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Body Lift Surgery and Body Contouring Surgery: Part Four

Recovery and Summary – Delaware and Pennsylvania

Body lift surgery, lower body lift surgery, and body contouring surgery are operations that can give fantastic and wonderful changes for many people. Understanding and learning about the cosmetic operations is always important for all people interested in the surgery. This educational series has four parts and will, in this section – Part Four, go over recovery from surgery and a general summary. Please review the three earlier parts and the “Procedure Info” section of my web page.

As discussed before, body lift, lower body lift, and body contouring operations can vary depending on what operations are done. Which specific operation you choose to do will determine the recovery for you. For example, a thigh lift operation alone will have a different recovery than a lower body lift or an operation that includes a tummy tuck or an arm lift also. Some patients choose to do larger operations than others. Larger operations will require more time off work and will have a longer recovery compared to shorter operations. First, general recovery from these operations will be reviewed and then some specifics for individual operations.

For those interested, detailed post operative instructions are available on my web page for all the operations I perform. Please see the instructions under “Patient Forms and Survey” in the menu. Then click on “Body, Thigh, and Buttock.”

General instructions for lower body lift recovery are to have ample time to rest and heal. It takes time to recover from these operations and people who try and rush back to their busy schedules can increase problems. It is recommended to have about 1-2 weeks off from most activities. It will be a month before unlimited exercise can resume.

We want to decrease our chances of blood clots in the legs or DVT. I have an acronym that will help people remember some of the important instructions after the surgery.

It is “PAIL.”

P – Patient Position. Keep the legs elevated. Venous blood flow is slow and dependent. Keep the legs elevated above the heart to promote drainage and blood return. “Toes above the nose.”
A – Ambulation. Early ambulation is very important. Moving the legs encourages blood flow and return. Get out of bed frequently and walk around. Usually you will need some assistance the first couple of days. The instructions are “Out of bed with assistance.”
I – Invisible Bicycle. When those legs are elevated, pretend you are riding a bicycle. Move them and pump them. This encourages blood movement. One leg can be done at a time so it won’t even hurt. Most find this is really helpful.
L – Leg compression stockings. Ted hose or other brand leg compression stockings should be worn until about two weeks after surgery. These help compress the veins to decrease clots.

Specific instructions for body lift recovery or body contouring recovery depends on the specific operation done. Please see the operations under “Patient Forms” in the menu section of my web page. Some specific instructions will be reviewed now.

Tummy tuck operations often involve muscle tightening. This is the part where the muscles are sutured together. This can cause pain, so a “Pain-Buster” is used. This device is fantastic! It trickles in Lidocaine to the muscle site for 72 hours or three days. It really works! I believe it has been one of the most significant advances in recovery for tummy tuck in the last decade. Most people are really surprised at how well it works.

Thigh lift, buttock lift, and tummy tuck operations usually require drainage tubes. These tubes collect fluid and prevent fluid accumulation. In my opinion, most people find them annoying but, overall, not that bad. I believe they lead to extra “flat” results and are well worth the minor discomfort involved.

Body Lift and Body Contouring Summary:

Benefits: The operations can give dramatic improvement to the stomach, buttocks, flanks, and thighs. This improvement might not be as much as desired, however. Realistic expectations are always important for all cosmetic operations.

Options: A complete review with the doctor is essential.

A woman may review options and decide against proceeding with any surgery.
A women may proceed with liposuction and “not” a body lift. This is easier surgery, but the results will not be as significant or dramatic.
It is important to understand the different incision patterns when considering a thigh lift.
Aesthetic Risks: A person must understand the incisions that are required for these operations. Different incision patterns can be used. The incisions turn into the scars. Other risks are important to understand and will be reviewed by Dr. Saunders in detail.

Recovery: The recovery is 1-2 weeks. Sometimes it is much longer than expected. The recovery requires a significant period of leg elevation and the use of a compression garment.

Body Lift Surgery and Body Contouring Surgery : Part Three

The Surgical Incisions and Results – Delaware and Pennsylvania

This educational writing on body lift surgery and body contouring surgery is part of a four part series. It is important to learn about the operations and all aspects about them. I specialize in exclusively cosmetic surgery and operations like body lift, lower body lift, and breast lift. Patients from Delaware, Pennsylvania, New Jersey, Maryland and surrounding states will find the these writings helpful. Similar concepts are reviewed for breast lift and can be seen in the writing “Breast Lift Surgery and Breast Reduction Surgery : Understanding the Incisions.”

