Exercise regimens will sometimes result in a similarly substantial weight loss. Most often, consequence for those successfully achieving their goals in weight loss after bariatric surgery is, hanging skin and local fat deposits.

 

Aesthetic Surgery After Weight Loss with Dr. Unal in Istanbul

Dr. Unal is sensitive about bariatric weight loss patients’medical and emotional status since they have not only accomplished a great achievement after the bariatric surgery, but also they have emotionally gone through a a lot. The needs of every patient who has experienced significant weight loss is extremely unique, Dr Unal carefully assesses every individual’s desire, expectation and goals.
After a weight loss plateau has been reached, plastic surgery is performed both to improve aesthetics and to alleviate symptoms of excess skin. Abdominoplasty (tummy tuck), lower body lift (belt lipectomy), mastopexy (breast lift), augmentation mastopexy (breast enlargement and lift), brachioplasty (arm lift), upper body lift (a combination of arm lift and breast lift that also removes the excess tissues of the sides of the ribcage), thigh lift or facelift may be performed.

 

Ideal Candidates Possess

• Skin laxity and regional fat deposits after massive weight loss
• Weight loss goal achieved, and at a weight loss "plateau", for at least 3 months

 

Timing Between Procedures

• 3 months

 

Procedures for Massive Weight Loss

• Lower Body Lift (Circumferential Abdominoplasty)
• Arm Lift (Brachioplasty)
• Breast Lift (Mastopexy)
• Thigh Lift,
• Facelift & Neck Lift

 

Return To Work and Exercise

• 2-3 weeks
• 3 weeks (light- moderate cardio), 6 weeks (weight lifting and streneous exercise)
• The most common procedures after weight loss are tummy tuck (or circumferential abdominoplasty), thigh lift, breast lift, and arm lift, but there are many additional procedures available to regain a natural and beautiful appearance.

 

Abdomen, Outer Thighs and Buttocks (Lower Body Lift / Belt Lipectomy)

After bariatric surgery, the fat tissue beneath the skin and inside the abdomen decreases; therefore, both excess abdominal wall skin and loose abdominal muscles result. The optimal procedures to treat the excess of the abdominal region will directly remove excess skin and fat, tighten the muscles and fascia of the abdomen, and remove regional excess fat and restore contour to the abdomen with liposuction. Occasionally, when the excess is limited to the front of the abdomen, a "classical" abdominoplasty (tummy tuck) is performed. If the excess skin progresses around the sides to the back, and a lower bodylift is indicated. The lower body lift removes the excess skin and fat of the abdominal area, flanks, and back, and tightens the abdominal wall. It also provides a lift to the buttocks and lateral thighs as well.

Occasionally, there are medical symptoms that are produced by the heavy, hanging skin along the lower abdomen that can lead to recurrent rashes, and infections (intertriginous dermatitis and panniculitis). Sometimes courses of medical treatment have been documented to have been ineffective, a lower body lift or belt lipectomy (the portion known as a panniculectomy, or the direct removal of the hanging excess below the navel solves the problem.

 

Breast Lift (Mastopexy) and Breast Augmentation with Breast Lift (Augmentation Mastopexy)

When breasts sag and lose volume after bariatric surgery and massive weight loss, depending on the degree of deflation, a breast lift (mastopexy) alone, or a breast lift and a breast enlargement (augmentation mastopexy to both lift and restore breast volume) can be performed. Breast implants are most often used to restore breast volume, however in selected individuals with excess skin and fat of the sides of the chest wall, your own excess tissue in the region (maintaining its own nourishing blood supply) may be used to give you a breast augmentation without the use of breast implants during the breast lift (mastopexy) procedure.

Men may develop breast sagging or enlargement, or gynecomastia after bariatric surgery. Although liposuction alone may provide adequate treatment is selected individuals, skin removal and tightening is most often required in conjunction with liposuction techniques.

 

Arm Lift (Brachioplasty)

Loose, hanging skin and excess fat of the arms are treated by brachioplasty, or arm lift. With the brachioplasty or arm lift procedure, excess fat is removed, and the skin is tightened and redraped.

 

Upper Body Lift (Breast Lift / Arm Lift / Chest and Back Lift)

When there is excess skin in the arms, and at the sides of the chest wall as well as breast droop, an upper body lift procedure should be considered. An upper body lift combines the breast lift (mastopexy) and arm lift (brachioplasty) procedures, and the removal of the skin and soft tissue excess of the upper torso in one confluent incision line.

 

Thigh Lift

The excess skin and fat of the thighs is planned according to the amount of excess. The medial thigh lift, or isolated inner thigh lift, is performed for those individuals with only mild or moderate excess limited to the inner thigh area. The medial thigh lift removes a crescent of inner thigh skin, leaving an incision line in the inner groin crease only. When skin excess continues from the groin region until the knee, a classical thigh lift is performed so the the circumferential excess skin is addressed. Most often, the circumferential thigh lift is preceded by a lower body lift to serve as a foundation for thigh lift.

 

Facelift and Neck Lift

With significant weight loss, wrinkles on the face become more prominent, and cheek and neck skin may become lax and loose, and the face loses the volume that makes it look younger. Fat injection to the midface, temporal area and to necessary parts is performed as well as a facelift and neck lift in some individuals.

• When is appropriate to begin the process?
• Which procedure should I have first, abdominoplasty or arm lift?
• Thigh lift or breast lift? Which procedures can be performed at the same time?
• How long do I have to wait between procedures?

Any procedure that is performed for aesthetic reasons is performed after a weight loss "plateau" has been achieved. Although there is no specific number with regard to the actual weight loss or body mass index (BMI), you should be at a sustained weight for approximately 3 months (or more). This 3-6 months of time period during the plateau phase allows for the skin's own elasticity to be revealed. Some individuals will have a lot of skin laxity, while the skin in some younger patients may "spring" back into place. It is therefore essential to allow your body to settle during this period until the lifting surgeries.

Dr. Unal's approach to the sequence of procedures can be tailored according to which part of your body you want to start with. If the excess of the mid-section bothers you the most, the lower body lift or belt lipectomy procedure can be performed first. If the arms give you the most trouble, the brachioplasty or arm lift procedure can be done, and if breast droop concerns you most, the mastopexy or breast lift is part of the initial procedure. If the thighs are your greatest concern, a thigh lift first may be considered. If you do not have a particular preference, Dr. Unal will guide you through the sequence of procedures. Quite frequently, the lower body lift or belt lipectomy is performed first to set a foundation for other potential procedures to come.

Safety is the most important factor in your care and in Dr Unal’s approach to her patients. Following massive weight loss, only combinations that will not subject you to prolonged operative times and those that allow for the quickest recovery will be combined. The lower body lift or belt lipectomy is ususally performed as a "stand alone" procedure, although in selected individuals, where the mid-section excess is largely "skin-only", other procedures such as breast lift (mastopexy), or arm lift (brachioplasty) can be considered at the same time. More often, the procedures are "staged", with a waiting period of 3 months between each procedure. The breast lift (mastopexy) and arm lift (brachioplasty) procedures are often combined at the same time, and frequently as an upper body lift procedure that not only provides an arm lift and breast lift, but a lift and tightening of the excess skin and fat of the sides of the chest and upper back. The thigh lift is most often performed after the "foundation-setting" lower body lift or belt lipectomy procedure. The most common waiting period between lift procedures after bariatric surgery and massive weight loss is three weeks.