, Mini Tummy Tucks, Liposuction and many other procedures is available on my main Walnut Creek Plastic Surgery website and information on breast implants and breast augmentation is available on my specialty breast site: San Francisco Breast.
The Tummy Tuck (Abdominoplasty) remains one of the most frequently performed cosmetic plastic surgery procedures. After blogging about the extreme tummy tuck last week, the fleur-de-lis tummy tuck, I received a lot of questions about when I would use that technique instead of a traditional abdominoplasty. Bay Area residents want to know, so let me start small and work my way through the time-tested techniques for tucking your tummy — from liposuction to the fleur-de-lis abdominoplasty.
Abdominoplasty - Left (before): Multiple rolls of redundant skin are seen after massive weight loss. Right (after): The loose abdominal skin is removed and the muscle wall is tightened, making finding clothes that fit much easier.
Tumescent Liposuction (Liposculpture, Suction Assisted Lipectomy or SAL)
Diet and exercise are always the first line of defense. No plastic surgery can eliminate the need for a proper diet and exercise plan. However, there are some problems that diet and exercise cannot fix. Localized accumulations of fat, which are disproportionate, are discussed in the previous post about Tumescent Liposuction. For bellies with small amounts of excess fat, that have good muscle and skin tone, tumescent liposuction provides a simpler and faster alternative to tummy tucks. Liposuction (SAL) cannot tighten loose skin. Even laser liposuction (LAL) and ultrasonic liposuction (UAL) cannot tighten skin that has lost its tone. If fact, liposuction can make loose skin look worse by further deflating the skin. By removing the fat, the support for the skin is removed, and the skin will fold over itself. The tummy tuck was designed specifically to address this problem.
Mini Tummy Tuck (Mini-Abdominoplasty)
When the abdominal skin and muscle laxity is isolated to the area below the belly-button (umbilicus), a mini tummy tuck may be the best option. For a mini tummy tuck, liposuction is often used in the upper abdomen and the sides to reduce unwanted fat, and a low abdominal incision is used to tighten the skin and muscles of the lower abdomen.
Tummy Tuck (Abdominoplasty) With a “Floating” Belly-Button
In situations where the abdominal skin and muscle laxity is isolated to the area below the belly-button, but there is a small amount of loose skin just above the belly-button a “floating” belly-button technique is used. This is not the normal way to do a tummy tuck, and patients for this technique need to be carefully selected by an experienced, Board Certified Plastic Surgeon. If you are a candidate, however, it usually means more improvement with the same scar as a mini tummy tuck.
Tummy Tuck - Top (before): Excess skin, muscle laxity and disproportionate lower abdominal fat contribute to a flabby appearance. Bottom (after): Excess skin and fat have been removed, and the abdominal muscles tightened. The sides of the rectus abdominus muscle are closer to the midline after the repair.
Tummy Tuck (Abdominoplasty)
The tummy tuck or abdominoplasty is the work horse of abdominal rejuvenation, and the gold standard to which every other abdominal tightening procedure is compared. It requires and incision low on the abdomen, and one around the umbilicus. The procedure allows not only for tightening the abdominal skin, but the removal of excess fat and tightening of the muscles of the abdominal wall. This muscle tightening provides a tighter foundation on which to build your new tummy.
The fleur-de-lis tummy tuck is used when the amount and laxity of the abdominal skin is massive. This is most often seen after bariatric surgery or weight loss of greater then 75 pounds. The fleur-de-lis abdominoplasty incorporates all the features of a tummy-tuck with an additional incision running down the middle of the abdomen to remove excess skin from the midline. It is the biggest operation available, designed to reduce the most extreme amounts of excess abdominal skin.
The Lower Body Lift (Belt Lipectomy)
The lower body lift is a tummy tuck that extends all the way around to body. It is almost exclusively performed in post-bariatric surgery patients. The combination of extreme weight gain stretching out the skin, followed by loss of this weight, leaves a skirt of loose skin that can extend all the way around the back. In these cases, additional weight loss will not improve the appearance. The lower body lift is also called a belt lipectomy because a belt of excess skin and fat is removed. The abdominal muscles can also be tightened to enhance the abdominal contours, like in a traditional tummy tuck.
