Clinical Care

Body Contouring

Body Contouring 2018-06-15T11:05:39+00:00

Body Contouring & Reshaping

When diet and exercise aren’t adequate enough to give you the look you want, the UPMC Aesthetic Plastic Surgery Center can help with several body contouring and reshaping procedures.

Through our nationally-acclaimed Life After Weight Loss program, we also have pioneered body contouring techniques for post-bariatric surgery patients who have excess skin because of massive weight loss.

Our body contouring and reshaping procedures include:

Overview

Liposuction slims and reshapes specific areas of the body by removing excess fat deposits through small incisions, and improving the body’s contours and proportion. Liposuction can be performed on the following areas:

  • Thighs
  • Hips
  • Abdomen
  • Buttocks
  • Waist
  • Upper arms
  • Back
  • Inner knees
  • Chest area
  • Calves
  • Ankles
  • Chin
  • Neck

Liposuction can be performed by itself or in conjunction with other plastic surgery procedures such as:

Who is a Candidate?

If you have excess fat deposits that are not responding to diet or exercise, liposuction may be an alternative for you. Liposuction is not a treatment for obesity.

Generally, liposuction candidates are adults who are:

  • Within 30 percent of their ideal weight
  • Have firm, elastic skin
  • Have good muscle tone

Candidates also must be healthy individuals who do not have a life-threatening illness or medical conditions that can impair healing. Many patients are more successful with their weight reduction program after a liposuction procedure because it can enhance their overall result.

Before the Procedure

The success and safety of your liposuction procedure depends on your honesty during the consultation with your surgeon. You’ll be asked a number of questions about your health, desires and lifestyle, and you should be prepared to discuss your reasons for having the surgery, your expectations, and desired outcome.

Some of the specific instructions you’ll receive about preparing for surgery include:

  • Smoking cessation
  • Medications to avoid
  • When to take your prescribed medications
  • Proper washing techniques
  • Restrictions regarding eating and drinking the night before surgery

Procedure Details

The surgeon will make small, inconspicuous incisions, and insert a thin hollow tube (called a cannula) to remove the excess fat. Some of the instruments have sound waves that facilitate the fat tissue removal. The doctors will inject sterile IV fluid containing local anesthetic and adrenaline to decrease the possibility of bleeding and postoperative discomfort.

Your improved body contour will be noticeable after the swelling and fluid retention subsides. Liposuction’s results will continue as long as you maintain a healthy diet and fitness regimen. Substantial weight gain, however, can reduce the surgery’s results.

Where Will the Procedure be Performed?

Liposuction is usually done in a hospital as outpatient surgery, and you will have to be driven to and from the hospital by a friend or family member.

Type of Anesthesia

Your doctor will recommend the best type of anesthesia for you but intravenous sedation or general anesthesia typically are used.

Immediate Postoperative Recovery

In most cases, the pain associated with liposuction is controlled with oral pain medication. At the end of the procedure, a compression garment is commonly applied to the area, and is worn for several weeks. Your surgeon will give you specific instructions about:

  • The compression garment
  • Normal increased progression of activity
  • Which activities should be avoided immediately following surgery

Depending on the type of job, most patients can return to work within two to five days.

Risks

In addition to the risks associated with anesthesia, other risks of liposuction can include:

  • Bleeding
  • Excess bruising
  • Slight skin discoloration
  • Skin numbness and tingling (which is usually temporary and lasts only a few weeks)
  • Swelling

Additionally, you may have asymmetrical, wavy, or irregular skin. Liposuction may not improve the appearance of cellulite.

Not every person is a candidate for this procedure, and your risks may be greater or different than those of other patients. Your plastic surgeon will review all potential risks and complications with you prior to the surgery.

Anticipated Results

As the swelling from the surgery subsides, you will begin to see improvements during the first six weeks after surgery. Controlling your weight and maintaining a healthy lifestyle can help you stay satisfied with the results of the procedure.

