Body contouring procedures are used to enhance natural body contour by sculpting undesirable areas of fatty tissue or reversing changes caused by pregnancies, weight loss or aging. Having excess skin and saggy tissue can affect patients not only psychologically, but also physically. In certain circumstances, saggy skin can cause excessive sweating, rashes under the skin, pressure and inability to fit clothes. In order to achieve maximum result from surgery, it is important to have healthy weight and lifestyle that includes a balanced diet and exercise. 

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Evidence shows that effects of surgery can not only improve the physical appearance, but also physical symptoms, enhance self-esteem and quality of life. 

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Abdominoplasty (tummy tuck)

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Abdominoplasty is a surgical procedure that removes the excess skin and tightens the muscles of the abdomen to give the stomach flat and firm look. 

 

Mini-abdominoplasty is less invasive, but it is more suitable for patients who have excess skin and subcutaneous tissue situated below the belly button. Mini-abdominoplasty removes  the excess skin from the lower abdomen only. 

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Fleur-de-Lis abdominoplasty is a more invasive and is appropriate for patients who have vertical excess of tissue above and below the belly button in addition to the horizontal excess. 

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Liposuction

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The procedure is designed to improve and refine natural body shape by removing exercise-resistant deposits of fatty tissue using vacuum device. The most common areas for liposuction include abdomen, flanks, inner and outer thighs, knees, back, breast, arms and neck. Liposuction is often performed in conjunction with other procedures to achieve maximum enhancement. 

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Revision liposuction

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Revision or secondary liposuction can sometimes be required following excessive previous liposuctions. There might be various contour irregularities caused by previous operations. In severe situations overly thinning the fatty tissue might cause sagging skin. It might be possible to improve the appearance by using a combination of liposuction and fat transfer in order to restore the contour and natural distribution of fatty tissue. 

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Inner thigh lift

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Thigh lift or reduction is a procedure that is designed to remove excess sagging skin and fatty tissue from inner thighs and improve the natural contour and the appearance of the thighs. Thighs can be prone to sagging due to gravitational change, weight fluctuations, aging and genetics. Exercise may also help to improve the contour and strengthen the tone of the underlying muscle. Thigh reduction might require open excision, liposuction or both.  

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Arm reduction (brachioplasty) 

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Arm lift or brachioplasty is a procedure that is designed to reshape the contour of the area of the upper arm. The area of upper inner arms is another area of the body whic is prone to sagging. Procedures to restore the shape of the arms can be quite complex and range from liposuction to arm reduction and lift performed in various different ways depending on the degree of sagging (hidden arm lift or traditional arm lift). In certain more severe cases, excision can extend onto the chest (extended arm lift). Exercise is essential to improve the contour and strengthen the tone of the underlying muscles for maximum result. 

 

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Body contouring after massive weight loss

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Massive weight loss can be achieved via diet and exercise or bariatric surgery. Regardless of how it was achieved, it is admirable and hugely beneficial for one's health in general. However, weight loss can result in developing areas of sagging skin and folds in various parts of the body which can be uncomfortable and interfere with normal daily activity. Patients can be psychologically and physically affected by these areas. Also, areas such as breast, arms and thighs can be affected in addition to the upper and lower body. There is a myriad of surgical procedures that can be used and tailored to the individual circumstances, desires and distribution of their folds. The aforementioned procedures might be sufficient, but frequently other procedures such as circumferential body lifts or belt lipectomy would be more appropriate especially if sagginess is circumferential. 

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It is important one has achieved a desired healthy body mass index (BMI) that has been stable for at least a year before considering surgery. It is also essential that patients managed to permanently change their lifestyle in terms of nutrition, good mental health and regular exercise. Nutrition screen should also be normal before proceeding with surgery. 

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Consultation will allow assessment and detailed discussion about what is possible taking under consideration personal circumstances and desires. There will be an opportunity to discuss alternatives, long-term implications and risks of surgery as well. 

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Before arranging a consultation, it is important to think carefully about what one would like to achieve to be able to discuss specific concerns and desires in detail. Surgery will improve one's own natural appearance, but will not completely change one's own natural characteristics in order to perfectly match the ideal. 

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What to expect from the consultation

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During the consultation, you will be asked about your desired size and anything related to the appearance of the specific areas that you feel is important to you. This will help the doctor to understand your expectations and determine whether they can realistically be achieved. You will be asked about your medical history, current medications, drug allergies and smoking. Physical examination will be carried out to establish the degree of the problem and help to select a procedure or a range of procedures most appropriate to achieve a desired improvement. It might be possible to create 3D simulations depending on the area and procedure. 3D simulations are not always possible due to the limitations of the software. Medical photographs might be taken as well. Explanation will be given as to which techniques would be most appropriate depending on the assessment and desires. You will receive a letter summarizing the consultation along with surgery fees.  

Clinical psychology consultation might be suggested in order to better assess your expectations and the degree the problem is affecting you. Joined effort from multidisciplinary team helps to improve the overall outcome of surgery.

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What does the surgery entail

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It all depends on what procedure is required. All the aforementioned procedures would require general anaesthesia. Liposuction, mini-abdominoplasty and arm reduction can be done as a day cases. Other procedures or combinations would require an overnight hospital stay. Ms Majdak-Paredes will utilise latest techniques to minimise the length of the incision necessary for surgery. Scars usually settle down reasonably well over time. 

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Recovery would vary from 2-8 weeks depending on the procedure. A garment would be required for 4-6 weeks to provide splintage and comfort. . You will require a nurse appointment a week after surgery and a consultant appointment 4-6 weeks after surgery or earlier if required. 

 

Risks and implications will be discussed in detail during your consultations and cooling off period will always be required. 

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