Body Contouring

Body Contouring after Weight loss bariatric surgery

The number of people who are undergoing bariatric procedures to lose weight has increased dramatically. The safety of these procedures has also improved significantly. This has been possible because of the both procedures Lap Band and gastric bypass procedures are being performed via an endoscope. This increase in safety has led to more patients willing to undergo weight loss procedures. At the same time there is growing evidence that many chronic illnesses including diabetes, hypertension and sleep apnea are reduced significantly in those who undergo these procedures. As the number of patients undergoing these procedures has increased, patients are left with extensive loose and sagging skin over the tummy, breasts, arms, thighs and over the buttock. Over the last five years many plastic surgeons have developed techniques to improve the outcome following these procedures.

After a significant weight loss many patients are elated that they have reached their weight goal but when they look in the mirror they are not happy. They do no know what to do about the sagginess and whom to turn to for help. This web page hopefully will give you an overview as to what is the latest and the best available to help you cope with your problems.

You are welcome to join our Oklahoma Bariatric Plastic Surgery Support Group by contacting Dr. Rane so you can join us at our next meeting and meet many patients who have undergone plastic surgery procedures to improve their self confidence.

Extended Tummy Tuck or Extended Abdominoplasty

Massive weight loss following bariatric surgery commonly leaves behind a large overhanging pannus which makes it very difficult to lose any further weight, maintain hygiene and is commonly associated with back pain too.

Patients with this large pannus commonly seek the help of a plastic surgeon asking for a tummy tuck. A tummy tuck or an abdominoplasty differs from panniculectomy where only the overhanging pannus is removed and no attempt made to tighten the muscles of the abdomen (belly) which is critical to create a well contoured abdominal shape.

Here is how Dr. Rane differs from others in tummy tucks for massive weight loss surgery

A regular tummy tuck generally does not address the outer aspect of the thighs or the excess skin and fat that overhangs over your jeans (muffin top). Dr. Rane commonly extends the incision beyond the hip bone onto the upper buttock line so that he is able to lift your outer thighs up and at the same take out the excess skin and the fat that overhangs in this area that gives you a muffin top. He also performs a liposuction of the lower back along with the flanks.

This allows him to re-shape your back just above your buttock thereby enhancing the shape of your buttock. He may even inject some of the fat back into your buttocks if they are sagging and improve its shape. This surgery has long been performed in Brazil (Brazilian butt lift) and Dr. Rane has visited the nation’s best plastic surgeon in Miami who specializes in the Brazilian butt lift. After all, body contouring means contouring the shape of your body both over the front and back and not just performing a tummy tuck. Finally, he removes fat around your new belly button so that your belly button is the deepest portion of your tummy and you have youthful concave contour of your tummy – one that will look like a saucer and hold water if your are lying flat. He believes in a three dimensional change in the contour of the abdomen and you can see his amazing results below.

Liposuction to tummy lower back and flank
area Extended Tummy tuck

Here is how Dr. Rane differs from other surgeons

Dr. Rane places the incision in the same area but lifts the buttock in an inner and upward direction (butterfly lift). This is allows the buttock to maintain its shape. Additionally he does not remove and discard the buttock skin and fat. He may either turn the excess skin and fat as a flap and place it back into the inner aspect of the buttock so that it dramatically improves the projection of the buttock. He may additionally inject some of the fat that was obtained during the liposuction and re-inject it back into outer aspect the buttock (Brazilian butt lift) so as to further enhance the shape of the buttock.

Belt Lipectomy

A belt Lipectomy is used if you have a pannus on your tummy and have sagging of your buttocks and outer thighs. This procedure involves placement of the incision above your pubic area and then extends in an outward direction onto the hip and upper buttock area so that the entire incision goes around like a low belt and at the same time keeps it along the bikini line and therefore well hidden.

A belt Lipectomy procedure is a long procedure as it involves placing the patient on the back first to perform the tummy tuck and then turn you onto your tummy so the surgery on the buttock can be accomplished. It commonly takes five to six hours to perform and therefore done only if the patient is young and fit and can withstand the long surgery and recovery.