Overview

Abdominoplasty or “tummy tuck” is a surgical procedure that is designed to treat:

  • Excess skin
  • Excess fat tissue
  • Muscle bulging in the abdomen due to:
    • Pregnancy
    • Weight fluctuations
    • Genetics

Who Is a Candidate?

Generally, patients are women between the ages of 30 and 60 who want a flat and attractive contour of the abdomen, but men also can have the procedure. While typically an aesthetic enhancement, an abdominoplasty can be performed as part of a panniculectomy (removal of excess skin from the lower abdomen) after massive weight loss surgery. Working with other surgical specialists, this procedure can be done in conjunction with a gynecological procedure, such as a hysterectomy, or with a urologic or general surgical procedure.

Before the Procedure

Your plastic surgeon will perform a comprehensive evaluation of your abdominal area including a detailed history of:

  • Pregnancy
  • Weight loss or weight gain
  • Previous abdominal surgeries

Some of the specific instructions you’ll receive about preparing for surgery include:

  • Smoking cessation
  • Medications to avoid
  • When to take your prescribed medications
  • Proper washing techniques
  • Restrictions regarding eating and drinking the night before surgery
Procedure Details

You and your plastic surgeon will discuss the concerns you have about your current abdominal shape and your goals regarding the abdominoplasty procedure. There are different variations of abdominoplasty procedures that include short or long incisions, and differences in areas of muscle tightening. Liposuction of the abdominal wall or in the hip and flank regions may be appropriate for some patients.

Your surgeon will decide which procedure is best based upon your goals and anatomic issues. The approximate location of the incisions and scars will be outlined directly on your skin or on a diagram.

Finally, your surgeon will perform a careful evaluation of your overall health as well as issues that could cause complications, such as:

  • Your blood pressure
  • Bleeding tendencies
  • Blood clotting disorders
  • History of adverse scar formation after previous surgeries

Where Will the Surgery be Performed?

An abdominoplasty usually is done in a hospital as outpatient surgery, and you must be driven to and from the hospital by a friend or family member. Your surgeon may want you to stay one night in the hospital to recover the help of skilled nurses.

Type of Anesthesia

An abdominoplasty usually is performed under general anesthesia however, certain types of lower abdominoplasties or “mini” abdominoplasties can be performed under local anesthesia with the use of intravenous sedation.

Immediate Postoperative Recovery

In most cases, you may experience pain for 24 to 72 hours. Swelling can occur in the abdominal wall tissue but this usually resolves within a month of surgery.

Short-term Recovery

You will be encouraged to get out of bed the night of surgery, and should be able to walk slowly by the next day. Most patients can go out in public within three to five days. Patients generally are asked to take at least a week off from work, but those who have highly physical jobs may require more time off.

Suction drains routinely are used following abdominoplasty procedures to help with normal healing. These drains are simple to care for and patients will be given instructions at the time of discharge.

You may be instructed in the use of an elastic abdominal binder to keep the area comfortable with gentle pressure. Vigorous physical activity is limited for four weeks following surgery.

Risks

An abdominoplasty typically enhances the appearance of your abdomen but it is considered major surgery. You should think carefully about your expectations, and talk with your plastic surgeon about your goals. In addition to the risks associated with anesthesia, there will be:

  • Scars
  • Complications including:
    • Seromas (collections of fluid beneath the abdominal skin)
    • Hematomas
    • Asymmetry of the abdomen

Not every person is a candidate for this procedure, and your risks may be greater or different than those of other patients. Your plastic surgeon will review all potential risks and complications with you prior to the surgery.

Anticipated Results

Abdominoplasty usually produces a rejuvenated, more youthful and attractive abdominal shape.

Overview

Upper bodylift, or a bra-line lift, is a surgical procedure designed to remove excess skin of the upper back that extends to the side of the chest. It is a procedure that commonly is performed in patients who have lost a large amount of weight and have loose sagging skin.

This procedure can dramatically tighten the loose skin of the back and improve the extra rolls on the back, but comes with a visible permanent scar that runs along the bra line. This procedure is performed most commonly with a breast lift for women or chest contouring procedures for men, giving the entire upper body a rejuvenated appearance.

