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Plastic Surgeon, Dr. William Albright, Speaks to BMI of Texas Support Group about Body Lift Surgery
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Plastic Surgeon, Dr. William Albright, Speaks to BMI of Texas Support Group about Body Lift Surgery

Written by
Dr. William Albright
Updated
Dr. William Albright is a board certified plastic surgeon specializing in breast and body procedures.
Dr. William Albright is a board certified plastic surgeon specializing in breast and body procedures.

Plastic Surgeon, Dr.William Albright, Speaks to BMI of Texas Support Group about Body Lift Surgery

A little about Dr.William Albright...

Dr. William Albright is a board certified plastic surgeon with advanced cosmetic training and specializes in breast and body procedures. He has performed over 1000 breast and body contouring procedures and even taught plastic surgery for several years.  As a San Antonio native, he’s committed to providing 5 StarService and likes to spend the extra time to make you feel comfortable, so you get the best results possible. At AlamoPlastic Surgery our mission is to provide exceptional value through patient education, empowerment, and incredible results.

Introduction

BMI of Texas at San Antonio welcomed Dr. Albright to speak at the support group on options for skin tightening and body contouring after rapid and extreme weight loss.  Beyond the clinical and surgical side, Dr. Albright has a very personal connection to the wonderful benefits of bariatric surgery. He credits this surgery for saving his Mother’s life and dramatically increasing the quality of life of his sister

Limitations of Plastic Surgery?

Dr. Albright dove into different body shapes (apple, pear, etc.) and different ways fat is typically stored on the body.  He mentioned some of the inherent limitations of body lift or body contouring procedures including:

-      Visceral fat (fat stored within the abdominal cavity and stored around important organs).  This is different form subcutaneous fat which is stored right under the skin. With subcutaneous fat, it can be accessed through liposuction.  Visceral fat cannot be removed.

-      Tissue laxity – remaining skin after a surgery may be damaged with stretch marks, distorted borders of the breast, or unable to support a breast implant.

-      Skeletal changes – flared lower ribs, loss of lower back hollowing, or flared pelvis can not be corrected with surgery at this time

-      Lymphedema.  

What is a Panniculectomy?

A panniculectomy is not a tummy tuck or abdominoplasty.  It is removal of the pannus – excess skin and tissue from the lower abdomen.  It does not include any liposuction or bellybutton recreation.  Although most insurance companies will cover a panniculectomy, they have varying requirements before covering.

Does Insurance Cover a Panniculectomy?

Common Body Lift Procedures?

Typically weight loss patients are interested in procedures abdomen, back, and breasts.  There are many types of surgeries to meet your goals.  

Abdomen

-       Skin excision

o  Traditional

o  Fleur de Lis

o  Circumferential

o  Reverse

-       Rectus Plication

o  Internal girdle

-       Liposuction

o  Contouring waist / costal margin

-       Manoplasty

-       Umbilicus

o  Reset

o  Reposition

Back

-       Buttock Lift

-       Upper back lift

-       Liposuction

-       Gluteal augmentation

o  Autologous

o  Implants

o  Fat Grafting

Breast

-       Lift / Mastopexy

-       Breast Reduction

-       Volume replacement

o  Implant (support)

o  Fat Graft

It may seem overwhelming to figure out the best surgery to meet your goals. If it is something you have been thinking about for a while, we recommend you schedule a consultation with Board Certified PlasticSurgeon.  

How to Choose a Plastic Surgeon?

You want your surgery done RIGHT the first time. It is imperative to research your surgeon to make sure they are very qualified specifically for the surgery.

1. Look at Plastic Surgeons Online

- 5 Star Online Reviews  

Check Google, RealSelf, and Healthgrades reviews on the plastic surgeon. On RealSelf you can look for Verified doctors which indicates they have good reviews and are skilled in plastic surgery. You really want someone with a 5 Star rating. Multiple poor reviews indicate the surgeon is not good.

- Review Before and After Photos

This is just as critical as the reviews. The surgeons should have awesome before and afters on their website for the surgery you are interested in. Bonus points if they have descriptions of the patient and surgeries performed.  For some procedures surgeons may only show before and after photos in the office.  

- Absolutely Ensure Plastic Surgeon is Board Certified

This is an absolute MUST. You may be surprised that a surgeon is not certified, but it is a huge red flag. There are surgeons in San Antonio who advertise as plastic surgeons who are not Certified by the American Board of Plastic Surgery. Be very wary. You can easily verify through this link.

