Abdominoplasty and Arm and Thigh Lifts Explained
Further to excessive weight loss, an unfortunate complication that can occur is excess skin. This can be distressing and impact how an individual feels, in addition to limiting choices of clothing and wearing swimwear. The only way to successfully remove excess loose skin is to have it surgically excised by a Plastic surgeon.
There are various procedure's for skin excision, that can be performed to improve body contours including: • Thigh lift • Arm lift • Abdominoplasty • Mini Abdominoplasty • Endoscopic Abdominoplasty • T-scar (Fleur-de-lys) Abdominoplasty
Anaesthetic
Most procedures involve the excision of excess skin and can be performed either under a general anaesthetic or a local with or without twilight (IV)sedation. This will depend on your plastic surgeon's preference, although if you would prefer a local with sedation you should tell your surgeon at your consultation.
Arm lift (brachioplasty) and Thigh lift explained
An arm lift is the only option to reduce sagging, upper arms (bat wings, or bingo wings).
Arm lift procedure
An arm lift procedure can include arm liposuction when there are fatty deposits in addition to excess skin. The excess skin is then removed through incisions, from the armpit (axilla) to the elbow. Visible scarring is unavoidable although your plastic surgeon will try to ensure the scars are concealed as much as possible in the inner arm area and once healed (without complications) the scars will fade and become harder to see over time.
Minimal scar modified axillary arm lift
Another option if there is less skin to remove is a modified axillary arm lift. The incisions are only made in the armpit and the scars should become almost invisible, although even if they are visible, they are very well hidden in the armpit area.
Thigh lift procedure
A thigh lift will address both sagging skin and fatty deposits. Your plastic surgeon will advise if liposuction or liposculpture will be sufficient, however, if there is skin laxity, you will normally need skin removed.
Medial thigh lift
Excess skin is normally removed through incisions starting at the groin and running vertically down the inside of the upper thigh, occasionally incisions can be semi-circular in the groin and buttock crease. It may also be necessary to combine the locations of the incisions to form a T shaped scar running down the inner thigh to the mid-thigh or knee.
Lateral thigh lift
The incisions are made on the outside of the upper thigh although this will be avoided where possible to eliminate visible scarring
Recovery time after an arm or thigh lift
You will have a compression garment on your thighs to help to reduce swelling and bruising; you may have a small drain to allow excess fluid to disperse quicker. The drainage tube is normally removed the following day and you will need to continue to wear the compression garments for the next 6 weeks.
You will be encouraged to move around to improve lymphatic drainage and blood flow, and prevent blood clots. You should avoid any strenuous activities for the first 6 weeks. Your plastic surgeon will normally ask you to return one week after the procedure to check how everything is healing well. Most individuals are then able to return to work and normal daily activities. You will then normally have another follow up 4 to 6 weeks later. There will still be significant swelling after 6 weeks and it may take up to 3 months before you can see any results and scars will continue to flatten and fade for up to 12 months after the procedure.
Risks and complications of arms and thigh lifts
• Bruising and swelling • Temporary numbness or tingling around the area where the skin has been removed • Tightness and discomfort especially when moving around • Delayed healing and, or wound breakdown • Visible scars that can widen, become keloid or migrate inferiorly • Infection • Bleeding and hematoma's or seroma's • Mild asymmetry • Poor skin retraction • Change to the shape of the vulva (labial separation) • Irregular contour of the arms or thighs • Under-correction or inadequate fixation can result in persistent sagging (ptosis) • Skin necrosis (death of skin cells) • Increased excess (ptosis) after liposuction • Revisional surgery due to wound breakdown or unsatisfactory outcome
Abdominoplasty Explained
Mini abdominoplasty
A mini abdominoplasty will address both sagging skin and fatty deposits on the lower abdomen, and may also involve tightening the muscles of the lower abdominal wall (rectus-abdominis muscles). This procedure is often combined with liposuction or liposculpture of the upper abdomen, thighs, and, or hips.
