Body Contouring after Weight Loss Detroit

Changing Shape, Shaping Change

With the growing popularity of bariatric, or gastric bypass, surgery as a treatment for obesity, body contouring after significant weight loss has become a focus of Dr. Lytle’ practice. By applying the latest techniques in body sculpting individualized to each patient’s specific needs and priorities, Dr. Lytle can help you realize the new shape that is hidden beneath the excess skin that remains after your goal weight has been achieved.
With significant weight loss over a relatively short period of time (usually 12-18 months), the remaining skin often does not retain the elastic qualities necessary to “shrink back down” to your new underlying shape. This often leaves patients with excessive amounts of hanging skin that creates a multitude of problems such as daily hygiene and finding clothes that fit properly.

One of the most important considerations for a plastic surgeon to realize is that a bariatric patient must be treated differently from non-bariatric body contouring patients. What has worked well for many years on other patients simply does not provide adequate shaping and contouring for the bariatric patient.

Common Concerns After Extreme Weight Loss

Patients who have undergone bariatric surgery and the subsequent significant weight loss have numerous but similar areas of concern. These areas usually include:

• Breast: For women, the breasts often become ptotic or saggy and a breast lift is often required. Additionally, many women lose significant breast volume with weight loss and require breast augmentation with implants. For men, several breast reduction techniques are available, depending on the degree of correction required.
• Face: A face lift (Rhytidectomy) is often required to remove the excess skin at the face. This can be done in conjunction with a brow lift or a blepharoplasty (eyelid surgery) as needed to achieve complete facial rejuvenation. Surprisingly, some patients actually require fat to be replaced back to the face. As the face loses fat, it appears older and tired. Fat grafting can significantly improve the appearance of the face and restore a youthful appearance.
• Abdomen: Abdominoplasty (tummy tuck) is often required following massive weight loss to remove the excess lower abdominal skin. For some patients, a vertical wedge excision is also often needed to removed excess skin that runs across the abdomen. A lower body lift or circumfrential lift not only removes the abdominal excess skin, but can contour the hips, outer and posterior thighs and can lift the buttocks.
• Arms: Brachioplasty (arm lift surgery) is a technique to lift and tighten the skin of the arm.
• Thighs: A medial thigh lift will remove excess skin and fat at the inner aspects of the thighs, whereas a lower body lift addresses the outer and posterior portions of the thighs.

Obviously all of these concerns cannot be addressed simultaneously during one operation. However, two procedures usually can be safely combined. During your consultation, Dr. Lytle will assess your anatomy as well as your own priorities to help you develop a comprehensive plan or blueprint for your body contouring. It is not uncommon to combine a tummy tuck with a breast lift (with or without the addition of breast implants), or a thigh lift with an arm lift, as well as other possible combinations of procedures.

The Consultation

During your initial consultation, Dr. Lytle will inquire about your medical history, prior procedures, medications, allergies, and your motivations for seeking plastic surgery. It is very important that you be thorough when providing your medical history, as this information helps to prevent complications during your care. When asked about medications, be sure to include any vitamin or herbal preparations, as these can affect your blood pressure and clotting ability. Honesty regarding your use of tobacco and alcohol is also very important, as these may have a profound impact on your recovery period and your ability to heal following your procedure.

After reviewing your medical history, Dr. Lytle will discuss your concerns, priorities and motivations for pursuing plastic surgery, as well as your fears. After examining you, Dr. Lytle will be able to offer advice and options to help you achieve the appearance you desire. He will explain the advantages and disadvantages of the different options you have before you.

Details of the Procedures

As mentioned previously, Dr. Lytle has developed a comprehensive approach to the bariatric patient that has evolved into specialized techniques meant to optimize your results. These include:

• Developing a clear overall strategy during the consultation process and reviewing this plan during the preoperative visit. This plan will be reviewed thoroughly so that you have a full understanding of the procedures, incisions, and results you can expect.
• Precise preoperative skin marking prior to surgery. While you are standing, Dr. Lytle will make marks on your skin identifying certain landmarks as well as the intended incisions. Not only does this provide him with information necessary during the operation, but it also allows you to review the operative plan one more time before undergoing the procedure.
• Using various positioning techniques on the operating room table to optimize visualization intraoperatively and enable Dr. Lytle to provide smooth, natural contouring from one body region to the next.
• Precise cutting, redraping and sculpting techniques
• Careful but considerable suture techniques to provide support to the incisions during the healing process. By using multiple layers of strong sutures beginning deep in the tissues and finishing superficially, the resulting scar is optimized and heals into an acceptable thin line. Even with this suture technique, Dr. Lytle is able to use sutures beneath the surface of the skin that do not require removal. Not having to undergo suture removal has greatly improved patient comfort and satisfaction post-operatively.

Depending on the combination of procedures you choose, your surgery will probably require four to eight hours to complete.

After Your Procedure

You should plan to take it easy following your surgery. No strenuous activities, heavy lifting (over 10 pounds), aerobic exercises, swimming, contact sports, tennis, or golf should be planned for the first three weeks. As Dr. Lytle monitors your recovery, he will advise you when it is safe to resume specific activities.

You should plan to wear the compression garment for six weeks following surgery. Dr. Lytle will remove the drainage tubes when the drainage decreases to an acceptable level.

The Results You Can Expect

You should plan to wear your surgical garments for at least 6 weeks following surgery, or until Dr. Lytle instructs you that they are no longer necessary or beneficial.

You will notice an improvement in your contour immediately. However, your shape will continue to improve in the following weeks as the swelling subsides. You should be up and walking the day following surgery to prevent blood clots from forming in the legs. Expect moderate pain for several days, but this will rapidly subside. You should able to resume your normal daily activities within 2-3 weeks following surgery, and you should be able to resume all of your physical activities within four to six weeks of surgery.

Post-Operative Massage

Depending on your specific surgery, you will have a 2 or 3 massages by our licensed massage therapist. This will be a lymphatic draining massage performed to decrease the amount of swelling and to improve the lymphatic drainage.