Cosmetic Surgery and Beauty Magazine #65

feature
Surgery after
massive weight loss
is an emerging field
in plastic surgery.
There are a number
of procedures
designed to improve
the body’s contours
following dramatic
weight loss. Caitlin
Bishop reports.
The process of losing extraordinarily large amounts of weight, whether it’s
through diet, exercise or bariatric surgery, can be a harrowing and seemingly
endless venture for the individual. This is because once the weight is off
the journey is still not over. Loose skin folds, fatty pockets and sagging tissue are
often the result of massive weight loss, and these areas – which are frustratingly
difficult to treat without surgery – can detract from an otherwise healthy figure.
Surgery to correct this, and assist in skin contraction following weight loss, has
become a major topic in the plastic surgery arena. Indeed the latest conferences,
including the Advanced Aesthetic Plastic Surgery Workshop (AAPSW) in
Melbourne earlier this year, have seen huge discussion on the possibilities in
body contouring following massive weight loss.
Body contouring surgery
Circumferential abdominoplasty is considered the most effective solution for
individuals who have experienced massive weight loss. Similar to a standard
abdominoplasty, but extending around the entire circumference, it is a surgical
procedure designed to remove excess skin, cellulite and fat from the abdomen,
buttocks, chest, back thighs and breasts.
US plastic surgeon Dr Simeon Wall Jr. spoke at AAPSW in Melbourne
and outlined his approach to circumferential truncal contouring. It involves
abdominoplasty, circumferential liposuction, fat resection and targeted fat grafting.
During the procedure, a horizontal incision – that extends the whole way
around the body – is made above the thighs and buttocks. Through this incision,
excess fat and tissue are removed, sometimes with the aid of liposuction, and
the stomach muscles are surgically tightened. Excess skin is then excised for
a tighter, toned look and the remaining skin is re-draped over the body’s newly
defined contours.
In some cases, a corset trunkplasty, which involves a different incision method,
is more suitable for certain patients. US plastic surgeon Dr Alex Moya explained
a corset trunkplasty can be very effective in highlighting the waistline.
‘A corset trunkplasty can create an aesthetically please body shape – similar
to that provided by a corset – and involves several carefully placed incisions
which interconnect to form the appearance of a sideways capital “H”,’ Dr Moya
explains. ‘The incisions are customised for each patient, and address excess
skin in both the upper and lower abdomen.’
To undergo either circumferential abdominoplasty or a corset trunkplasty,
patients should be as close to their ideal weight as possible or, if that is
unachievable, at a steady weight that they are likely to maintain. It is recommended
patients wait at least one year following bariatric surgery before undergoing
circumferential reduction surgery.
In some cases, liposuction can be sufficient in removing excess fat and causing
effective skin contraction in weight loss patients. Power-assisted liposuction,
using radiofrequency, ultrasound or laser technology alongside liposuction, can
help increase skin contracture and tone and tighten in the skin’s surface.
Dr Wall Jr. shared his experience using the S.A.F.E liposuction technique at
AAPSW in Melbourne. This acronym stands for Separation, Aspiration and Fat
Equalisation, and depicts a strategy for performing liposuction that results in
slimmer, smoother and more even body contours.
While Dr Wall Jr. avoids using power-assisted liposuction, he uses these three
steps – separation, aspiration and equalisation – to achieve the best results in
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