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Body Contouring

Posted December 25, 2014 in Uncategorized

According to the American Society of Plastic Surgeons, body contouring following major weight loss removes excess sagging fat and skin, while improving the shape of the underlying support tissue.

Body Contouring Procedures may include:

  • Facelift: sagging of the mid-face, jowls, and neck
  • Breast lift: sagging, flattened breasts
  • Tummy tuck: apron of excess skin hanging over the abdomen
  • Lower body lifts: sagging of the abdomen, buttocks, groin and outer thighs
  • Medial thigh lift: sagging of the inner, outer and mid thigh
  • Brachioplasty (arm lift): sagging of the upper arms

Body Contouring in San Diego

Coastal Plastic Surgeons is nationally recognized for Gastric Bypass Reconstruction or GBRx™.

Dr. Batra’s GBRx article in Bariatric Times describes his staged approach for achieving a well-contoured shape.

Click here to review Body Contouring San Diego before and after pictures.

The following is a GBRx case study from our video gallery:

Consultation Phase:

Excerpts from Dr. Batra’s Body Contouring article:

While there are certain commonalities between these patients, such as their desire to “look and feel better” about themselves, there is considerable difference between their expectations. There has been shown to be an increased risk of postoperative complications with increasing BMI before body contouring surgery.

This increased risk along with the patient’s expectations have to be set and reinforced during the preoperative appointments. There are at least 2-3 preoperative visits before surgery. During these visits, patients and I discuss their goals and expectations. If both the physician and patient are not upfront about realistic goals and expectations, then both may face disappointment. I ALWAYS discuss the potential for some relapse of their skin postoperatively. No matter how much tightening is done during surgery, at about 6-12 weeks there is some relaxation of the skin, whether it be in the arms, neck or abdomen.  Therefore, at the consult I show pictures of patients that are 6-12 months out of surgery and that patient’s degree of relapse. The resulting scars are also shown. Also discussed in the preoperative visits is the timeline for recovery and potential complications. 8 If both the patient and I feel that the goals are realistic, then consideration is given to move forward with surgery. GBRx™ is not considered unless the patient is at least 1 year from time of last bariatric surgery and has 3 consecutive months of stabilized weight.

Preoperative Preparation

Preoperatively, the patient’s blood work is checked and an EKG is performed. Patients are also given information on how to prepare themselves nutritionally before surgery. We make sure they are taking their multivitamins and increase their protein intake to 1.5 gram/kilogram body weight two weeks before surgery and after surgery for at least 6 weeks post-operatively. The day prior to surgery the patient is brought in for
marking, which can take up to 30-45 minutes. This saves time the following day. The anesthesiologist typically calls the patient the evening before surgery and meets them in the preop waiting room.

Stage 1

Stage 1 typically involves addressing the abdominal and chest wall regions. Almost invariably, the loose skin and abdominal wall weakness with bulging are the primary concerns for the patient. An extended abdominoplasty is planned.

Stage 2

The second stage addresses the laxity of the upper and lower back, the buttocks, and the medial thighs. I address the upper folds of the back through an incision that is made along the side of the chest pulling the upper back skin forward and excising it. This results in a scar on the side of the chest which is camouflaged with the arms down. The lower back folds are addressed as part of the back and buttock lift. Both of these areas are addressed with the patient placed face down on the surgical table. The upper back and lower back generally takes about 2-3 hours. Afterwards, the patient is then turned onto his or her back and the medial thighs are addressed.

Stage 3

The third, and usually the final stage, addresses the face, neck, brows and eyes. At this stage, a facelift, neck lift, brow lift, and upper and lower blepharoplasty is planned. This procedure typically takes 5½ – 6 hours and perhaps has the most dramatic impact on the patients’ sense of wellbeing and his or her overall psychological outcome. Once again, an overnight stay is required not so much for pain control, but to monitor for any bleeding from the facelift procedure overnight. Contrary to popular belief, facelifts are not very painful procedures and this is perhaps the easiest recovery for the patient.

Body Contouring Complications

Our practice has employed these reconstructive options in over 200 patients (at the time of the article publication) without a single incidence of Deep Venous Thrombosis, and only one patient requiring blood transfusion after a GBRx™ surgery. There has been approximately a 10% incident of Seroma of the abdomen, and 13% incident of Seromas of the thighs. Overall, our patients’ satisfaction rate has been extremely high and over 87% of our patients have reported that they have been either very satisfied or extremely satisfied with their out comes.

These patients comprise the most satisfied and realistic patients in our practice. They tend to be a very tight knit and thoroughly researched group of patients also. They are for the most part extremely grateful as evidenced by their loyalty to the practice and their referral of other members of the support group.