After Weight Loss Surgery in New Jersey

The skin is often irritated, red, and painful. On occasion, the skin may break down and bleed or even become infected. Non-surgical means of treating this problem include keeping the skin folds dry. This can be frustrating and is only a temporary solution to the problem. Fortunately, with proper documentation, insurance companies may recognize this problem and provide coverage for the surgical removal of the excess skin, a procedure called a panniculectomy. Panniculectomy in the region of the abdomen is also referred to as an abdominoplasty or tummy tuck. The technique usually involves tightening the muscles of the abdomen and removing excess skin as well.

Addressing the excess skin of the abdomen is often very satisfactory following pregnancy but is usually inadequate following massive weight loss. As mentioned earlier, weight loss following bariatric procedures is generalized; consequently, excess skin is not just confined to the abdomen but involves the thighs and buttocks as well. For these reasons, Dr. Capella almost exclusively performs a procedure called a body lift on weight loss patients. The operation involves an abdominoplasty, thigh, and buttock lift all at one time. This technique is also often referred to as a “lower body lift” or “belt lipectomy.” The operation very effectively addresses loose skin and cellulite along the thighs and buttocks as well as the abdomen. Patients are often exhilarated just to learn that such an operation exists. While the scar is lengthy, it is confined to the bikini line and is hidden by conventional underwear, panties, and bathing suits. Both men and women find the operation very rewarding. Dr. Capella will perform a body lift along with an upper body lift for appropriate candidates. See below regarding upper body lift.

Women who sustain significant weight loss in the fourth and fifth decades of life can have a marked change in breast size and shape. By this age, a significant portion of the breast glandular tissue has been replaced with fat, and therefore marked weight loss will lead to a rapid decrease in the amount of breast tissue. The skin, unable to retract completely, produces severely ptotic (sagging) breasts. This condition is called breast involution. The treatment options for women’s breasts following weight loss are several. If a woman desires larger, fuller breasts but has little sag, an implant alone may be satisfactory. This scenario is not the norm, however. More often, women have concerns about sag and want to be larger. In this case, a breast lift or mastopexy is needed in addition to the placement of an implant. The options for breast lifts are several. For small amounts of sag, a circumareolar technique can be used, which only involves an incision around the areola. For moderate amounts of sag, a vertical mastopexy can be used. With this technique, there is an incision around the areola as well as extending from the areola to the base of the breast. For severe sag or ptosis, an anchor-type incision may be necessary. The above-mentioned incisions are utilized in addition to one at the base of the breast. For patients not desiring to be larger and who have an adequate amount of breast tissue, a lift without an implant may produce an aesthetically satisfactory outcome.

The problems in men are similar; however, the terminology and treatment are slightly different. In the obese state, men tend to have large breasts. With weight loss, some fat and glandular tissue remains. Depending on a man’s age, degree of weight loss, and other factors mentioned above, he might end up with large breasts relative to his torso, large and/or sagging breasts, or satisfactory-appearing breasts. Large and/or sagging breasts in men are called gynecomastia. For men with large breasts following weight loss, liposuction alone may provide adequate treatment. This is not typical, however. Most men who present for treatment have concerns about both size and sag. Dr. Capella prefers to remove excess skin, breast tissue, and fat in one procedure that typically involves an incision along the base of the breast. The nipple and areola are then usually moved as a graft to a higher, more aesthetically pleasing position. Because men often have hair on their chests, scars are well concealed and thus better tolerated. Dr. Capella will very often combine breast surgery with flank and arm surgery in the weight loss patient in a procedure called an upper body lift. (See below)

In addition, Dr. Capella does not feel that weight loss patients achieve satisfactory results with procedures limited to only the armpit. For individuals with excess skin and fat limited to the armpit and upper arm, a procedure with a scar in the armpit and along the upper third of the inner arm in combination with liposuction can produce good results. Most weight loss patients have concerns about more than just the upper arm, particularly women. For this reason, to achieve an excellent result in these patients, a scar in the armpit is required in addition to one along the arm and extending to the elbow in most cases. Dr. Capella places the arm scar along the lower part of the inner arm, the same location where tailors place the seam of a sleeve in a dress shirt, and usually combines liposuction with these procedures. For women in their 60s and beyond, loose skin along the forearm, beyond the elbow may be a concern. For these patients, Dr. Capella will extend the incision onto the inside of the forearm.

The treatment options for weight loss patients are essentially the same as their non-weight loss counterparts. A facelift, which almost always incorporates a neck lift, treats very effectively the deep wrinkles of the face as well as the excess fat and skin of the neck. The technique of face lifting usually involves an incision beginning in the scalp above the ear, continuing immediately in front of the ear, and extending around and behind the ear and just inside the hairline of the scalp below the ear. The skin of the face and neck is elevated, and the excess is removed. Other components of the operation usually include tightening the superficial muscle layer just deep into the skin and removing the excess fat from the neck. Face lifting can significantly refresh the appearance of weight loss patients.