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This operation is ideal for patients who
have had a drastic weight reduction -' either
after gastric surgery or an iron will. The
purpose of the lower body lift is to remove
excess (loose) skin from the abdomen area,
back, and thighs. Skin that has lost its
elasticity, or is drooping will be trimmed
to better fit the slimmer body of the patient.
Liposuction may be used to add a final effect
of smoothness in particular areas.
Commonly asked questions
about circumferential abdominoplasty
Am I
a good candidate for circumferential abdominoplasty
- lower body lift?
This is best decided
during a consultation, but generally speaking
if you have redundant folds of abdominal
skin, or a bulging abdomen, even after exercise
and weight loss and you are in good physical
and mental health with reasonable expectations
you should be an appropriate candidate.
If you have a significant amount of skin
all the way around your central body, you
may well be a candidate for a circumferential
abdominoplasty lower body lift. Typically
the sort of patient suited to this procedure
will have lost a significant amount of weight,
without the skin recovering and shrinking
back ' for instance after gastric
surgery for obesity, or weight loss by other
means.
After assessing you in consultation, I will
discuss all suitable surgical options with
you.
Finally, if you are a smoker, you will be
asked to stop smoking for six weeks before
surgery and to avoid inhaling other peoples’
smoke secondarily. Smoking significantly
increases the risk of postoperative complications
and often ruins the results of this operation,
so I do not perform this operation on smokers.
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How
is a circumferential abdominoplasty performed?
I will start operating
with you lying on your front and operate
on your back, buttocks and posterior thighs,
then under my supervision, whilst the anaesthetist
cares for your airway, trained operating
theatre staff will turn you so that I can
finish by operating on your abdomen and
thighs with you lying on your back.
To start, excess skin and soft tissue will
be removed from your back, buttocks and
posterior thighs, after which these wounds
will be stitched before turning you. In
front, I make an incision in your abdominal
skin and lift it off the muscles of your
abdominal wall. The belly button is released
from original position in the skin, but
remains attached to your abdominal wall
and will be re-positioned appropriately
in your new tummy. The muscles are then
tightened and the skin re-draped over the
abdomen. Your skin is stitched back in place
with absorbable stitches so that the scar
in front runs seamlessly with that behind.
Drains are placed under the incisions that
will remain, possibly for several weeks,
so as to remove the normal healing fluid
that the body produces.
The operation typically lasts between three
and five hours.
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What
should I expect from my consultation?
During your consultation,
I will take a full medical history. I will
ask you specifically about any diseases
you have suffered that have affected your
abdomen, as well as any previous surgery
you may have undergone. I may need to write
to surgeons who have operated on you in
the past to discover what you have had done,
so the more detailed information you can
bring with you, the better.
I will examine you completely, then focus
on your abdomen to assess whether you have
muscle or soft tissue herniae, and the size,
symmetry and shape of your excess subcutaneous
fat. I will also look at the quality and
elastic tone of your abdominal skin.
Finally I will then take standardised-view
photographs in order to help plan and discuss
your operation.
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What
does my operation involve?
Before surgery, you
will meet and be assessed by your anaesthetist
who will prescribe you medications for your
comfort and to lessen anxiety if need be.
On the evening before, or the morning of
your operation I will review what we have
discussed and planned previously and we
will both sign your operative consent forms.
Then I will draw the incision lines on your
abdomen with a marker whilst you wear typical
underwear ' with the aim of concealing
your final scar (allowing for future variations
in underwear fashions!)
The operation is performed under General
Anaesthesia ' you will be asleep.
Once anaesthetised you will be catheterised
to drain urine from your bladder for your
comfort and safety during the peri-operative
period.
After surgery you will be monitored in a
recovery area. You will have some discomfort
following surgery for which you will receive
pain relief. You will able, and encouraged
to walk with help within 8 - 12 hours of
surgery to maximize your recovery.
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What
about my recovery and return to normal activities?
Typically you will
stay in hospital for two days after the
operation and then most patients are able
to go home with their wound drains still
in place.
Following surgery, you will wear a compression
garment for 3 weeks, 24 hours a day; 7 days
a week (except when washing it or you!)
and then during the night for the next 2
weeks ' this helps your new abdomen
settle in the correct position.
When you are discharged from hospital, someone
must drive you home and someone must stay
with you to assist you the first few days
whilst at home.
Plan on at least 6 weeks to recover fully.
For the first few days you will walk slightly
stooped over. As the skin relaxes you will
slowly straighten up. Wound drains are usually
removed within 3 weeks depending on their
output ' based on a record of how
much fluid is draining that you will keep.
Wound care around the drain sites is easy
and you will be taught how to care for these
areas before you leave the hospital.
You will feel tired and somewhat sore for
a week or two following your surgery, but
you will be able to move around and function
relatively normally.
You will have buried, soluble stitching
which will dissolve and doesn’t need
to be taken out.
Generally, you can return to work if your
occupation is sedentary, after 3 - 4 weeks,
but if your work involves heavy lifting
or is strenuous in other ways, for instance
women police officers, 6 - 8 weeks might
be a more realistic period off work. So
long as you can do so with due care and
attention, you can begin driving 3 - 4 weeks
after surgery.
You should restrict yourself to light exercise
for 4 - 6 weeks - avoiding lifting anything
over 5Kg and aerobic exercise for at least
4 weeks.
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What
about my final scar?
Whenever surgery is
performed on your body a scar will result.
Scar healing is dependent on multiple competing
factors which include: my surgical technique;
wound tension and position; any post-operative
trauma and infection; but mostly on your
genetic makeup. My expertise is directed
towards providing you with the least noticeable
scar possible, but because each individual's
result is unique, wound healing and your
abdominal scar appearance are only partly
under my control.
It will take at least a year for the scar
to mature and fade from red to pale pink
(or whatever is your normal skin colour).
The scar will be positioned, where possible,
so as not to be visible in your swimsuit
or underwear.
New scars benefit from friction-free massage
(using vaseline, for instance, to lubricate
the massaging process). Beginning to massage
scars two to three weeks after surgery,
will help them mature, soften and flatten
faster than if left to their own devices.
New scars should be protected from sunlight
for 2 years to avoid them pigmenting differently
to the surrounding skin and becoming a different
colour permanently. Factor 15 sun block
should be applied whenever they are exposed
- even to a British winter sun.
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