The success of plastic surgery after weight loss is determined by several factors such as patient selection, surgical planning, doctor’s skills and qualifications, postop care, and long-term weight management through healthy lifestyle choices.
The preparations also play a crucial role in its long-term success, as suggested by Riverside plastic surgery expert Dr. Tarick Smaili.
Dr. Smaili explains the basic ways to prepare for body contouring surgery after weight loss, which typically involves combining two or more procedures (e.g., tummy tuck and thigh lift) to achieve a near normal appearance or to address non-healing irritations caused by the redundant skin.
- Reach your ideal weight first. After reaching your ideal body weight, it remains helpful to wait at least six months to ensure that you can sustain your lifestyle long-term, meaning no yoyo dieting and “unbearable” exercise routine.
- Make sure you are not suffering from nutritional deficiencies. It is not uncommon for massive weight loss patients to have anemia and other similar conditions due to the sudden change in their diet and calorie intake, level of physical activities, and other aspects of their lifestyle.
Prior to surgery, most MWL patients are instructed to take vitamin supplements, change their diet (daily protein intake should be at least 50-70 grams), and work with nutritionists and behaviorists to prepare them not just physically but also emotionally and psychologically.
- Stop smoking. If you are a smoker and/or using smoking cessation products such as “the patch” and nicotine gum, avoid them for at least four to six weeks to reduce the risk of complications such as skin necrosis (death of skin tissue), poor healing, unfavorable scarring, and less-than-optimal results.
- Establish a reliable support network. In the first few days of your recovery, you will need someone to help you with your basic needs and allow you to focus on your healing rather than stress over your daily responsibilities such as house chores and childcare.
- Make the necessary preparation. Take note that you will need at least a three-week off, or sometimes even longer if your surgery is quite extensive. For this reason, it might be ideal to clean your house, buy your medical supplies and easy-to-prepare meals, do the laundry, etc. days before your operation.
Liposuction for men is slightly different than women’s because of gender specific beauty standards and their anatomical difference—e.g., male patients generally have a larger body frame and have more fibrous fatty tissue than females.
Also, some “treatment areas” are almost exclusively for women such as the ankles, calves, and upper arms. On the other hand, male patients often ask for liposuction to address their overlarge breast, a procedure which is not popular among females.
Body contouring surgery expert Dr. Tarick Smaili explains the ideal candidates for male liposuction.
- Steady weight. The general rule of thumb is to be near your ideal weight or at least within 20 percent of your ideal body weight. Take note that no body contouring surgery can serve as a substitute for weight loss or healthy lifestyle.
And even if your weight is steady prior to surgery, it is your lifelong commitment to maintain it that way to preserve the results of liposuction. Simply put, your willingness to stick to a healthy lifestyle really matters in the long run.
- You have pockets of excess fat, which does not respond to diet and exercise. Liposuction is not a substitute for weight loss. In fact, it has no effect on the appearance of “beer belly” since it is generally caused by large abdominal contents, deeper visceral fat, and/or weak surrounding muscle.
- You have a healthy skin with good elasticity. Sagging skin is a contraindication to liposuction, unless body lift with skin tightening will be performed as well.
To achieve smooth results, your skin must be able to bounce back to its former tightness. If not, there might be some residual skin asymmetry, which may or may not improve with Endermologie, laser, or external ultrasound.
- You are physically fit. You should have no active disease or medical condition that could make liposuction or any elective plastic surgery too risky. For this reason, it is not uncommon for surgeons to work with their patients’ general physician or specialist to make the procedure reasonably safe.
- Your motives and expectations are reasonable. Any prudent surgeon will not promise a perfect body silhouette since cosmetic plastic surgery is only designed for improvements. Also, bear in mind that aside from your doctor’s skills, the postop results are largely affected by your underlying anatomy.
- You are emotionally stable. No prudent cosmetic surgeon will work on a patient who is emotionally and/or mentally unstable since there is only a very small chance that he will be satisfied with the results.
Brazilian butt lift surgery enhances the shape and size of a patient’s butt using her excess fat, typically derived from the abdomen, flanks, or other areas where the superficial fat is quite abundant. For the right candidate, the surgery’s results are supposed to last a lifetime or at least a couple of years.
As with any body contouring surgery, some Brazilian butt lift patients may need a minor touch-up to correct some asymmetry. However, revisions are often performed to make the results bigger.
While the amount of fat grafts differs from patient to patient, most of them will need at least 500 cc per buttock to see a significant improvement. However, “slight over-correction” or injecting more fats than intended is a common practice because the body will absorb 20-40 percent of grafts within three to six months of injection.
Because the survivability rate of fat grafts is quite unpredictable, some plastic surgeons inject at least 800 cc per buttock to minimize the reoperation rate.
If revisions are needed, the general rule of thumb is to wait at least three months. Some doctors even require a waiting period of six to eight months just to make sure that all the postop swelling and bruising are gone, helping them to make an accurate assessment.
The “right” timing also plays a crucial role in achieving high survival rate of fat grafts. The idea is to allow the fat cells injected during the initial surgery to settle before causing additional trauma in the area.
