Loose saggy skin in the abdomen is a fairly common condition due to aging, weight gain or after pregnancy. This is sometimes associated with lax abdominal musculature and poor quality abdominal skin with the presence of stretch marks. While the excessive fat in the abdominal wall can be removed with liposuction, the removal of saggy extra skin would require surgical excision. Tummy tuck is a surgical procedure designed to remove excessive abdominal skin and tighten the abdominal musculature. Tummy tuck is often combined with liposuction to remove excessive abdominal fat that is present. The result is well-contoured abdomen with an attractive waistline curvature.
During the surgery, a horizontal incision is made just above the pubic area. The abdominal skin is freed from the underlying structure and the excessive skin is trimmed. At the same time the abdominal wall muscle is plicated to tighten the waistline. Liposuction is performed as indicated. Standard tummy would required ward admission while mini tummy tuck with a smaller incision can be performed on daycare basis. The scar of tummy tuck is located in the position that is hidden by underwear. Postoperatively a compression garment is advisable to support the abdomen during recovery period.
Excessive fat and skin can form in the upper arms. This usually happens after weight gain but can also be part of the aging process of the body. After significant weight reduction, the skin in the upper arm may become saggy. This gives a ‘butterfly-wing’ appearance and the patients may feel embarrassed especially if they are wearing sleeveless clothing or in swimming suits. An aesthetically attractive arm is lean and firm, displaying the curvature and contour of the underlying muscle. The outline of the arm should merge harmoniously with the shoulder and body as well as with the distal forearm to present an elegant appearance of the upper limb.
Depending on the level and amount of excessive fat and skin, various surgical modalities are available to restore the contour of the upper arm. If fat accumulation is mild to moderate and the overlying skin is still firm and elastic, liposuction alone should be able to produce a satisfactory result. However if the skin becomes loose and saggy, then additional surgical resection of the excessive skin is necessary. The site of the incision is dictated by the location and amount of the excess skin. For moderate cases a short incision placed on the armpit is suffice. For removal of larger area of skin, an incision along the inner aspect of the arm is required. In selected cases the incision may have to be extended into the armpit and upper chest to remove excessive skin around the armpit and upper lateral chest.
Arm lift procedure can be performed under local or general anaesthesia, depends on the size of skin removal and the request of the patient. The surgery is done on a daycare basis and the patient can go home on the same day of the surgery. During the recovery period the patient should refrain from lifting heavy objects and strenuous movement involving the arms. Smoking before and after surgery is to be avoided to optimize wound healing.
The aim of buttock lift is to create a round and a more up-lifted shape and profile of the buttocks in patients with small, flat or saggy buttocks. Buttock lift not only changes the shape and profile of the buttock, but it also indirectly results in a more curvy outline of the waist, flanks and hips.
Buttock lift can be achieved by either fat transfer or the use of buttock implant. In fat transfer, fat is harvested from the body (usually the abdomen or thighs). The fat is then processed and injected in a small amounts into various site in the buttock in a meticulous manner. This will create a more projected and prominent appearance of the buttock. Fat transfer may be combined with liposuction of the surrounding areas to obtain a more aesthetically pleasing result. Alternatively, in small-sized or thin patients with little fat to harvest, buttock implants can be used to obtain the same result.