Body Beautiful on KRON4
Next Monday, March 14th, at 11:00 AM, I will be on KRON4′s Body Beautiful discussing Tummy Tucks. Feel free to call in and have your questions answered live, on the air. For a less public response, use the contact form on the left. While I do my best to provide you with accurate general information about all aspects of cosmetic plastic surgery on the San Francisco Plastic Surgery Blog, the only way to get information specific to your needs is with a personalized consultation appointment. Give me a call at (925) 943-6353 to schedule your consultation today.
Variety is the spice of life, and it is the single most important aspect of plastic surgery that makes my job both rewarding and challenging. Abdominal rejuvenation provides a simple example of what I mean.
From tight bodied bikini models looking to remove that last little area of disproportionate fat, to patients who have lost massive amounts of weight and who are left with rolls of redundant skin, patients looking to smooth out their abdomen come in all shapes an sizes. While a little liposuction may be the perfect fix for small areas of disproportionate fat, it will not remove excess skin. Larger problems usually require larger solutions.
When skin is loose and redundant, liposuction, even laser liposuction and ultrasonic liposuction, will not significantly tighten the skin. Small amounts of skin excess, isolated to below the belly button, can be removed with a mini tummy tuck. However, as the skin laxity becomes a problem above the belly button, the full tummy tuck takes over as the procedure of choice. A full tummy tuck allows for removal of excess skin and fat, and also allows for tightening of the abdominal muscles beneath the skin, all along the midline, from the ribs to the pubis.
Left - Before Fleur De Lis Tummy Tuck after massive weight loss. Notice the abdominal skin is wider than the thighs. The excess skin makes is very difficult to find clothes that fit well. Right - After Fleur De Lis Tummy Tuck with removal of lower and mid abdominal skin excesses, reveals a smooth, well proportioned abdomen after massive weight loss. The decision to use a Fleur De Lis Tummy Tuck was simplified by a preexisting vertical scar.
For the most redundant abdominal skin, even a full tummy tuck may not be enough. Enter the Fleur De Lis Tummy Tuck. The Fleur De Lis Tummy Tuck is more than the full tummy tuck. Like a full tummy tuck, the Fleur De Lis Tummy Tuck incorporates removal of skin and fat from the lower abdomen, and tightening of the abdominal muscles. In addition, the Fleur De Lis Tummy Tuck allows for removal of excess skin from the center of the abdominal wall from the ribs to the pubic region.
A Fleur De Lis Tummy Tuck is reserved for patients with massive amounts of abdominal wall skin. Most commonly this is seen in patients who have lost a significant amount of weight, like that seen after bariatric surgery or after remarkable changes in diet and exercise. If you have seen NBC’s the Biggest Loser, you have seen what happens when massive weight is lost, and the excess skin remains. The Fleur De Lis Tummy Tuck’s additional removal of the excess skin centrally, allows for horizontal tightening, and an overall firmer result.
If you are a San Francisco Bay Area Plastic Surgery patient, looking for abdominal rejuvenation from a Board Certified Plastic Surgeon offering the entire range of treatment options, call today, (925) 943-6353, to arrange your private personalized consultation.
Brachioplasty is the plastic surgery term for an arm lift. For large excesses of upper arm skin, there is no better treatment. While liposuction can address excess fat in the upper arm, it cannot reduce loose skin.
For women and men who have lost a significant amount of weight, the upper arm is an area that can be problematic. With weight gain, the skin expands to cover the increased size. This happens any place on the body that fat is stored, not just the upper arms. The arms, abdomen, breasts, thighs, face and back are frequently lifted and tucked after massive weight loss and post-bariatric surgery. The tailoring of excess skin is an important component of cosmetic plastic surgery, and can dramatically improve appearance. If you have lost a large amount of weight, removing the excess skin completes the transition.
Before and After Brachioplasty (Arm Lift)
Right Arm after weight loss and before Arm Lift (Brachioplasty)
Right Arm after weight loss and after Arm Lift (Brachioplasty)
Above is a woman who has lost about half her weight. She was left with a large amount of skin on her upper arms, sometimes referred to as “bat wings”. Brachioplasty (arm lift) before and after pictures are shown. The picture on the left shows the amount of excess skin present before her arm lift. The picture on the right reveals her appearance after brachioplasty. The incision is placed along the inferior border of the arm to keep it out of sight.
After Weight Loss, When is it Time to Consider a Lift?