2. Book Consultations!

Choose two to three plastic surgeons in your area and schedule consultations based on your research above. Check consultation fees. Make sure to ask if the consultation is complimentary. Alamo Plastic Surgery has free consultations mainly because we want there to be no barrier for Dr. Albright to educate you on the procedure. We encourage people to go to at least two consultations so they can make sure the plan the plastic surgeon suggests is sound and meets their cosmetic goals. Some may have a small fee to hold your appointment and to cover the doctor’s time. Although the fees can add up, it is worth the peace of mind to know you’ve picked the surgeon best suited to meet your goals.

3. Bring a Friend to the Consultation

The consultation may feel a little overwhelming so often a friend is great for moral support!

4. Questions to Ask at the Consultation

  • Procedure related questions (length of surgery, type of implant, areas for liposuction, recovery time, etc.)
  • Has the plastic surgeon experienced complications with the surgery? What are they?
  • If there are complications, how are they handled and what costs could be incurred?
  • Where is the operation performed? Although it can be done safely, you may want to think twice about surgeons performing major procedures in their office. Unfortunately, complications are sometimes ignored or dismissed at an office without proper treatment capabilities, versus at a surgical center or hospital, where complications are monitored and may need to be reported to the state. Surgery at a hospital or surgical center may also ensure     additional competent medical support if it becomes necessary.

5. Quote

Many surgeons will tell you to put a down payment on the procedure at the consultation for 10% discount.Don't fall for this pressure sales tactic!!!!

  • Unfortunately there are many bad sales tactics that plastic surgeons use. Do not fall for pressure sales. It is a major RED FLAG.
  • Quotes should break out surgeons fees, implant cost (silicone more expensive than     saline), anesthesia, and surgery center fees.
  • Ask about financing options.
  • You should review the quotes from the other consultations and go with who you     think is best for the price!

What is Abdominoplasty?

A tummy tuck or abdominoplasty is a cosmetic surgery that will remove excess skin from the abdomen.  For weight loss patients you will be able to wear ‘regular’ clothes without any binders or compression garments.  For these women, there really is no “minimally invasive” or non-surgical substitute for a tummy tuck.  While loose skin is being removed, a stretched or damaged looking belly button (umbilicus) can often also be rejuvenated and any rectus diastasis (separation of the abdominal muscles) and umbilical hernia fixed at the same time.  Full or droopy pubic mound (mons pubis)?  This can be corrected during a tummy tuck as well.

The common scar pattern is a horizontal(side-to-side) scar located above the pubic mound near where a C-section scar would be placed. The scar is contoured and positioned so that it should be fairly easy to hide with most types of underwear and bikini bottoms.  The scar is longer than a C section scar, and the length depends on how much skin needs to be removed with a "mini abdominoplasty" having the shortest length scar. Occasionally, if the belly button is being relocated, a short vertical scar may be necessary between the belly button and the low horizontal scar, and a scar will be placed around the ‘new’ belly button.  

Other scar options are a “reverse tummy tuck” where the scar is placed redundant skin is moved upward, and a horizontal scar is placed under the breasts.  Finally, for patients  who have had dramatic weight-loss success including after bariatric surgery, it may be necessary to perform a “fleur-de-lis” incision which combines a traditional lower side-to-side incision with a long vertical incision creating an upside down ‘T’ pattern.  This is sometimes needed to address not only top-down skin excess but also side-to-side skin excess. Although the scar pattern is more visible and difficult to hide out-of-clothing, the resulting improvement in shape and waist definition is usually considered a fair trade by these patients.  

For abdominoplasty, Dr. Albright recommends waiting until at a stable body weight for 3 – 6 months (BMI < 35), no nicotine exposure for at least 6 weeks before surgery, and medically safe for general anesthesia.  

For recovery after an abdominoplasty, the first week after surgery, the patient will need to maintain a flexed waist (bent-over) position while standing, sitting and lying down. In the first week, patients will wear an abdominal binder 24/7, followed by 5 weeks of a compression garment.   Walking exercise may be resumed by 4 weeks in most patients, followed by advancing to strenuous activities at 6 weeks.  Most patients will be unrestricted by 2 months after surgery.  

Breast Surgery Options?

1. Male Chest Contouring  

Men can develop prominent fat deposits on the chest from obesity, or even develop rudimentary breast tissue (glandular tissue) as is the case with "gynecomastia", a medical condition.These conditions can be worsened by certain medications, and activities that can stimulate this glandular tissue development.  So whether your purpose is to achieve a more sculpted chest or to remove feminine breast-like tissue, it would be worth a consultation with a board certified plastic surgeon to develop a plan to meet your goals.  

In some cases with only a small amount of excess subcutaneous fat, then liposuction alone may be sufficient. If there is a small "breast bud" or firm button of tissue beneath the nipple, then liposuction and a small incision along the areola (pigmented skin around the nipple) to help remove the glandular tissue may be needed. For more breast tissue, the incision pattern becomes more significant, and can range all the way to an incision placed along the lower fold of the breast mound with an incision all the way around the areola (although this is rarely needed).

