Expandable Brachioplasty - Thoracoplasty
Expandable Brachioplasty - Thoracoplasty
One of the areas that experience severe sagging after weight loss is the breasts. Sagging in the formerly obese is greater and usually extends beyond the elbow joint in the upper extremity and beyond the armpit in the trunk. The treatment for sagging skin in these patients is expansion brachioplasty, which corrects the contour of not only the upper limbs but also the chest, in several cases.
WHAT CAN BE DONE?
Excess skin, stretch marks and the presence of a small to medium amount of fat in the subcutaneous tissue of the arm, forearm and lateral chest wall are treated only surgically and the surgery is called extended brachioplasty (extended brachioplasty) and thoracoplasty (thoracoplasty). The purpose of the surgery is to restore the normal contour of the upper limb and trunk. Excess skin is treated with a horizontal incision in the vertical axis of the arm when the extremities are in abduction, which may extend to the forearm (extension brachioplasty) and/or the lateral chest wall through the axilla (extension brachioplasty + thoracoplasty). The operation is always combined with liposuction. The doctor will explain which technique is indicated for you based on your history and clinical examination.
EXTENDED BRACHIOPLASTY WITH THORACOPLASTY
Expansion brachioplasty is usually recommended for patients who have lost a lot of weight, usually after bariatric surgery, and who have vertical excess skin on the arm when it is in abduction and horizontal excess on the lateral chest wall. As a result of the operation there is a horizontal incision on the medial surface of the arm, which at one end terminates beyond the elbow and at the other beyond the armpit, in the mid-axillary line. Post-operative scarring should be discussed with the patient prior to surgery, who should be aware that despite a significant improvement in the contour of their upper limbs and trunk, there will be an incision that will be visible through certain clothing.
WHO IS EXTENDED BRACHIOPLASTY FOR?
Candidates for extended brachioplasty are adult patients with the aforementioned characteristics, who have stabilized their body weight, have achieved a normal BMI (body mass index) and have no other serious health problems.
WHAT IS THE TYPE OF ANESTHESIA?
The operation is performed under general anesthesia in an organized clinic. The duration of the surgery is 3 to 4 hours. After the surgery, it is advisable to stay in the clinic for 24 hours and to immediately mobilize the patients.
WHAT WILL THE SCARS BE LIKE AFTER THE EXPANDING BRACHIOPLASTY?
The type of scars depends on the surgery that will be chosen. In the extension brachioplasty, there will be an incision that starts at the armpit and ends after the elbow joint. Scars are more visible in the expansion brachioplasty with thoracoplasty, in which the incision begins just before the elbow and through the armpit continues into the chest at the mid-axillary line. Scars are covered by clothes in winter and summer with special body makeup. For the first 8 months they are visible, after this time they discolor, shrink and become less intense. For the majority of patients, however, the scars are negligible compared to the improvement in their body contours. To avoid misshapen or hypertrophic scars, you will be given instructions immediately after the stitches are removed, and you will be put on a follow-up program if you have a history of keloids.
HOW LONG WILL THE RESULTS LAST?
The results are almost permanent and will remain stable as long as patients do not gain weight and maintain a moderate level of exercise. Scars will be visible for the first 8 months, after which they fade and sag.
WHAT ARE THE LIMITATIONS OF A BRACHIOPLASTY?
In a brachioplasty, the skin of the back and medial surface of the thigh is removed, along with old stretch marks. Surgery will not correct the quality of the skin that will be left, and patients should be aware that some stretch marks and thinning of the skin will remain after surgery, but will be less noticeable because the skin that is preserved is stretched.
One of the most serious limitations of brachioplasty is the existence of old deformed scars and keloids in other parts of the body, because the possibility of creating hypertrophic scars on the thighs is great. Also, patients with serious health problems, with delayed healing, who cannot receive general anesthesia or those with dysmorphic syndrome should be prevented from cosmetic surgeries.
WHAT ARE THE RISKS OF BRACHIOPLASTY?
The doctor will assess your general condition and your history and, if she decides that you are suitable for surgery, she will inform you about the possible complications and what needs to be done to reduce the possibility of their occurrence. You will also be asked to stop smoking and refrain from using supplements that affect blood clotting. The anesthesiologist will then talk to you about the type of anesthesia you will receive and the possible complications.
WHAT SHOULD YOU DO BEFORE SURGERY?
Depending on your age, you will be given instructions on the medications you may be taking and should be stopped or replaced, as well as on the additional testing you may need to do based on your history. Your weight should remain stable at the lowest levels, because possible fluctuations may delay the surgery, and you will be asked to gently exercise the muscles of the lower limb 2-3 months before the surgery.
The doctor will explain the value of smoking cessation and proper nutrition in wound healing. One week before the surgery, measurements will be taken to order a special pressure garment, you will be photographed and the consent form will be signed.
WHAT SHOULD YOU DO AFTER THE OPERATION?
You stay at the clinic for a few hours, but your time away from work must have been calculated at 2 weeks. This doesn't mean you won't be able to do light work much sooner, but you'll generally feel overwhelmed. It is also recommended to refrain from sports for 1 month.
When you leave the surgery, you will wear a special pressure garment which you will keep for 6 weeks. You will likely have a drain that will be removed in the first 24 hours, and you will need to be mobilized as soon as possible. Pain and swelling when present are easily treated. Because the sutures are intradermal, no stitches need to be removed.
WHAT IS THE COST OF THE OPERATION?
The cost of the surgery is calculated by adding the cost of the clinic, in which the patient is operated and treated, the fee of the Plastic Surgeon and the Anesthesiologist. The purchase of the special pressure garment must be included in the costs.