If you have recently lost weight, or have had bariatric surgery, it is worth giving your body a year to adjust. This gives your skin a chance to contract, and your body’s digestive system a chance to absorb the nutrients you need to heal. If it has been a year, and there is still too much skin, cosmetic plastic surgery can help.
In this segment from KRON’s Body Beautiful, I talk about ways to get safe and predictable liposuction. Are the latest technologies the best? Some are more controversial than others. There is still something very beneficial about seeing a Board Certified Plastic Surgeon before choosing any treatment.
With a consultation, I can provide you with a list of treatment options, and match the most appropriate treatment with your goals. More importantly, I can get to know you and what the problem is. I can provide much more targeted treatments, after I know where we are starting, what your perceptions are, and where you would like to be after we are done.
Liposuction currently comes in many flavors. Whenever there are multiple solutions, either there are multiple problems, or no one solution is clearly superior. Most liposuction problems are consistent, but there are a few instances that need special treatment to get the desired goals. My patients come to me, because I have years of training and experience. While I try to share this information via the SanFranciscoPlasticSurgeryBlog, you can’t get all the information necessary from reading articles.
As my patient, you need to know, and trust, that I will use the smallest hammer it takes to get the job done. For disproportionate fat pockets, most the time, tumescent liposuction is going to get the job done; however, it is not the only option. I like to keep up with all the latest technology, so in the cases where the technology has something to offer, I can choose it as the best treatment. For the situations when liposuction is not going to be enough, I can offer you more, discuss the options, and take it up a notch when necessary. This is the advantage you get, when you see someone fully trained and dedicated to all aspects of Cosmetic Plastic Surgery.
Liposuction Video for San Francisco’s KRON Body Beautiful
What is the latest technology available for liposuction, and does it provide you with the promised benefits? This segment reviews the current art of liposuction on KRON‘s Body Beautiful with host Vicki Liviakis. The show a half hour long, so I have divided this liposuction video review into four segments. The third lipo video segment is in this post. Links to the other three parts, and the liposuction introduction post can be found below.
Additional liposuction information is available on the Liposuction Page of DrMele.com. Your questions about liposuction will be answered if you to use the contact form to the left. Without an in person consultation, I can only offer generalized answers. Specific answers regarding liposuction are best answered in person.
For more liposuction information, liposuction price ranges or to schedule a personal professional consultation appointment, please call my Walnut Creek Plastic Surgery office at (925) 943-6353. Please do not call the 800 number in the video below. It is only used for viewer questions during the live broadcast.
This video includes viewer phone calls and more information about liposuction. Walnut Creek plastic surgeon, Joseph A. Mele, MD, FACS, answers these questions and more:
Viewer phone call:
Rochelle from Berkeley, had gastric bypass weight loss surgery one year ago. She has questions about how to treat the skin on her arms and inner thighs. Liposuction may help if the skin if tight and some disproportionate fat remains, but if the skin is loose, other procedures may be more appropriate.
More information including:
Does age effect liposuction?
Does weight loss effect liposuction?
Does skin elasticity effect liposuction?
How often is liposuction performed?
Why should you see a Board Certified Plastic Surgeon for your Liposuction?
What does Board Certification mean?
Lip augmentation with HA’s (Hyaluronic Acid)?
Lip augmentation Collagen vs. HA’s (Hyaluronic Acid)?
What types of liposuction are being tried, and do they provide superior results
Tumescent liposuction (dumb lipo) – Still the best liposuction?
The other segments of this broadcast can be found here:
You have reached the fourth and final part of Post Bariatric Surgery San Francisco. The segments can be viewed in any order, but if you missed the first three releases, links are included at the bottom of the page.
I have had the opportunity to discuss post weight loss plastic surgery live on KRON4‘s Body Beautiful. The 800 number appearing on the video was only for the live show. To contact my Walnut Creek plastic surgery office for additional information, or to schedule a private consultation appointment, please call (925) 943-6353. Alternatively, a contact form on the lower left side of this web page has also been provided for your convenience, or click on this link for an expanded contact form.
Topics covered in this segment of Body Beautiful include:
Arm Lift Surgery, with Brachioplasty before and after pictures.
How do age and health effect plastic surgery?
How do I get rid of my baby pooch? Exercise, Tummy Tuck, both?
How can lumps left after liposuction be corrected?