Recovery is very similar to male liposuction, as most male breast surgeries involve liposuction. The surgery itself is an outpatient procedure in most cases. The patient will wear a compression garment continuously (24/7 except for showering) for at least 4 weeks, while they have to abstain from exercise.After these 4 weeks, most men will be able to transition to daytime compression alone (no compression at night), while they slowly advance exercise activities over the next 2 weeks. Most men will be finished with compression and back to full unrestricted exercise activities by 6 weeks after the procedure. Swelling may still occur up to five months.  

2. Breast Reduction  

When your breasts are causing problems such as neck/shoulder/back pain, painful/unsightly grooves in your shoulders, recurrent rashes, or limiting your mobility and activities with exercise, it may be time to consider a breast reduction. By reducing the weight of the breasts, many of these symptoms will improve and possibly resolve completely. Incidentally, a good plastic surgeon can create a more youthful appearing breast by lifting the remaining breast tissue and nipple back up where they belong.  Most women undergoing breast reduction surgery are thrilled with their improvement in function and appearance.  The most common responseDr. Albright gets from his reduction patients is “I should have done this YEARSago!”  It can change your life!  Less well known breast reduction benefits particularly for women with very dense breast tissue is the possibility of detecting an early breast cancer or precancerous lesion, as well as a slight reduction in risk of breast cancer.

Recovery from a breast reduction is 2 weeks with minimal reaching/pulling with the arms, and less than 20 pounds lifting of weight.  This is followed by 2 more weeks of less than 45 pounds lifting, but during this time you may reach and pull with the arms.  In total, there will be 4 weeks of no intense exercise and you will be in a bra 24/7 except for showering.  After these4 weeks, most patients may begin regular exercise as tolerated.

3. Breast Augmentation with Lift

For women with massive weight loss, they typically desire a lift to restore sagging breast and augmentation either through fat transfer or implant to restore breast volume.  For massive weight loss patients, consider staging the procedure; doing a lift first then recovering from surgery and allowing the breast to settle before performing a breast augmentation later. Additionally, excess skin and residual fullness may exist around the sides of the breast toward the back (bra line).This may require additional surgery including excision (leaving a scar) and/or liposuction. Although this does increase the surgery time, complication risk, and overall cost, it may be necessary to give you the results you are looking for. Finally and perhaps most critically, where will breast rejuvenation fit in with your other cosmetic surgery goals (belly, arms, thighs, face, etc)? This requires a thorough assessment and discussion of your goals to fully answer

Thigh Lift

For thigh lift, there is no magic bullet that can produce perfect thighs in all patients.  A realistic goal should be created based on what cosmetic issues are present.  If cellulite is the issue, treatments should be focused on this. If excess skin is present, excision will likely be recommended in some form. If there are just a couple areas of bothersome fat, then liposuction is likely needed. However, for most patients, there are a combination of these issues with varying degrees of severity. The treatment plan should reflect these nuances.

 

Arm Lift

One of the more difficult areas to conceal, particularly in Texas, is our upper arms. If you struggle with excess skin or fullness of the upper arm and armpit and feel uncomfortable with the appearance, it may be time to consider an arm lift. This can include both liposuction and removal of excess skin.  Patients often notice improvement in their daily activities as well as boosted self confidence.  

Question and Answers

1.     What compression garments do you recommend?  Dr. Albright recommended Marena garments which have medical grade compression to help give patients comfort and ease immediately following the surgery.

2.    Why do plastic surgery costs vary so much? – At a consultation a plastic surgeon will come up with a plan to best fit your goals.  Sometimes these plans vary which can lead to different costs.  Geographic location and age of plastic surgeon are typically the other variables.

3.    What pain medication is recommended for tummy tuck – Typically for post-bariatic surgery patients Dr. Albright will prescribe narcotics for the first couple of days and then Tylenol?

4.    How long after a surgery before leaving the country safely.  If you are not concerned about your cosmetic appearance and do not plan on swimming, most procedures you can leave the country safely after 1 month.  Work with you plastic surgeon to approve your upcoming travel plans.

5.    What procedures can you combine? – Typically breast and abdomen procedures are combined with no issue.  

6.    How can you get rid of visceral fat? – Dr. Albright doesn’t have a surgical solution and typically visceral fat is very resistant to diet and exercise.

Wrap up

For further information, the presentation, or a complimentary consultation please contact Dr. Albright and team - (210)670-5302/ hello@alamoplasticsurgery.com

 

Written by
Dr. William Albright
Updated

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