Expandable Brachioplasty - Thoracoplasty
One of the areas that experience severe sagging after weight loss is the breasts. Sagging in the formerly obese is greater and usually extends beyond the elbow joint in the upper extremity and beyond the armpit in the trunk. The treatment for sagging skin in these patients is expansion brachioplasty, which corrects the contour of not only the upper limbs but also the chest, in several cases.
WHAT CAN BE DONE?
Excess skin, stretch marks and the presence of a small to medium amount of fat in the subcutaneous tissue of the arm, forearm and lateral chest wall are treated only surgically and the surgery is called extended brachioplasty (extended brachioplasty) and thoracoplasty (thoracoplasty). The purpose of the surgery is to restore the normal contour of the upper limb and trunk. Excess skin is treated with a horizontal incision in the vertical axis of the arm when the extremities are in abduction, which may extend to the forearm (extension brachioplasty) and/or the lateral chest wall through the axilla (extension brachioplasty + thoracoplasty). The operation is always combined with liposuction. The doctor will explain which technique is indicated for you based on your history and clinical examination.
EXTENDED BRACHIOPLASTY WITH THORACOPLASTY
Expansion brachioplasty is usually recommended for patients who have lost a lot of weight, usually after bariatric surgery, and who have vertical excess skin on the arm when it is in abduction and horizontal excess on the lateral chest wall. As a result of the operation there is a horizontal incision on the medial surface of the arm, which at one end terminates beyond the elbow and at the other beyond the armpit, in the mid-axillary line. Post-operative scarring should be discussed with the patient prior to surgery, who should be aware that despite a significant improvement in the contour of their upper limbs and trunk, there will be an incision that will be visible through certain clothing.
WHO IS EXTENDED BRACHIOPLASTY FOR?
Candidates for extended brachioplasty are adult patients with the aforementioned characteristics, who have stabilized their body weight, have achieved a normal BMI (body mass index) and have no other serious health problems.
WHAT IS THE TYPE OF ANESTHESIA?
The operation is performed under general anesthesia in an organized clinic. The duration of the surgery is 3 to 4 hours. After the surgery, it is advisable to stay in the clinic for 24 hours and to immediately mobilize the patients.
WHAT WILL THE SCARS BE LIKE AFTER THE EXPANDING BRACHIOPLASTY?
The type of scars depends on the surgery that will be chosen. In the extension brachioplasty, there will be an incision that starts at the armpit and ends after the elbow joint. Scars are more visible in the expansion brachioplasty with thoracoplasty, in which the incision begins just before the elbow and through the armpit continues into the chest at the mid-axillary line. Scars are covered by clothes in winter and summer with special body makeup. For the first 8 months they are visible, after this time they discolor, shrink and become less intense. For the majority of patients, however, the scars are negligible compared to the improvement in their body contours. To avoid misshapen or hypertrophic scars, you will be given instructions immediately after the stitches are removed, and you will be put on a follow-up program if you have a history of keloids.
HOW LONG WILL THE RESULTS LAST?
The results are almost permanent and will remain stable as long as patients do not gain weight and maintain a moderate level of exercise. Scars will be visible for the first 8 months, after which they fade and sag.
WHAT ARE THE LIMITATIONS OF A BRACHIOPLASTY?
In a brachioplasty, the skin of the back and medial surface of the thigh is removed, along with old stretch marks. Surgery will not correct the quality of the skin that will be left, and patients should be aware that some stretch marks and thinning of the skin will remain after surgery, but will be less noticeable because the skin that is preserved is stretched.
One of the most serious limitations of brachioplasty is the existence of old deformed scars and keloids in other parts of the body, because the possibility of creating hypertrophic scars on the thighs is great. Also, patients with serious health problems, with delayed healing, who cannot receive general anesthesia or those with dysmorphic syndrome should be prevented from cosmetic surgeries.
WHAT ARE THE RISKS OF BRACHIOPLASTY?
The doctor will assess your general condition and your history and, if she decides that you are suitable for surgery, she will inform you about the possible complications and what needs to be done to reduce the possibility of their occurrence. You will also be asked to stop smoking and refrain from using supplements that affect blood clotting. The anesthesiologist will then talk to you about the type of anesthesia you will receive and the possible complications.
WHAT SHOULD YOU DO BEFORE SURGERY?
Depending on your age, you will be given instructions on the medications you may be taking and should be stopped or replaced, as well as on the additional testing you may need to do based on your history. Your weight should remain stable at the lowest levels, because possible fluctuations may delay the surgery, and you will be asked to gently exercise the muscles of the lower limb 2-3 months before the surgery.
The doctor will explain the value of smoking cessation and proper nutrition in wound healing. One week before the surgery, measurements will be taken to order a special pressure garment, you will be photographed and the consent form will be signed.
WHAT SHOULD YOU DO AFTER THE OPERATION?
You stay at the clinic for a few hours, but your time away from work must have been calculated at 2 weeks. This doesn't mean you won't be able to do light work much sooner, but you'll generally feel overwhelmed. It is also recommended to refrain from sports for 1 month.
When you leave the surgery, you will wear a special pressure garment which you will keep for 6 weeks. You will likely have a drain that will be removed in the first 24 hours, and you will need to be mobilized as soon as possible. Pain and swelling when present are easily treated. Because the sutures are intradermal, no stitches need to be removed.
WHAT IS THE COST OF THE OPERATION?
The cost of the surgery is calculated by adding the cost of the clinic, in which the patient is operated and treated, the fee of the Plastic Surgeon and the Anesthesiologist. The purchase of the special pressure garment must be included in the costs.
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