Body contouring or body lift operations are composed of many different operations that can be combined or done separately. These operations include arm lift, breast lift, tummy tuck, buttock lift, and thigh lift. Lower body lift surgery usually is the combination of a tummy tuck and thigh lift surgery. Sometimes staging of operations is required as they all can’t be done at one time. Please see the “Procedure Info” section of my web page under Body Lift, for further discussion of this topic and staging surgery.

Thigh lift surgery typically has one of two incision patterns. The first pattern involves an incision high on the thigh in the groin crease. The incision length is typically 6 to 9 inches long. The second pattern involves a “stocking seam” incision from the groin to the knee area. This pattern has a longer incision. People all want the shorter incision. The cosmetic surgeon does also. This first incision pattern is the shorter one, but does not work as well as the second pattern, with the incision down the leg. This is because the second pattern allows for significantly more skin removal and usually dramatically better results.

The first pattern in the groin area is placed in a well hidden area, and this is the main advantage of this incision. New techniques involve suturing the deeper layers of the thigh skin or flap to the bony tissue of the pubis. This new technique, that I use, is reported to give superior results than standard thigh lifts. It is sometimes claimed that this thigh lift gives better scars, without spreading of the scar with time. The “Real-Reality” or truth is that thigh lift incisions can spread, regardless of which pattern or surgical technique is used. Most of the time the incision fades well. Most people are very happy with the operation and the results. But it is important to understand that a risk of the operation is the incision not fading as well as hoped or spreading of the incision.

Now that we understand what the thigh lift or lower body lift scar might look like, it is important to understand what type of results we can expect from surgery. In general, the thigh lift with the incision pattern in the groin, usually involves lower thigh liposuction. This operation typically gives moderate improvement to the upper inner thigh area. The improvement is best in the 4 to 6 inch area near the groin. Beneath the 6 inch area and further down the thigh, the results are from liposuction alone. The results are best in that small distance, very close to the groin. Further down the thigh, there is going to be persistent looseness of skin. This is because it is not removed by the smaller incision pattern that does not go down the leg.

Liposuction, which is done to the lower thigh, makes a person “a smaller version of you.” Please see the educational writing on liposuction titled “Delaware Body Contouring – Understanding Liposuction.” There is minimal tightening of skin with liposuction in this type of situation, with loose thigh skin to start. With incision pattern one, with just the groin incision, the thigh lift result or lower body lift result is improvement for a short distance in the upper inner thigh with substantially less improvement further down the thigh.

The second incision pattern is a stocking seam incision running down the inside of the thigh. This incision is along the inside of the thigh and tends to be longer. However, it allows for significant excess skin removal and hence significantly better results. A basic concept in plastic surgery involves the understanding of the relationship between skin removal and incisions. Small incision patterns allow for small skin removal. Larger incision patterns allow for larger skin removal. Larger skin removal gives better and more dramatic results.

This concept is very important when it comes to thigh lift results or lower body lift results. The same concept applies to tummy tuck surgery when comparing mini tummy tuck versus a “classic” tummy tuck operation. With the mini tummy tuck, less skin is removed. The results will not be as dramatic as with a classic tummy tuck with the longer incision. When it comes to the thigh incisions, longer incisions give better results. The stocking seam incision or the second incision pattern discussed for thigh lifts tends to be associated with much better thigh improvement and results. These patients tend to get much more substantial and dramatic improvement in the appearance of the thigh.

The best candidates for this procedure are patients who really want improvement, and typically need it. Significant weight loss for example is a good indication. These patients typically have major or significant looseness of the skin. Patients might say, ”I don’t care about the incision, just get rid of all this loose skin.” When they have this much loose skin, patients tend to love the result of the thigh lift, with the stocking seam incision. The operation gets them back into tighter pants and clothing.

In contrast, women who have minimal loose skin in the thighs, with some excess fat, might not want the longer incision. They might want less dramatic changes, and hence the long scar can sometimes outweigh the benefits achieved by the thigh lift. This patient might choose liposuction only or the shorter incision pattern. The doctor will review these options in detail with you.

If a patient is considering a thigh lift or body lift, she must understand the “Real-Reality” of the scars and the “Real-Reality” of the results. If a patient has significant loose skin, then there is a good chance they will be happy with the dramatic results that can be achieved with a thigh lift. However, if a patient has minimal looseness of the thigh skin, then they must be very careful when deciding to proceed with this surgery, other options must be considered.

Body Lift Surgery and Body Contouring Surgery: Part One – Scar Healing Factors

These educational writings on body lift surgery and body contouring surgery are designed to give the reader a higher level of understanding about the operations they are considering. The writings are meant to be more in depth and informative to provide a greater understand of the facts and operations. Many operations are considered part of body lift or body contouring procedures. These include but are not limited to arm lift, breast lift, tummy tuck, thigh lift, buttock lift, and thigh lift. People interested in these procedure might have developed loose skin from loss of elasticity, pregnancy, and or weight loss or aging.

