This need for this group of surgical procedures (operations) has grown due to, in part, the rapid increase in invasive surgery to deal with the epidemic of obesity.
There are specific definitions of obesity but Dr Goldman does not perform any procedures that constitute bariatric surgery such as laparoscopic banding (lap band) or sleeve gastrectomy.
These operations are so effective (for the majority of people) that massive weight loss ensues. What actually defines massive weight loss remains controversial. I believe any loss of weight over 30kg fulfils the criterion of massive weight loss.
Currently, I am seeing patients who have lost anything from 30-160kg of weight. The single most distressing issue in this group of people is the empty, extreme sagging of the skin that has been dramatically overstretched as a result of the equally massive weight gain that occurs in these individual’s lives. The unfortunate consequence of the weight gain is that on losing all the excess weight and expending all the effort to reduce the weight back to more normal levels, the skin no longer has any ability to contract and cannot ‘shrink-wrap’ back down to the new fat layer.
In these situations, the loose and stretched skin is almost as distressing as the original overweight situation. The operations to deal with this excess of over-stretched skin constitute body lift surgery. The most well known of these operations is the so called abdominoplasty. This operation has evolved in modern times to also include those individuals who have not lost weight but wish for a surgical solution to their excess lower abdominal fat.
The operations that are included in this group of surgical procedures include:
- arm lift (brachioplasty).
- upper abdominal lift (reversed abdominoplasty), front only or including the sides and part of the upper back.
- belt lipectomy (a circumferential procedure that includes a abdominoplasty but continues all the way around the back to the other side) this also results in a buttock lift.
- leg lift – This can either be for upper, inner thigh laxity and here, the incision and therefore the scar follows the groin crease, the medial thigh lift. The alternative and more radical operation is a vertical thigh lift which results in a long vertical scar down the inside of the thigh from the groin down to the inner aspect of the knee. This latter operation is for excess skin and sag that extends all the way down to the knees.