Body Lifts and Circumferential Liposuction of Legs

by A. KARACA, MD

Body lifts are an often preferable option to reshape and recontour the body to give a younger, firmer appearance. This is usually achieved through such procedures as abdominoplasty, or tummy tuck, thigh lift and buttock lift as well as an inner thigh lift. These procedures render dramatic results and give the patient a taut, toned and more youthful look.

In the upper body, a breast lift in conjunction with a lift of the upper arms will give the patient a more confident appearance. At the same time, the surgeon can tighten the contours and remove excess skin, often making an extension to the underarm areas.

All these procedures consist of the removal of excess skin and the underlying fatty tissue. Incisions are very small and carefully placed in inconspicuous areas so that scarring is minimal and often hidden.

Due to advancements in surgical procedures, pain is extremely minimal and easily managed and recovery is a lot faster allowing patients to resume their normal activities. A small amount of adrenaline which is injected into these areas prior to surgery causes minimal blood loss thereby greatly reducing the risk of complications, even during prolonged surgeries where we are doing multiple procedures.

The safety of these procedures has placed them at the forefront of all desired cosmetic surgery procedures in recent years.

Sometimes due to increasing age or with significant weight loss, we see an excess of skin and subcutaneous fat around the waist and thighs. Often this fatty tissue deposit is even found in the small of the back. In these cases, a “Belt lipectomy" is performed where 4 to 6 inches of skin is removed around the waistline or circumference of the body. In many cases, we perform a lower body lift which includes an abdominoplasty with lateral tension, a thigh lift, and/or a buttock lift. A tightening of the vertical abdominal muscles is also performed in each tummy tuck, thus strengthening the abdominal wall and the lower back and returning a normal balance to the patient.. No external sutures are used on the skin, eliminating the cross-hatch marks and minimizing any long term scarring.

Brachioplasty or upper arm lift is a procedure to correct and eliminate the sagging skin of the upper arms. With weight loss or aging, unfortunately the skin weakens and sags, giving a “bat-wing” appearance. We make a tiny incision in the underarm or sometimes on the inner part of the upper arm to completely remove the skin and fat. Liposuction is frequently used on the back of the arm in addition to skin removal for optimum results.

These lifts differ from liposuction because they tighten the skin as well the underlying tissues.

The hospital stay is usually one to two days. Patients normally return to work in 3 to 4 weeks and can exercise in 6 weeks. Some insurance coverage is possible in abdominoplasty cases, if the patient has an apron-like hanging skin fold and if he/she has lost over 100 lbs. Insurance coverage should be discussed with your plastic surgeon.

Many patients are unaware that circumferential liposuction of the thighs or calves is available and produces very good results. These are technically challenging procedures that require a great amount of skill and additional training on the part of the surgeon. Circumferential liposuction produces the best results in younger women with heavy, thick thighs and calves. The advantage of circumferential liposuction is that it removes fat all the way around. It allows for greater skin shrinkage and tighter, smoother results.

A woman who has only saddlebags or isolated bulges of the inner thighs does not need additional suctioning of the front and back of the thighs. As for the ankles and calves, the circumferential liposuction is almost always preferred for optimum results.

This technique requires an artistic eye to follow the natural curves of the legs. Very small cannulae (2mm or 3mm) are used following the tumescent fluid injection. In the lower leg, very little fluid is required. The incisions are very small. Postoperative care requires the use of pressure stockings, especially for the lower legs which have to be kept elevated as much as possible to decrease the duration of the swelling which can last up to 4 to 6 months. The recommendation is to take a week off work following surgery and wear support hose for another four months while standing or walking.

It cannot be emphasized enough that patients should put a lot of thought and research into their choice of surgeons. The technical ability and experience of a Plastic Surgeon is the single most important factor that determines the outcome of the surgery. Checking the surgeon’s qualifications, staff privileges at local hospitals and having their own physician recommend a particular plastic surgeon can only increase the level of comfort for the patient desiring these procedures.

Even though these are cosmetic procedures, as surgeons we rely on our reconstructive talent and expertise. Not only are physical imperfections corrected, but the body image of the person is greatly improved. Suddenly, clothes fit better, the elusive shapely legs appear under a new skirt and a whole new attitude emerges. The effect on one’s confidence and self esteem is profound.