While traditional abdominoplasty reliably addresses excess skin and loose tissue over the anterior abdomen, it does little for the back, upper thighs and flanks. It could be argued that in some patients, abdominoplasty alone may highlight these remaining areas, as the transition from tight contour to loose tissue becomes more obvious.
What can I expect?
Circumferential lipectomy comprises anterior abdominoplasty with excision of flank and back excess tissue, plus lifting of the buttocks, flanks and thighs into a more elevated position. Because this requires surgery on both the back and front of the body, Richard and his team will need to patients are turned over during surgery whilst under anaesthesia. This procedure can result in some profound changes in body contour. Like all post-massive weight loss body contouring procedures, time and gravity will allow some relaxation of the final shape.
What happens during surgery?
Circumferential lipectomy surgery is performed under general anaesthetic, and may be combined with other procedures during the same anaesthetic. Once all our pre-operative safety checks are complete and anaesthesia carefully underway, the excess skin is removed from the lower back or flanks, then the patient is turned onto their backs to allow excess abdominal tissue to be removed. Often, liposuction is used to fine tune the result. In the end, a fine line surgical incision is closed along the lower back/flanks and lower abdomen where it is least conspicuous. Compression garments are applied before you are gently woken up and taken to the recovery area. Occasionally, Richard uses surgical drains to remove any excess fluid over the few days or so. Given the broad extent of tissue removed, this procedure can take 4-8 hours.
What happens after surgery?
Richard recommends all circumferential lipectomy patients stay in hospital for at least 1-2 nights to recover. Expect swelling and a considerable degree of tightness in both the abdomen and back. In conjunction with your Anaesthetist, you will be given sufficient analgesia and encouraged to mobilise the day following surgery. Once you are home, we encourage you to move around the house and do the usual light activities of daily living, but nothing heavier than a big book for the first week. Most patients can return to office-based work after around 2 weeks. It’s really important to keep your surgical garment on full time for the first two weeks, and no lifting/ pulling/ straining for the first month and 6 weeks before jogging or sit-ups. Expect areas of numbness over the abdomen, mostly around the incision lines, which become less noticeable over time. You’ll be seen in our rooms at one week to ensure you’re doing well and at around six weeks with Richard. As always, please don’t hesitate to contact us if you have any concerns. Over the coming 6 months, your shape will settle and scars start to mature.
As in all body contouring surgery following significant weight loss, the post-operative scars may stretch or migrate over time, as tension dissipates and the skin stretches.
Possible complications:
The decision to undergo cirumferential lipectomy surgery should only be made after considering if the potential benefits can achieve your aims, and whether the risks are acceptable to you. The possible risks/ complications of this procedure include (but are not limited to):
- Cardiac problems, including heart attack or arrythmias.
- Venous thromboembolism (including deep vein thrombosis and pulmonary embolism, which may be fatal).
- Surgical site infection.
- Haematoma/ seroma requiring return to theatre.
- Wound breakdown, delayed healing or protruding sutures.
- Conspicuous scars, including hypertrophic, stretched or migrated scars.
- Possible need for revisional surgery. Richard will only consider revising your circumferential lipectomy if he believes:
- there is a definable structural issue,
- this issue is realistically able to be improved with surgery and
- the risk of revisional surgery causing a worse result are minimal.
- Dissatisfaction with the degree of abdominal/ back tightening.
- Hernia or abdominal bulge.
- Umbilical necrosis (death of the belly button)
- Contour asymmetry.
- Compression neuropathy or nerve injury.