For more than 70 years, plastic surgeons have treated skin relaxation due to loss of elasticity and gravity with certain procedures. The modern era of these procedures actually began with the popularity of liposuction in the 1980s. As dietary procedures are time-consuming and often unsuccessful, more and more patients have begun to turn to minimally invasive laparoscopic gastrointestinal bariatric procedures that have become more successful and with less risk. Bariatric surgery is not a cosmetic procedure. It functions by reducing the size of the stomach and bypassing part of the digestive system. In this way, calorie intake is reduced and absorption is reduced, resulting in weight loss.
Modern laparoscopic bariatric surgery is with minimal pain and rapid recovery, discharge from the hospital within a few days, return to work within a few weeks. Patients are satisfied with small portions of high-protein and low-fat meals and refined sugars cause painful diarrhea and other inconveniences. Unwanted body fat is thus mobilized for energy by reducing quickly centimeters on the torso. This is a major advance compared to the early 1950s and operations that excluded more than half the small intestine, the so-called jejuno-ileal bypass. The successes of bariatric surgery and rapid extreme weight loss led to the need for a unified approach in terms of total body lift afterwards in one or two procedures.
Despite the exercise program and special diets, after massive weight loss there is no contraction of the skin around the smaller volume of the body resulting in the appearance of melted wax around a lit candle or "Michelin" doll. Obese people still look "normal", "deflated" after extreme weight loss not really.
Total body lifting requires new skill, perseverance, art and above all teamwork in a bariatric team. As surgical methods of obesity reduction yielded more dramatic results in a shorter time interval, plastic-reconstructive surgery had to go in the direction of more aggressive procedures of tailoring the skin, subcutaneous tissue and even muscles and fascios in order to achieve the transformation of the body into a more desirable form.
The previously predominantly female population, especially after childbirth, which required such procedures in recent times is increasingly balanced with the male population. The reason for this is that sexually specific contours and curves are irretrievably lost and we can talk about the androgenization of women and the feminization of men. Men are affected by their now hanging breasts and skin folds that are associated with cellulite in women. In women, the hips and thighs become square and the buttocks are flat, which, along with the hanging skin of the inner side of the thighs and the bizarrely lowered mons pubis that passes over the external genitals, ultimately completely eliminates the perception of femininity.
Until 2000, very little was written in the professional medical literature and presented at professional conferences on body contouring after weight loss. This was mainly related to excisions of too much skin and only functional reasons because hanging skin folds were often the cause of friction, moisture, eczema and infection. Contouring of the body was of secondary importance and cosmetically satisfactory results were rare. Modern bariatric surgery has posed new challenges for plastic-reconstructive procedures: how to remove a large amount of excess skin from the walls of the abdomen, breasts, upper arms, thighs, neck, and at the same time achieve satisfactory cosmetic contouring of the body with acceptable scars?
So, how to combine functional and cosmetic requirements. The beginning of the answer is individualization. For body-lift procedures, there can be no predetermined forms or operations. Each patient is a challenge for himself and requires on the one hand an arsenal of reconstructive procedures and on the other hand artistic adaptation to the individual body. But no less is the patient's contribution to maintaining a healthy lifestyle afterwards to make the results long-lasting.
Without it, all the effort and cost of bariatric and plastic-reconstructive surgery will not result in the return of functional work and life skills, which is an imperative of the whole procedure. Without it, the patient cannot functionally return to the living and working environment and the procedure is not complete. This is exactly why "Body-lift" after bariatric surgery is a functional and cosmetic procedure in one.
The term Total Body Lift means lifting and tightening the skin of the body normally after a large weight loss as a result of bariatric procedures.
The Upper Body Lift includes:
- Reverse Abdominoplasty or Reverse Tummy Tuck,
- IMF (Inframammary Fold) Reconstruction
- „Mid-torso Lift“,
- Mamopexy and Breast Remodeling,
- Brachiplasty.
The Lower Body Lift includes:
- Belt Cirkumferential Abdominoplasty (Lokwood),
- Inner-thigh Lift,
- Monsplastica.
As an additional finishing procedure ("refinement") comes into consideration liposuction for the pubic region, „riding shorts" and medial accumulations of fat on the knees.
https://zlatkovlajcic.eu/total-body-lift/
ASPS link: https://www.plasticsurgery.org/cosmetic-procedures/body-lift