In our continuing series highlighting Plastic Surgery procedures in Singapore, Expat Choice caught up with internationally acclaimed Plastic Surgeon Dr Marco Faria Correa to discuss Plastic Surgery After Massive Weight Loss.
According to Dr Marco, Massive Weight Loss (MWL) – is defined as 30 percent, 50 percent, or greater loss of a person’s excess weight. After MWL, a patient may experience over redundant folds of skin, random pockets of fat in different parts of the body, and stretch marks - also known as Striae.
MWL patients are often left with significant functional and cosmetic issues related to the excess skin, and in some cases Plastic Surgeons are challenged to rectify the problems easily and efficiently, although Plastic Surgery does plays a vital role in the lives of these patients, through positive aesthetic and cosmetic planning and execution of the prescribed procedures.
Many patients refer to the areas of the body including the face, breasts and buttocks as - deflated. In the upper torso, this can cause upper and mid-back rolls, breast droopiness or ptosis - the drooping of the upper eyelid, and excess skin in the arms.
In the lower torso, a pannus or apron may develop in the mid abdomen, lower abdomen and pubic area as well as excess tissue in the flanks. Excess skin develops in the inner thighs as well, creating skin excess both vertically and horizontally and cellulite often develops in the hip area.
Who is a good candidate for plastic surgery after massive weight loss?
Dr Marco explain that, a Plastic Surgery after MWL is a growing field in constant evolution. Conventional procedures are not always able to address all patients. A patient becomes a good candidate when their weight has been stable for at least three to six months after the initial Massive Weight Loss.
MWL patients need to understand that Body Contouring or Body Lift is a process rather than a one-time event. They may require two or even three procedures to address all of their concerns. This is not always physically or economically feasible and some compromise may need to be realised.
What parts of the body can be lifted after MWL?
ABDOMEN – Abdominoplasty is the most required operation. It aims to remove excess tissue, to remove excess skin above and beneath the umbilicus, and to repair the rectus diastasis muscles resulting from pregnancy, or from pressure formerly exerted by fat before weight loss. Hernias, if present, need to be addressed too.
The scar resulting from the abdominoplasty is situated very low, just above the pubis, going up slightly on either side, and can be hidden in the swimsuit. The pubic hair is repositioned as normal.
An additional liposuction may also be performed to improve the abdominal contour, creating a more defined waist, shaping the hips and decreasing the “Venus mount” area.
BREASTS – Most MWL patients lose significant volume from the loss of fat in their breasts along with their trunk. Patients require mastopexy or breast lift surgery.
Some patients opt to increase their breast volume by having an implant or by the use of their own fat which can be suctioned from another area.
Men with MWL may have deflation of their chest resulting in a flabby hanging breast. The technique to treat it is different than those used for female breast lift. The goals for a male would be skin removal in a cosmetically satisfactory appearance. So, as not to be embarrassing when in public.
The main goal of the breast plastic surgery for man and woman after MWL is to recreate a normal shape and volume, for each specific patient case.
INNER THIGHS – The thighs are arguably the most difficult area to treat in MWL patients. This is one of the areas of the body where skin is the thinnest. Many women retain adiposity in their thighs despite weight loss.
Excess skin in the lateral thigh may be addressed through lower body lifting. Liposuction may be needed to contour the lateral thighs or debulk the thighs in cases of severe lipodystrophy.
As the patient loses weight, the skin shrinks, creating a distressing roll of fat, which in turn leads to functional problems and aesthetic consequences. Surgery is effective and discreet because the scar can be hidden at the root of the thigh.
BUTTOCKS – A body lift is often performed in conjunction with liposuction and with the fat transfer to the buttocks.
ARMS – In MWL patients, excess skin and fat are present around the arms in between the elbow and the axilla. This is often an area of concern for women due to the difficulty finding clothes that fit and the inability to “hide” the deformity often likened to wings.
Even if concealed by clothes, the excess of fat and skin on the upper arms can be a problem, nevertheless. Lifting of the arms or Brachioplasty is straightforward and the scar is hidden under the arm.
Liposuction alone is insufficient treatment but may be used to debulk the arms in select patients in a staged procedure done three to six months apart.
FACE AND NECK – The face and neck are least commonly treated areas for MWL patients. This is due to the severity of skin laxity present in other areas including the abdomen. Facial lift can decrease the drooping of the skin on the face and the neck.
The goal of facial rejuvenation in these patients is to remove excess skin and restore structures to their anatomic position and augment the volume of the subcutaneous tissue. The aim is to give the face and the neck a firm, jovial and fresh contour.
According to Dr Marco, MWL patients are more complex surgical patients than non-MWL patients. They can be successfully treated by plastic Surgeons adept in their care who customize staging of the procedures as needed to yield a faster recovery, better results, and lower complications.
According to Dr Marco it´s important for the Plastic Surgeon to assess case by case, to understand the unique needs of the patient, and to recommend the techniques that will help to achieve a natural and appropriate result for the patient´s silhouette.
Dr. Marco reiterates, “In our clinic, we tailor our surgical plans and treatments by considering the anatomy of each particular patient, whether male or female”.
Dr. Marco is a pragmatic surgeon who has mastered the traditional open and minimally invasive methods of Plastic Surgery by applying the latest techniques for properly hiding the scars in the anatomical folds and crease of the skin, leaving inconspicuous scars.
He is a well-versed Plastic Surgeon in the various benefits and limitations of the different procedures and methods; hence, he will always advise his patients on what is the best option to achieve the outcome that they want.
For more information about each procedure visit www.drmarco.com or call Dr Marco Faria Correa, Internationally trained Plastic & Cosmetic Surgeon with over 30 years of experience on +65 6464 8075, WhatsApp +65 9176 1813 or email admin@drmarco.com