Who is a Candidate?

Patients of any age with loose skin on the back may be candidates for this procedure.

Before the Procedure

Your plastic surgeon will perform a comprehensive evaluation of your lower body including any scars from previous surgeries.

Your plastic surgeon will give you specific guidelines about preparing for surgery including:

  • Smoking cessation
  • Medications to avoid
  • When to take your prescribed medications
  • Proper washing techniques
  • Restrictions regarding eating and drinking the night before surgery

Procedure Details

Your plastic surgeon will listen carefully to your concerns about excess skin of the back and side chest, and your surgical goals and expectations. The length and position of the scar on your back can usually be limited to the location of a bra for women, and the surgeon can draw the approximate scar location on your skin with a medical skin marker.

A common alternative to removal of the skin is liposuction. Although this option usually avoids a long scar and may deflate some of the rolls of the back, it may make the loose skin worse. The risks and benefits of all procedures will be discussed in greater detail at your initial consultation.

It’s important to know that although the upper bodylift can have a significant impact on the upper back, it will not change the appearance of lowest part of the back or the buttocks. The low back and buttocks may be best treated by a lower bodylift. Your surgeon may recommend performing an upper body lift and a lower body lift at separate times to maximize safety, and to achieve the best results.

In addition to the aesthetic evaluation, your surgeon will perform a careful evaluation of your overall health, as well as issues that could cause complications, such as:

  • Blood pressure
  • Bleeding tendencies
  • History of adverse scar formation after previous surgeries

Where Will the Surgery be Performed?

The surgery usually is performed as an outpatient procedure. If it is combined with other operations, you may need to stay one or two nights in the hospital. You must be driven to and from the hospital by a friend or family member.

Type of Anesthesia

An upper bodylift is done under general anesthesia.

Immediate Postoperative Recovery

In most cases, patients may experience pain in upper back and side of the chest for the first two or three days. Compressive wraps are placed around the chest and back.

Short-term Recovery

In most cases, patients will be able to go out in public in four to five days but vigorous physical activity is limited for four weeks following surgery.

Risks

An upper bodylift tightens the skin on the buttocks and thighs but does involve a permanent scar, and is considered major surgery. In addition to the risks associated with anesthesia, infection and bleeding can occur but are uncommon. Not every person is a candidate for this procedure, and your risks may be greater or different than those of other patients.

Your plastic surgeon will review all potential risks and complications with you prior to the surgery.

Anticipated Results

An upper bodylift usually produces a tightened and more attractive appearance of the upper back and helps with the appearance in clothes. The permanent scar may stay thick and red, but tends to fade over time and reaches its final appearance over 12 to 18 months.

Overview

Lower body lift is a surgical procedure designed to remove excess skin from the outer thighs and buttocks. It is a procedure that commonly is performed in patients who have lost a large amount of weight and have loose sagging skin. This procedure can dramatically tighten the loose skin on the outer thighs and buttocks.

The use of state-of-the-art techniques allow for the preservation of volume in the buttocks thereby preventing a flattening effect. This procedure is performed most commonly with an abdominoplasty so that the entire waist line is sculpted. The scar can usually be concealed below underwear.
Who is a candidate?
Patients of any age with loose skin on the buttocks and outer thighs may be candidates for this procedure.
Before the procedure
Your plastic surgeon will perform a comprehensive evaluation of your lower body including any scars from previous surgeries.

Your plastic surgeon will give you specific guidelines about preparing for surgery including:

  • Smoking cessation
  • Medications to avoid
  • When to take your prescribed medications
  • Proper washing techniques
  • Restrictions regarding eating and drinking the night before surgery

Procedure details
Your plastic surgeon will listen carefully to your concerns about excess skin on your thighs and buttocks, and your surgical goals and expectations. The length and position of the scar on your thighs and buttocks can vary, depending on whether the excess tissue is based high above the buttocks or low around the saddlebags.

