Body contouring (after massive weight loss)
a. abdominoplasty (see section)
b. Arm lift (see section)
c. Belt lipectomy
Skin excess around the trunk is one of the most common findings after massive weight loss. Abdominoplasty addresses only the frontal part of the problem. Therefore belt lipectomy is advised. The incision is placed from one flank to the other, to the front as in abdominoplasty and to the back as in buttocks lift. It’s mainly planned in such a way that it can be hidden by the underwear. It’s one of the most extended incisions in plastic surgery.
The operation
The incision leaves a scar around the base of the trunk. There is also an additional scar around the umbilicus (resembling a laparoscopic scar), through which, umbilicus is placed in its new position. Liposuction is routinely carried out at the sides of the trunk, to augment the postoperative result. The procedure is done under general anaesthesia and you have to be hospitalized for minimum one day. Postoperative pain is controlled by iv painkillers and after your discharge from the hospital with tablets. There is a possibility of having 2 drains (tubes that collect excess fluid from the surgical wound) when you come out of surgery. These are usually removed the next day. The surgeon doesn’t usually use drains.
Complications
Belt lipectomy is not indicated in obese patients, therefore your weight must be relatively stable and within healthy limits. Smoking might lead to bad wound healing and wound dehiscence. There is also limited possibility for:
• Infection
• Hematoma (blood collection under the skin from a ruptured blood vessel)
• Seroma (clear fluid collection) can be a result of the operation and it sometimes needs drainage by a syringe
• Visible hypertrophic scars. The formation of “ugly” scars is genetically controlled. Certain people have a predisposition in the formation of keloid scars.
• There is low possibility (1.2%) for clot formation in the lower extremity and for pulmonary embolism (0.8%), even though you will be receiving anticoagulant injections postoperatively.
After the operation
It will be more convenient to sleep with a pillow under your knees and your head for a couple of days, as this will relieve tension on the incision line. If liposuction was carried out, you have to wear a special compression garment for 4-6 weeks. Sutures are removed after 15 days and then you can return to your job if it’s not physically demanding.
Full recovery is expected after 4-6 weeks from the operation. The surgical wound has to be kept dry and clean, therefore it’s advised to cover it with a waterproof adhesive when you shower.