Mini abdominoplasty (tummy tuck ) procedure
Excess skin and fatty tissue of the lower abdomen are removed through a vertical excision, just above the pubic area and without relocating the belly button (umbilicus). If required the correction will be made to the muscles of the lower abdominal wall (rectus-abdominis muscles) which are stitched back together to become taught and firm again. This procedure is most often done as a day case and you will return home on the same day.
Endoscopic abdominoplasty
An endoscopic abdominoplasty will only tighten your stomach muscles (rectus-abdominis muscles) and will not improve the appearance of sagging skin. Incisions are small and made just above the pubic area. This procedure is most often done as a day case and you will return home on the same day.
Full abdominoplasty
A full abdominoplasty may be recommended if there is a lot of excess skin that needs to be removed and will address both sagging skin and fatty deposits and also involves tightening the muscles (rectus-abdominis muscles) of the lower abdominal wall.
Full abdominoplasty procedure
Excess skin and fatty tissue are removed through a longer, vertical, excision just above the pubic area, between the hips. You may also need correction of the splitting of the stomach muscles (rectus-abdominis muscles ) which are stitched back together in their correct position. Liposuction or liposculpture may also be performed to remove any excess fat. Your belly button (umbilicus) will be moved and occasionally may need to be reconstructed. Your plastic surgeon may also want to make a horizontal incision when there is horizontal and vertical laxity of the abdomen, this is also called acT-scar (Fleur-de-lys) abdominoplasty. Recovery time after a Full Abdominoplasty procedure, T-scar (Fleur-de-lys) abdominoplasty
You would normally stay in the hospital for between 1 to 2 nights and may have drains to help to reduce swelling and bruising and allow excess fluid to disperse quicker. The drainage tube is normally removed the following day and you will need to continue to wear the compression garments for the next 6 weeks. You will be encouraged to move around to improve lymphatic drainage and blood flow and prevent blood clots. However, you should avoid any strenuous activities for the first 6 to 8 weeks. Your plastic surgeon will normally ask you to return one week after the procedure to check how everything is healing well. Most individuals can return to work and normal daily activities 2 weeks after the procedure.
You will then normally have another follow up 4 to 6 weeks later. There will still be significant swelling after 6 weeks and it may take up to 3 months before you can see any results and scars will continue to flatten and fade for up to 12 months after the procedure.
Risks and complications of abdominoplasty (tummy tuck) and lower or upper body lift
• Bruising and swelling • Temporary numbness or tingling around the area where the skin has been removed • Tightness and discomfort especially when moving around • Delayed healing and, or wound breakdown • Visible scars that can widen, become keloid or migrate inferiorly • Infection • Bleeding and haematoma's or seroma's • Permanent numbness of lower abdomen • Residual stretch marks in the upper abdomen • Bulging of the upper abdomen • Skin contour irregularities including dips and lumps on the surface of the skin (most common at sites of liposuction) • Belly button (umbilicus) position is incorrect or, and looks misshapen • Revisional surgery due to wound breakdown or unsatisfactory outcome • Fat necrosis, resulting in lumps or discharge
Questions to ask your Plastic Surgeon
• Why are you recommending this procedure? • What type of anaesthetic will you use? • What are the risks and complications? • How many of these types of procedures have you performed in the past 12 months? • How many patients had complications and required additional surgery? • Does the price include all after care and revision surgery if complications arise? • Will I have to pay anything additional for revision surgery if I am not satisfied with the results? • Will I have to pay anything for scar revision surgery if I am not happy with my scars?
Risks and Complications of all surgical procedures
• Chest infection • Infection, wound breakdown, skin necrosis • Hematoma's and Seroma's • Keloid scars • Blood clots [DVT’s, pulmonary emboli (PE’s)] (which can be fatal) • Allergy to General Anaesthetic (which can be fatal)
Check out our previous blog on Liposculture here[]https://www.advancelymphatics.co.uk/blog/liposculpture-and-liposuction-explained