SEBASTIEN GARSON M.D
This fact sheet was developed under the aegis of the French Society of Plastic Reconstructive and Aesthetic Surgery (SOF.CPRE) as an addition to your initial consultation, to try to answer all the questions you can ask yourself if you plan to use surgery baldness. The purpose of this document is to provide you with all the necessary and essential elements of information to help you make your decision with full knowledge of the facts. Also you is it advisable to read with the greatest attention.
• DEFINITION OBJECTIVES AND PRINCIPLES
BreastThe objective is to remove the excess skin. When there is also excess fat, they are removed at the same time with a dramatic decrease in total body volume.
The body lift is so effective:
• forward on his belly, pubis and upper thighs
• back, buttocks
• laterally on the hips and saddlebags
We can better visualize this intervention imagining that removes a strip of skin from 20-25 cm around the body and located at the belt. The resulting circular scar may seem important. But in fact, experience shows that if it is well positioned (and thus easier to hide in a small underwear) and if the improvement of the silhouette is spectacular, it is very well accepted.
There are still 10 years, this operation was not performed because it was considered risky. But in recent years, demand has increased significantly due to the large number
important chokes (and their processions of excess skin) due to gastric bands, inducing major technical progress in its implementation.
Today, the operation is greatly improved and sophisticated. The surgeon can thus offer a lot more patient (s): in fact, and all those who have excess skin around the body. The causes can be many:
• the massive weight loss is of course the most common cause occurring after diet, gastric banding or bypass. The candidate (s) for this surgery have lost tens of pounds but it often remains of fat to be removed.
• obesity lower body, called gynoid, which resists schemes
• widespread obesity in this case the body lift can also be considered a surgery to reduce fat. They are patient (s) who have tried everything on the diet plan and do not want to undergo a troublesome stomach surgery or bowel constraints. The reduction can exceed 10 kg. But in this case the surgical team should be well established in this type of intervention.
• the age and deterioration of post-menopausal skin elasticity: in the same way as facelifts is practiced can be practiced facelifts body
• the consequences of liposuction which can leave excess skin if it was performed in a low skin elastic capacity
• congenital fall buttocks and thighs: that is to say without real cause and at puberty the person skin soft and drooping buttocks. The abdomen may be perfect and in this case it is convenient that the posterior part of the intervention.
• BEFORE THE OPERATION
In so-called "cosmetic" cases, for which there is only a correction of the excess skin, consultation, respect the classical criteria of consultation cosmetic surgery and will carefully analyze the reasons. But in addition, we will notify well (the) patient (e) that it is more tiring than the average transaction.
In case of surgery in the context of obesity preoperative consultations should address:
• Other adjuvants means. Before turning to plastic surgery, they must be analyzed and should not hesitate to ask the colleagues from other specialties: nutritionist, endrocrinologue, behavioral psychiatrist, bariatric surgeon (GI) if the body mass index (BMI ) is greater than 40, personal trainer ... Plastic surgery is certainly radical, but it is just one solution to the problem of contouring.
• changes in the weight of the patient. It is logical to perform the operation when the weight is stable for several months.
• the psychological side. A rapid and dramatic change in body shape can have a strong psychological impact. The surgeon must ensure the absence of too fragile at this level. When in doubt, it will help from a psychologist or psychiatrist who will diagnose feasibility.
• good physical condition and the absence of deficiency because the body lift is a long action (4-6 hours) and tiring. All this is controlled by the anesthesiologist who sees the patient in consultation long enough in advance to allow time to prepare the response and request a complete preoperative workup.
Smoking cessation is required 1 month before and 2 weeks after surgery.
Smoking increases the risk of postoperative complication of any surgery. Quit 6 to 8 weeks before surgery removes the excess risk. If you smoke, talk to your surgeon and your anesthesiologist. You can also call Tobacco-Info-Service (3989) to help you to re-duce the risk and put the odds on your side.
The expected result will be simulated from photographs by computer morphing, remaining however below the expected result.
The scar, which is long enough, eventually the only remaining brand operation. It must be explained in detail including its shape and especially its future position can vary depending on the desire of the patient to adapt to the preferred type of garment. Currently, the choice is most often a low position for wearing hipsters. But it may well choose a high position to suit swimwear indented "Brazilian" style. The width of the final scar is variable, from "fine" to "a little stretched" (vagaries of healing). No medication containing aspirin should be taken within 10 days before surgery.
Skin preparation is usually prescribed the day before and the morning of surgery.
• TYPE OF ANESTHESIA AND CONDITIONS OF INTERVENTION
Type of anesthesia: general anesthesia is required because the operated area and the duration of the intervention beyond the capabilities of local or regional anesthesia.
Terms of hospitalization hospitalization April-June days is required.
Each surgeon has adopted procedures which are specific to it and it adapts to each case to selectively correct defects in the presence and achieve the best results. It is therefore difficult to systematize the procedure. However, it may hold common basic principles:
Preoperative markings: they are essential to proper positioning and symmetry of the scar and are made before premedication that (the) patient (s) can stand up.
Installation: the operation involves two phases of roughly equal length. In principle, it starts in the prone position and ends in the dorsal position.
Liposuction: intervention often begins with liposuction of saddlebags and hips to remove the volume and mobilize even more excess skin.
