Mark Soldin Plastic Surgery for Body Contouring and Weight Loss
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Massive Weight Loss - Information For Patients

Introduction:
Significant weight loss after dieting or bariatric surgery is subsequently associated with significant overhang of the remaining subcutaneous fat and skin. This can be embarrassing, uncomfortable, and interfere with daily activities

The typical areas affected:
ŒAbdomen / Flanks / Buttocks
Breasts / back
Ž Inner thighs
 Arms
Plastic surgery can improve these areas by removing excess tissue. Four or more operations may be required to improve the body shape. Before proceeding with surgery it is important that your weight has remained stable for at least 1 year and that your other medical conditions are stable. It is also IMPERATIVE that you have stopped SMOKING and that your nutritional state is good as this may otherwise interfere with the healing process after your operations. As extensive surgery is undertaken, patients require psychological support and input from the bariatric multidisciplinary team. Furthermore, special funding approval by your primary care group (PCT) is required.

What procedures are done and how will I look at the end?
Œ Excess abdominal tissue can be removed by a procedure known as abdominoplasty. If the excess tissue also affects the back, a bigger procedure known as “lower body lift" may be required. Pre-operative markings are made on your trunk to guide the surgeon on how much tissue to remove. During surgery, the overhanging abdominal skin, and the folds from the lower back are excised. With closure of the wounds the buttocks and thighs are lifted. Sometimes it is possible to use the tissue to augment the buttocks. The stomach muscles can also be tightened at the same time by using a special suturing technique known as "rectus plication". Your own belly button is usually retained This is an extensive procedure that typically takes 4 hours of surgery. Several surgical drains are left coming from the wounds to avoid any fluid from collecting within. Afterwards, elasticised abdominal support is needed. The typical length of hospital stay is 4-5 days.

Risks: As this is a long procedure there are increased risks of infection and development of leg vein clots. The scar can open up under tension and may take a short while to heal. Loss of tissue (necrosis) rarely occurs as the operation interfere with the blood supply of the tissues.  Other complications include asymmetry and fluid collection under the wound (seroma).
Typical time off work: 6 weeks


 The loose breast tissue can be improved by lifting/reshaping the existing fatty tissue and trimming the excess skin. This procedure is known as a mastopexy. On the day of the operation, the surgeon puts several marks on the breasts as a guide during the operation. An inverted T-shaped scar is the result. This scar is placed around and under the nipple and within the lower breast fold. After the operation, you may need to stay into hospital for 1-2 days and you may have surgical drains.

Risks: Infection, bleeding, numbness, loss of the nipple, asymmetries and scarring can occur. Typical time off work: 2-4 weeks

ŽArms: A procedure known as "arm lift" or "brachioplasty" can be performed. The skin overhang is marked before the operation to determine how much skin should be taken off. During the operation the skin and superficial fat is then removed by a long incision extending from the elbow to the armpit and the skin edges sutured together. An attempt is made to hide the scar line in the same place as the bottom seam of a shirt. This procedure may be combined with liposuction, or breast surgery.

Risks: Asymmetries, scar widening, bleeding and infection. Occasionally, superficial nerves that supply sensation to the forearm and arm may also get damaged/stretched but this rarely causes problems.
Typical time off work: 4 weeks

Excess loose skin from around the thighs can be corrected by an operation known as medial thigh lift. The surgeon marks an ellipse on the inside of your thigh before the operation. During the procedure, the marked area is liposucked and the skin and superficial fat layers are cut out. The skin edges are then sutured together. The scar can run from knee to the groin on the inside of the thigh. A surgical drain may be required.

Risks: This includes infection, bleeding, collection of fluid (seroma) within the wound and stretched scarring
Typical time off work: 3 weeks
Photos showing the appearance and scarring of a patient before and after a medial thigh lift procedure
Thigh Lift
 
Please be realistic about what you expect as a result of this surgery and consider all the points highlighted in this information sheet before finally deciding on having any operation
 

Massice Weight Loss Male
Typical appearance of a patient following massive weight loss
 
Massive Weight Loss Female
Post Op Abdominoplasty
Photos show patient before
and after
abdominoplasty (tummy tuck)
and mastopexy/augment
(breast lift)
 
Pre Op Brachioplasty
Post Op Brachioplasty
Photos before and after brachioplasty.( Arm lift )

For further information please contact my private secretary Angie Harrison on
07961 221874
Mark Soldin - Consultant Plastic & Reconstructive Surgeon
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