Here is how Dr. Rane differs from other surgeons

Dr. Rane places the incision in the same area but lifts the buttock in an inner and upward direction (butterfly lift). This is allows the buttock to maintain its shape. Additionally he does not remove and discard the buttock skin and fat. He may either turn the excess skin and fat as a flap and place it back into the inner aspect of the buttock so that it dramatically improves the projection of the buttock. He may additionally inject some of the fat that was obtained during the liposuction and re-inject it back into outer aspect the buttock (Brazilian butt lift) so as to further enhance the shape of the buttock.

Thigh Lift

Massive weight loss can lead to loss of fat and significant sagging of the thigh both over the inner (medial) aspect or the outer aspect (lateral). These sagging areas need to be elevated and corrected to create a smooth contour.

Lateral or outer thigh lift: Dr. Rane commonly passes a long instrument over the outer thigh when he is performing the extended tummy tuck and elevates or lifts the outer thigh skin and fat. He sutures and fixes this lifted tissue on to the deep tissue around your hip area and thereby creates a smooth contour over the outer aspect of the thigh. This smooth convex contour of the outer thigh merges beautifully with the concave contour in the region of the love handles. This creates an hour glass figure. 

Inner Thigh

Inner or medial thigh lift: The thigh is no different than the rest of the abdomen and unfortunately it sags with some lose skin and fat collections too. Inner thigh lifts have undergone a significant improvement in its technique. Dr. Rane adopts only the latest techniques. Depending on the extent of the skin required to be removed, you may need an incision that is only in the groin crease. If you have more laxity of the skin you may need an additional incision over the inner side of your thigh. Dr. Rane limits the length of the incision so that it is only over the upper half of the thigh so that you can still wear shorts. He also attaches the deeper tissues to the inner aspect of your groin so that your results last longer and there is no alteration in the shape of your genital area. This attention to details is critical to create an excellent result. It is not uncommon to add some liposuction to the area undergoing thigh lift so as further enhance the outcome following surgery.

Breasts
Prior to weight loss many women with large breasts loose significant fat from the breast area leading to sagging and loss of volume within the breasts. The vast majority of women choose to have a breast lift and have a breast augmentation with saline or silicone implants. If the breasts are asymmetrical, then having adjustable saline implants provides a great option to create symmetrical breasts by allowing the surgeon to inject more saline in one implant than the other even six months after the surgery. Please read under breast augmentation in this web site for more information about breast implants and mastopexy.

Arm Lifts
Some women and men after surgery develop floppy skin and sagging fat on the lower aspect of the arms and this does become a source of great embarrassment. In the past surgery was done by placing a long incision over the inside of the arms. Sometimes these incisions lead to thick and wide scars. Latest techniques allow incisions to be placed in a curved lazy zig zag direction and over the back part of the arms so the incision heals with minimal scars that can be concealed very easily. Additionally if you have minimal laxity you could have SmartLipo and just have a small incision very close to your underarms.

When is the best time to have surgery?
Most patients lose weight for a year after bariatric surgery. It is therefore best to wait for a year when your weight has stabilized and you are not losing any more weight.

How many surgeries can be combined together?
It is best not to have a surgery that lasts over 5-6 hours. After this time complications from surgery including blood loss and low body temperature add significantly to the overall risks of the surgery. Generally it is best to combine adjacent areas together. Here are some combinations that Dr. Rane performs:

  • Tummy tuck and inner thigh lift
  • Tummy tuck and outer thigh lift
  • Belt Lipectomy (tummy tuck and buttock lift)
  • Breast surgery and Arm lifts

Where does Dr. Rane perform the surgery?

Dr. Rane strongly believes that safety is of paramount interest to the success of this procedure. He therefore performs these surgeries in a hospital setting so that you have all the emergency services including overnight stay available in the hospital if necessary. He commonly performs surgery at Edmond Medical Center or Foundation Bariatric Hospital, both of which are located in Edmond OK.