One major point to learn is that these operations require incisions to remove loose skin. The incisions turn into the scars. Understanding the nature of the scars is critical, as this is what you will have after the procedure is finished. Most people love the flatter abdomen after the tummy tuck or the thinner thighs after the thigh lift, but do they like the scars? This is the key question. If they like or accept the scars, then most people will be happy. Some are not happy with the incisions, and hence they might not be good candidates for the operation. A person must accept the necessity of the scars or probably not do the operation. A similar theme is discussed in the educational writing “Breast Lift Surgery and Breast Reduction Surgery : Understanding the incisions or scars.” Please see this for those interested.

This first educational writing will focus on scar healing and scar maturation. If we need to understand the incisions, we better understand how scars heal first. Further educational writings will focus on body lift results, realistic expectations, incision patterns, risk-benefit analysis, and recovery.

Part One:

Scar Healing Factors – The Surgeon and the Location:

It is important to understand a few concepts about scar fading and scar maturation. Some information and education will make for better understanding of what can be realistically achieved. By understanding scar healing, a person will have a better understanding of the “Real-Reality” of thigh lift and buttock lift.

Different factors are important to get a smooth, flat, and thin scar. Of course, one of these factors is your surgeon. Most people want a plastic or cosmetic surgeon, who uses delicate and gentle handling of tissues. He will use layered closures and use tiny sutures to give your incision or scar the best possibility to heal nicely. These are critical skills used by your plastic surgeon.

Another major factor, however, is where the incision is placed or its “location.” For example, the location of the scar depending on the operation might be the face, the back, the buttock, or the thigh. Eye lifts have incisions in the eyelid crease and typically heal phenomenally. The scar fades extremely well. The scars are placed in the eyelid crease and can be described as “privileged”. This means the scar fading is so nice that the normal result is a scar that is extremely difficult to see. The incision in this location fades typically so well it eventually becomes almost totally concealed.

However, body lift and body contouring scars are not like eye lift scars. The location is totally different and will be reviewed as a factor. All scars never disappear completely. Scars are always permanent. As described, some scars become hard to see and have “faded well.” Others are more visible and can be considered more normal than eyelid scars. Some become widespread or elevated and can be considered “bad scars.” This scar fading over time is considered scar maturation. The final permanent fading of a scar can take up to a year, or even longer in some locations. As described, some incisions, like those for eye lifts or facelifts have excellent fading. Most of the time, these incisions are not seen because they are hidden and very thin. The location of a scar is a critical factor in how well it will fade.

Tummy tucks have incisions in the bikini line. Typically, the incision is hidden at the top of the pubic hair. This incision allows for it to be hidden in bathing suits, bikinis, and underwear. The transformation in the stomach area from a tummy tuck can be a very dramatic change. In the case of a woman with loose or excessive stomach skin, the incision tends to be well worth the results of surgery. However, it is always there; and when a patient is undressed, the incision will be visible. It can spread with time. The incisions from a tummy-tuck can spread 3 to 5 mm or approximately one quarter of an inch. What about body lift incisions?

Thigh lift incisions tend to be in areas that are not perfectly concealed. They can be placed down the inside of the leg and can come out of the coverage provided by shorts and clothing. This is suboptimal for many patients. The buttock incisions tend to be hidden in underwear and bathing suit lines. This is better as it allows concealment. The body lift incisions of a thigh lift and a buttock lift also haver a greater chance of scar spreading. The location is not as nice or as “privileged.” The particular anatomy of the skin of the thigh and buttock tends to produce a wider spread scar than other locations. This is because of the characteristics and thickness of the skin. The skill of the plastic surgeon can not overcome the healing characteristic of the skin in this area. The location of these incisions is a factor that might lead to scar spreading after body lift surgery. It does not mean the scar “will” spread, but a person needs to understand it is a risk. Most people will in fact be happy with their operations and the scar fading. But this in depth understanding of the scar is necessary.

To summarize, scar healing and fading is influenced by different factors. Your surgeon is, of course, an important factor. Some patients are bad “healers” prone to keloids, hypertrophic, or other bad scars. Where the incision is placed or its location is another critical factor. Surgical incisions turn into scars; surgical incisions are needed for cosmetic operations. The incisions or scars fade. This scar maturation or fading of scars, takes time, sometimes years. Some operations require incisions that don’t heal as well. Thigh and buttocks lifts require incisions that don’t always heal well. They are not “privileged” locations, and understanding of the healing of these scars is important to the “Real-Reality” of these operations.