Meanwhile, the success of revision largely depends on the volume of excess fat. It is important to have enough “material” to reshape the buttocks and deliver a noticeable amount of augmentation.
The success of revision also depends on the surgeon’s skills. To promote high survivability of fat, leading Beverly Hills plastic surgery expert Dr. Tarick Smaili highlights the importance of “gentle” liposuction to minimize damaging the material, purification to eliminate any impurity, and correct injection.
After purifying the liposuctioned fat, Dr. Smaili says only the “best” tissue is injected into the buttocks with the use of micro-needles at various depths; the goal is to deliver natural feel and look.
To further promote high survival rate of grafts and near permanent results, the celebrity plastic surgeon ensures that there is a space between each microdroplet of fat to allow blood supply formation around the material.
In the first three weeks, there should be no sitting to prevent the fat grafts from shifting or dying due to pressure. The goal is to wait for them to “settle” and to access their new blood supply, leading to long-lasting results.
The goal of any body contouring surgery is to deliver natural results that no ordinary observer can tell that someone has had the procedure. In liposuction of the arm, this is achievable through proper patient selection, surgical planning, and postop wound care.
Liposuction surgery is only reserved for patients of normal weight with isolated pockets of fat which do not respond to exercise and diet. As long as they maintain a healthy weight, the results could last a lifetime.
People experiencing “yoyo weight cycling” due to crash dieting and unsustainable exercise program are less likely to achieve predictably good results. Also, they are at increased risk of developing skin irregularities and other telltale signs of plastic surgery.
Aside from proper patient selection, achieving natural results from arm liposuction also entails the surgeon’s technical know-how. The general rule of thumb, according California Surgical Institute website, is to choose doctors certified by The American Board of Plastic Surgery and other reputable affiliations such as the American Society of Plastic Surgeons.
A skillful surgeon understands that correct placement of scar is one way to achieve natural results from any type of surgical enhancement. In arm liposuction, the incisions are usually placed in or near the armpit to hide them from view.
However, patients who need more contouring or have excess fats that are evenly distributed may need another incision in the elbow.
Modern liposuction cannulas or hollowed steel tubes are notably small that they can easily fit into a 2-4 mm round incision, which for the vast majority of patients can fade into a barely noticeable scar (within six months) that one needs to stretch the skin and look very closely.
However, ethnic patients may experience longer post-inflammatory hyperpigmentation that makes their scars more noticeable. If they remain conspicuous even after months of waiting, bleaching creams and hydroquinone could help them fade quicker.
Contrary to popular belief, liposuction is not about removing as much fat as possible. In fact, liposuction of the female arm entails preserving a layer of fat so the results will look natural and feminine.
Over-aggressive liposuction, meanwhile, can lead to the destruction of the feminine contour. For this reason, prudent plastic surgeons err on the side of conservative fat removal since under-correction is much easier to address than over-correction.
Over-correction or removal of too much fat is expensive and difficult to address since it involves “reverse” liposuction or fat grafting in which excess fatty cells are harvested from one area of the body, purified and washed, and re-injected to smooth out skin asymmetries and other signs of botched results.
Plastic surgery after weight loss generally involves skin removal to address non-healing irritation, ulceration, and poor hygiene and bad odor as the extra flap of skin can trap sweat and moisture. For the right candidates who understand the importance of keeping a healthy weight, the procedure can provide near permanent results.
Oftentimes, surgery after massive weight loss is performed to restore the normal proportions of breasts, abdomen, thighs, buttocks, and upper arms. For some patients, the sagging skin around the face and neck must be addressed as well to achieve a more balanced look.
According to previous studies, body contouring after weight loss could serve as a strong impetus for patients to stick to a healthy lifestyle in an attempt to preserve their new figure, although long-term medical assistance and strong family support remain crucial to help them keep motivated.
The list below shows the tried-and-tested methods that can help maintain the results of body contouring surgery after weight loss.
- Strict patient selection. Because one’s physical appearance is not an accurate indication of health, physical exams and lab work are important prior to any type of body contouring after weight loss. Also, the ideal candidate should be near his or her ideal body weight, which is achieved through healthy lifestyle rather than yoyo dieting and latest fitness fads.
- Stable weight. The right candidates should maintain a stable weight for at least six months prior to surgery; anyone experiencing yoyo weight changes must postpone any body contouring procedure because the results could be unpredictable and the risk of complication is higher in obese patients due to their susceptibility to poor wound.
- Superb nutrition. Maintaining a stable, healthy weight is only possible through correct diet. The general rule of thumb is to eat more whole foods—e.g., fruits, vegetables, and foods that have been refined as little as possible such as whole-grain pasta and brown rice—and avoid or at least minimized highly processed foods and “empty calories.”
- Regular exercise. Long-term weight management not only involves superb diet. Physical activities also play an important role in preventing obesity and its subsequent health problems.
- Cognitive behavioral therapy. A spectrum of weight issues is not really about weight itself or food; oftentimes obese individuals have harmful behavior patterns and “unresolved” psychological issues that lead or at least contribute to their unhealthy view of foods.
The idea with cognitive behavioral therapy is to break or at least control the negative behavior cycles that contribute to unhealthy eating, thus helping patients in long-term weight management.