Upper body lift after massive weight loss
Haytham Mohamed Salah Mohamed El Desoky;
Abstract
The plastic surgeon most often will see the patient after he/she has lost weight and stabilized. Body contouring of the massive weight loss patient represents the ultimate opportunity for body sculpting in these formerly obese patients, resurrecting normal body contour where previously only excess skin and tissue existed (Aly, 2006).
They represent unique challenges and are often burdened with medical, psychological, and physiological problems that add complexity to any surgical intervention (Aly, 2006).
Post–bariatric weight loss contour deformities will exceed contour deformities plastic surgeons have encountered previously. After a majority of bariatric patients shed greater than 50 % of their excess weight, they are often left with the indignity of loose, ptotic skin envelopes, and oddly shaped protuberances where vestiges of adipose tissue remain (Fotopoulos, 2000).
Skin of patients with massive weight loss is much weaker and less resistant; it lacks the integrity of epidermis and dermis; the epidermis was significantly affected with marked thinning, irregularities, and atypical cells with obvious changes to the dermoepidermal junction; the collagen fibers are seen damaged in different degrees with lack of normal shape, distribution, and even density mainly in the reticular dermis with marked decrease in collagen fiber diameter; and areas of fibrosis could be seen obviously in the dermis. Elastic fibers were damaged and even absent in many subjects (Khaled et al., 2015).
The inflation process of weight gain causes the thorax, from the clavicle to the inframammary crease, to expand in a circumferential and a vertical fashion (Aly, 2005).
After weight loss, the thorax is deflated as the lamp shade would be. The resultant excess is two dimensional: circumferential (horizontal) and vertical (Aly, 2005).
As the patient loses weight, the zones of adherence act as suspension hooks for the hanging thoracic tissues leading to the final configuration of tissues (Aly, 2006).
Thoracic tissues located laterally tend to descend in massive weight loss patients because they are located at the greatest distance from either of the anterior and posterior zones of adherence. The degree to which any of these deformities occurs varies from patient to patient depending on their body mass index, their fat deposition/loss pattern, and the quality of their skin-fat envelope (Soliman et al., 2008).
A variety of surgical options are available, ranging from upper body lift for extensive deformities to brachioplasty, abdominoplasty and/or breast surgery as individual procedures for more limited problems (Hurwitz, 2006).
They represent unique challenges and are often burdened with medical, psychological, and physiological problems that add complexity to any surgical intervention (Aly, 2006).
Post–bariatric weight loss contour deformities will exceed contour deformities plastic surgeons have encountered previously. After a majority of bariatric patients shed greater than 50 % of their excess weight, they are often left with the indignity of loose, ptotic skin envelopes, and oddly shaped protuberances where vestiges of adipose tissue remain (Fotopoulos, 2000).
Skin of patients with massive weight loss is much weaker and less resistant; it lacks the integrity of epidermis and dermis; the epidermis was significantly affected with marked thinning, irregularities, and atypical cells with obvious changes to the dermoepidermal junction; the collagen fibers are seen damaged in different degrees with lack of normal shape, distribution, and even density mainly in the reticular dermis with marked decrease in collagen fiber diameter; and areas of fibrosis could be seen obviously in the dermis. Elastic fibers were damaged and even absent in many subjects (Khaled et al., 2015).
The inflation process of weight gain causes the thorax, from the clavicle to the inframammary crease, to expand in a circumferential and a vertical fashion (Aly, 2005).
After weight loss, the thorax is deflated as the lamp shade would be. The resultant excess is two dimensional: circumferential (horizontal) and vertical (Aly, 2005).
As the patient loses weight, the zones of adherence act as suspension hooks for the hanging thoracic tissues leading to the final configuration of tissues (Aly, 2006).
Thoracic tissues located laterally tend to descend in massive weight loss patients because they are located at the greatest distance from either of the anterior and posterior zones of adherence. The degree to which any of these deformities occurs varies from patient to patient depending on their body mass index, their fat deposition/loss pattern, and the quality of their skin-fat envelope (Soliman et al., 2008).
A variety of surgical options are available, ranging from upper body lift for extensive deformities to brachioplasty, abdominoplasty and/or breast surgery as individual procedures for more limited problems (Hurwitz, 2006).
Other data
| Title | Upper body lift after massive weight loss | Other Titles | إعادة هيكلة الجزء العلوى من الجسم بعد الفقدان الشديد للوزن | Authors | Haytham Mohamed Salah Mohamed El Desoky | Issue Date | 2015 |
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