What is the difference between liposuction and lipodisolve?
Post Bariatric Procedures
More information about Post Bariatric Plastic Surgery can be found on the Post Bariatrics page of DrMele.com. Here are links to video presentations about the more common Post Bariatric Plastic Surgery Procedures, and links to the first 3 parts of the above video can be found at the bottom of the page.
This is part 3 of a 4 part series on cosmetic plastic surgery after bariatric surgery or cosmetic plastic surgery after massive weight loss.
Who Gets Post-Bariatric Plastic Surgery?
When we lose weight, there is often enough elasticity in the skin to maintain our shape. With the massive weight loss seen after Bariatric Surgery, and often after pregnancy, the skin is stretched beyond its ability to recoil. Skin can change from form-fitting to redundant, causing bulges in the same places that the fat used to. Skin can change from an unnoticed covering, to an organ that moves with its own momentum, making exercise uncomfortable. When this happens, a board certified plastic surgeon can help.
Cosmetic or Reconstructive? The Answer is Yes.
A lot of time is spent trying to pigeon hole plastic surgery into cosmetic and reconstructive procedures. The truth is all plastic surgery is a mixture of cosmetic and reconstructive elements. The classification is less absolute and more yin and yang. Everything I do is a mixture of both cosmetic and reconstructive surgery, and for post bariatric plastic surgery it is easy to understand.
Post bariatric plastic surgery removes excess skin and tightens the skin that remains. Yes is it cosmetic. Excess skin is not life threatening, and the cosmetic appearance is improved when skin no longer overflows the waist band. However, excess skin can also be painful. It can develop rashes in the folds which can lead to sores and life threatening infections. Correcting or preventing these types of problems is reconstructive.
The following segment focuses on the interplay between weight, exercise and plastic surgery. The 800 number appearing on the video was only for the live show. To contact my office for additional information, please use the form on the lower left side of this web page, or give us a call at (925) 943-6353.
Questions answered in this segment of Body Beautiful include:
Who has more surgery? Men or Women?
How does age, weight and weight loss effect plastic surgery?
Does plastic surgery replace exercise?
How much weight should I loose before plastic surgery?
Once the weight is lost, how long should I wait before plastic surgery?
Post-Bariatric Surgery (Plastic Surgery after Massive Weight Loss) Links:
Sometimes weight loss is not enough. I see many patients who have lost hundreds of pounds, who still are not happy with their shape. If you were overweight, and lost 100 pounds, you should be very proud of yourself. It is not easily done. Whether accomplished with diet and exercise or bariatric surgery, it takes a lot of effort to change one’s lifestyle dramatically. Most patients are very happy with the weight loss. Often, however, more improvement is desired.
Where did all this skin come from?
After weight loss, the problem is no longer excess fat, but excess skin. Rolls of skin that bind at the waist. Redundant skin that drapes on the inner thighs. Flaps of skin that keep moving after the arm has stopped waving. Loose skin that can no longer support the breast and keep it on the chest.
The skin is an amazing organ. It is our greatest barrier to the outside world. It keeps us warm. It cools us down. It protects us from the elements and infection. When we gain weight, it grows, and continues to protect us. When we lose weight, it can shrink too, but there are limits. With weight gain, the skin can be stretched too far, and it cannot shrink back to its original size.
Post-Bariatric Plastic Surgery
Post-Bariatric Plastic Surgery can help. As a member of The American Society of Bariatric Plastic Surgeons, I am able to assist my patients in their transition to a happier, healthier lifestyle. By removing excess skin, an tailoring what remains, I can help complete the transformation in ways that weight loss alone cannot.
Below is part two of a discussion about post weight loss plastic surgery that originally aired on KRON4‘s Body Beautiful.
This segment shows before and after pictures for liposuction, mini-tummy-tuck and tummy tuck. While most tummy tuck have only a horizontal scar that runs below the bikini line, I have included a fleur-de-leis tummy tuck. This type of tummy tuck is most often used after massive weight loss. A fleur-de-leis tummy tuck has a vertical incision in the midline in addition to the lower incision, which is used to further reduce the excess skin left after massive weight loss.
Please note, the 800 number appearing on the video is only for the live show. For more information, or to schedule a consultation appointment, please call me at (925) 943-6353, or contact me via the form on the lower left side of this web page.