A common alternative to removal of the skin is liposuction. Although this option usually avoids long scars, it may make the loose skin worse. The risks and benefits of all procedures will be discussed in greater detail at your initial consultation.

It’s important to know that although the lower body lift can have a significant impact on the outer portion of the thighs, it will not change the appearance of the inner thighs. The inner thighs are best treated with a thigh lift. In most cases, your surgeon will recommend performing the lower bodylift and the inner thighlift at separate times to maximize safety, and to achieve the best results.

In addition to the aesthetic evaluation, your surgeon will perform a careful evaluation of your overall health, as well as issues that could cause complications, such as:

  • Your blood pressure
  • Bleeding tendencies
  • History of adverse scar formation after previous surgeries

Where will the surgery be performed?

The surgery usually is performed in a hospital and you’ll have a one or two night stay in the hospital. You must be driven to and from the hospital by a friend or family member.
Type of anesthesia
Lower body lift is done under general anesthesia.
Immediate postoperative recovery
In most cases, patients may experience pain in the thighs and buttocks for the first two or three days. Compressive wraps are placed on the legs.
Short-term recovery
In most cases, patients will be able to go out in public in four to five days but vigorous physical activity is limited for four weeks following surgery.
Risks
A lower body lift tightens the skin on the buttocks and thighs but does involve a permanent scar, and is considered major surgery. Portions of the wound may be slow to heal and require treatment with gauze dressings. In addition to the risks associated with anesthesia infection and bleeding can occur but are uncommon. In rare cases, patients may experience prolonged or even permanent leg swelling (lymphedema).

Not every person is a candidate for this procedure, and your risks may be greater or different than those of other patients. Your plastic surgeon will review all potential risks and complications with you prior to the surgery.
Anticipated results
Lower body lift usually produces a tightened and more attractive appearance of the buttocks and thighs. The permanent scar may stay thick and red, but tends to fade over time and reaches its final appearance over 12 to 18 months.

Overview

Panniculectomy is a surgical procedure designed to remove excess skin from the lower abdomen. This operation is different from an abdominoplasty because it is intended solely to relieve symptoms related to an overhanging apron of skin and is not considered a cosmetic operation. The procedure involves a scar that is located across the lower abdomen
Who Is a Candidate?
Patients of any age with an overhanging apron of skin on the lower abdomen may be candidates for this procedure. Symptoms may include:

  • Skin irritation
  • Fungal infections
  • Lower back pain

Some patients with an apron of skin also may be candidates for a standard abdominoplasty. Patients with a lower body mass index at the time of surgery will get better results. Some insurance companies cover this operation. You should check with your instrongidual insurance carrier to see what the requirements are for coverage (i.e. three months of prescription creams or oral antibiotics).
Before the Procedure
Your plastic surgeon will perform a comprehensive evaluation of your abdomen, including any scars from previous surgery.

Some of the specific instructions you’ll receive about preparing for surgery include:

  • Smoking cessation
  • Medications to avoid
  • When to take your prescribed medications
  • Proper washing techniques
  • Restrictions regarding eating and drinking the night before surgery

Procedure Details
Your plastic surgeon will listen carefully to your concerns about excess skin on your abdomen and your surgical goals and expectations. The length and position of the scar on the abdomen will be discussed, and the surgeon can draw the approximate scar location on your skin with a medical marker. Risks and benefits specific to this procedure will be discussed in greater detail at your initial consultation.

In addition to the panniculectomy evaluation, your surgeon will perform a careful evaluation of your overall health, as well as issues that could cause complications, such as:

  • Your blood pressure
  • Bleeding tendencies
  • History of adverse scar formation after previous surgeries

Where Will the Surgery Be Performed?