Dorsal phase excess skin is then removed down the back, over the buttocks and laterally to tighten the outer thighs. If the buttocks are flat, the surgeon can use the excess fat at the hips, down, used to reshape the buttocks and increase volume. No drain is necessary because the lymphatic vessels are few in the region and the limited and padded separations.
Reversal of (the) patient (s): This is a highly codified and carried out with great caution step. After turning on (the) patient (s) is again prepared (e) (antiseptic rigorous protocol) for the second phase of the operation.
Ventral phase (it is identical to a conventional abdominoplasty): it allows to reach the abdomen down to the pubis and thighs up. It begins with liposuction to tissue mobilization while minimizing separations. The surgeon joined the posterior incision that will enable continuity with the previous incision. No drain is necessary either because many lymph vessels are respected by dissection, limited and padded separations.
AFTER THE INTERVENTION: THE OPERATING SUITES
Recovery is a bit longer than for another operation because of the duration of the procedure, carried surfaces and removals. The swelling and bruises appear quickly and can be quite intense as well as fatigue and pain.
If fatigue is too high a blood transfusion may be indicated. Regarding the pain, they are supported by anesthetists and are greatly diminished by powerful products. Wearing a compression sleeve is essential for a month to reduce edema. The risk of phlebitis complicated by pulmonary embolism is very low thanks to the anti-coagulant injections and early rise. The scar should not be exposed to sunlight or UV before 3 months.
• THE RESULT
Part of the result is immediately visible because the re-tensioning of the skin is always spectacular. After three weeks starting from edema and the result is even more impressive. Regarding the scar, you should know that if it fades well in general with time, it does not disappear completely. In this regard, we must not forget that, if the surgeon who performs the suture, the scar, it is the fact of (the) patient (s).
Beyond the cosmetic improvement is often appreciable, body lift provides generally to the patient (or patient) a significant improvement in terms of comfort. In addition, this functional improvement and psychological well-being help the patient or the patient in adjusting their weight balance.
The goal of this surgery is to make an improvement and not to achieve perfection. If your wishes are realistic, the result should give you great satisfaction. Anyway, this is an important and delicate surgery, for which the quality of the indication and the severity of the surgical procedure is put in no way immune to a number of shortcomings or complications.
• FAULTS OF THE RESULT
In most cases, a body lift properly indicated and performed makes a real service to the patient (s), with obtaining a satisfactory and consistent with what was expected result.
However, it is not uncommon for localized imperfections are observed, but they are real complications:
Unsightly scars: it is impossible to predict how the scar will behave. Most often all goes well and the scar still red initially bleached twelve to eighteen months. Sometimes it widens or thickens. In this case it is always possible to resume under local anesthesia.
Reappearance of excess skin especially in patient (s) who have lost weight and whose skin elastic fibers in poor condition. It is always possible to make alterations under local anesthesia to further improve the end result.
• POSSIBLE COMPLICATIONS
A body lift, although carried out for mainly aesthetic reasons, are nevertheless a real surgery, which involves the risks associated with any medical procedure, however small it may be. We must distinguish the complications of anesthesia and those related to the surgery.
Regarding anesthesia, during the consultation, the anesthetist inform himself the patient anesthetic risks. You should know that anesthesia in the body sometimes unpredictable, and more or less easy to control: having recourse to unAnesthésiste perfectly competent working in a surgical context, that the risks have become statistically extremely low. You should know, indeed, that the techniques, anesthetics and monitoring methods have made tremendous progress over the past thirty years, providing optimum safety, especially when the procedure is performed outside the emergency and in a healthy person.
Regarding surgery: choosing a qualified and competent plastic surgeon, trained in this type of surgery, you limit these risks, without removing them completely. Fortunately, real complications are rare after a body lift made in the rules. In practice, the vast majority of happens without any problems and the patient (s) are fully satisfied (s) of their income.
However, despite their rarity, you must be informed (e) of the possible complications:
• the thromboembolism (blood clots, pulmonary embolism), although generally rare after this type of surgery are among the most dangerous. Rigorous preventive measures should minimize the impact: port anti-thrombosis stockings, early mobilization, anti-coagulant therapy.
• Bleeding: they are possible the early hours but are usually very moderate. When they are too im-portant, it may justify a recovery in the operating room.
• Hematoma: they may require removal if they are large or too painful
• HIV-lymphatic effusion or abdominal side: It may appear a few days after surgery and can be punctured. It then dries without special sequel
• lnfection: despite the naturally occurring microbes to the anal region, it is very rare. If necessary, it quickly justify appropriate treatment.
• Skin necrosis: although rare, they are still pos-sible, often at the navel or buttocks. Simple erosions due to dressings heal spontaneously without a trace, unlike skin necrosis, fortunately exceptional, which often leave a small scar.
Overall, due to technical improvements, the body lift has become a more reliable operation that is to say, more efficient while reducing the risk of complicated postoperative course.
In total there should not overstate the risks, but just be aware that surgery, even seemingly simple, still a small share of hazards. The use of a qualified Plastic Surgeon ensures that it has the training and knowledge required to avoid these complications, or effectively treat if jurisdiction.
These are the pieces of information that we wanted to bring you in addition to the consultation. We recommend that you keep this document, read it again after the consultation and reflect "a clear head." This reflection may raise new questions for which you wait for additional information. We are available to talk during the next consultation, or by phone, or even on the day of surgery when we meet in any way before anesthesia.
Phone : + 33344282959
7 impasse de la Passerelle 60300 SENLIS
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