A panniculectomy usually is done in a hospital as outpatient surgery or it can involve an overnight stay. You must be driven to and from the hospital by a friend or family member.
Type of Anesthesia
Panniculectomy is performed under general anesthesia.
Immediate Postoperative Recovery
In most cases, patients will experience pain in the abdomen for the first 24 to 48 hours; a compressive binder is placed around the abdomen.
Short-term Recovery
In most cases, you will be able to go out in public in four to five days. You should stay flexed at the waist for several days. Showering is permitted within the first several days. Vigorous physical activity is limited for four weeks following surgery.
Risks
A panniculectomy removes skin on the lower abdomen, but involves a permanent scar and is considered major surgery. This operation will not correct loose skin on the upper abdomen, and the belly button may not be preserved. Portions of the wound may be slow to heal and require treatment with gauze dressings. In addition to the risks associated with anesthesia, infection and bleeding may occur with panniculectomy, but at a low frequency.

In some cases, a collection of fluid (called seroma) may occur under the skin and require drainage in the surgeon’s office. Not every person is a candidate for this procedure, and your risks may be greater or different than those of other patients. Your plastic surgeon will review all potential risks and complications with you prior to surgery.

Anticipated results

Panniculectomy is expected to remove the apron of skin from the lower abdomen and relieve symptoms of skin rash and irritation.

Overview

Thigh lift or “thighplasty” is a surgical procedure designed to remove excess skin from the inner thigh. It is a procedure that commonly is performed in patients who have lost a large amount of weight and have loose sagging skin on the inner thighs.

This procedure can tighten the loose skin on the inner thigh but involves a scar that can run down the entire length of the thigh when an extensive amount of skin is removed. Shorter scars can be used for less extensive amounts of loose skin. The appearance of the thigh scar is unpredictable, but the scars tend to fade with time.
Who is a Candidate?
Patients of any age with loose skin on the thighs may be candidates for this procedure.
Before the Procedure
Your plastic surgeon will perform a comprehensive evaluation of your thighs, including any limitations in range of motion or previous injuries or surgeries. You will receive specific guidelines about preparing for surgery including:

  • Smoking cessation
  • Medications to avoid
  • When to take your prescribed medications
  • Proper washing techniques
  • Restrictions regarding eating and drinking the night before surgery

Procedure Details
Your plastic surgeon will listen carefully to your concerns about excess skin on your thighs, as well as your surgical goals and expectations. The length and position of the scar on your thighs will be discussed, and the surgeon can draw the approximate scar location on your leg with a medical skin marker.

The most common alternative to removal of the skin is liposuction. Risks and benefits specific to all procedures will be discussed in greater detail during your initial consultation.

In addition to the aesthetic evaluation, your surgeon will perform a careful evaluation of your overall health, as well as issues that could cause complications, such as:

  • Your blood pressure
  • b=Bleeding tendencies
  • History of adverse scar formation after previous surgeries

Where Will the Surgery Be Performed?

A thigh lift usually is done in a hospital as outpatient surgery. You must be driven to and from the hospital by a friend or family member. If you are combining a thighlift with another body contouring procedure, you probably will stay one or two nights in the hospital.
Type of Anesthesia
Thigh lift typically is done under general anesthesia.
Immediate Postoperative Recovery
In most cases, patients may experience pain in the thighs for the first 24 to 48 hours, and compressive wraps are placed on the thighs.
Short-term Recovery
In most cases, patients will be able to go out in public in four to five days. You should keep your legs elevated as much as possible for the first week after surgery. Showering is permitted within the first several days. Vigorous physical activity is limited for four weeks following surgery. Swelling in the ankles may be noticed as you become more active.
Risks
A thigh lift tightens the skin on the upper thighs, but involves a permanent scar that may be quite visible and is considered major surgery. A thigh lift does not correct loose skin on the calves, and there may be a noticeable transition where the newly tightened skin of the upper leg meets the calf. In addition to the risks associated with anesthesia, leg swelling may occur after this procedure. This often improves with time, but can be permanent in some cases (lymphedema).

Portions of the wound may be slow to heal, especially up in the groin crease where it is moist and there is a lot of friction with moving, and require treatment with gauze dressings. Infection and bleeding are uncommon with thigh lift, but can occur. Not every person is a candidate for this procedure, and your risks may be greater or different than those of other patients. Your plastic surgeon will review all potential risks and complications with you prior to the surgery.
Anticipated Results
Thigh lift usually produces a tightened and more youthful and attractive appearance to the inner thigh. The permanent scar may stay thick and red, but tends to fade over time and reaches its final appearance over 12 to 18 months.

Overview

Brachioplasty, or armlift, is a surgical procedure designed to remove excess skin from the upper arm. It is a procedure that commonly is performed in patients who have lost a large amount of weight and are left with loose sagging skin on the arms. This procedure can tighten the loose skin on the arms, but comes with a visible permanent scar that runs along the inside of the upper arms. The appearance of the arm scar is unpredictable, but the scars tend to fade with time.
Who is a Candidate?
Patients of any age with loose skin on the upper arms may be candidates for this procedure.
Before the Procedure
Your plastic surgeon will perform a comprehensive evaluation of your arms, including any limitations in range of motion or previous injuries or surgeries. You will receive specific guidelines about preparing for surgery, including:

  • Smoking cessation
  • Medications to avoid
  • When to take your prescribed medications
  • Proper washing techniques
  • Restrictions regarding eating and drinking the night before surgery

Procedure Details
Your plastic surgeon will listen carefully to your concerns about excess skin on your arms, as well as your surgical goals and expectations. The length and position of the scar on your arms will be discussed, and the surgeon can draw the approximate scar location on your arm with a medical skin marker.

The most common alternative to removal of the skin is liposuction. Although this option usually avoids a scar, it can make loose skin worse. Another option is a “short scar” brachioplasty, which keeps the scar in the armpit region, but it will not be useful for patients who have excess skin encircling the arm. Risks and benefits specific to all procedures will be discussed in greater detail during your initial consultation.

In addition to the aesthetic evaluation, your surgeon will perform a careful evaluation of your overall health, as well as issues that could cause complications, such as:

  • Your blood pressure
  • Bleeding tendencies
  • History of adverse scar formation after previous surgeries

Where will the Surgery be Performed?

A brachioplasty usually is done in a hospital as outpatient surgery. You must be driven to and from the hospital by a friend or family member. If you are combining a brachioplasty with another body contouring procedure, you probably will stay one night in the hospital.
Type of Anesthesia
Brachioplasty typically is done under general anesthesia.
Immediate Postoperative Recovery
In most cases, patients may experience pain in the arms for the first 24 to 48 hours, and compressive wraps are placed on the arms. You may have drains that typically stay in for one week.
Short-Term Recovery
In most cases, patients will be able to go out in public in two or three days, and light use of the arms, such as personal grooming and computer use, is permitted immediately after surgery. You should keep your arms elevated for the first week. Showering is permitted within the first several days. Vigorous physical activity is limited for four weeks following surgery.

Swelling in the hands can increase a few weeks after surgery as you start using your arms more frequently.
Risks
A brachioplasty tightens the skin on the upper arm, but involves a permanent scar and is considered major surgery. Brachioplasty does not correct loose skin on the forearm and there may be a noticeable transition where the newly tightened skin of the upper arm meets the forearm. In addition to the risks associated with anesthesia, you may experience some patches of numbness on the forearm because of the skin removal but this improves with time and does not affect the function of the arm or the hand.

Not every person is a candidate for this procedure, and your risks may be greater or different than those of other patients. Your plastic surgeon will review all potential risks and complications with you prior to the surgery.

Portions of the wound may be slow to heal, especially in the armpit where it is moist and there is a lot of motion. Infection and bleeding are uncommon with brachioplasty, but can occur. In rare cases, patients may experience prolonged or even permanent arm swelling (lymphedema).
Anticipated Results
Brachioplasty usually produces a tightened and more youthful and attractive appearance to the upper arm. The permanent scar may stay thick and red, but tends to fade over time and reaches its final appearance over 12 to 18 months.

Through our nationally-acclaimed Life After Weight Loss program, we also have pioneered body contouring techniques for post-bariatric surgery patients who have excess skin because of massive weight loss.