Surgery can be nerve wracking because you never really know what to expect until you go through it. We care for body contouring patients on a daily basis at Southern Aesthetic Plastic Surgery. It is our years of experience that will give you confidence and comfort. We will be sure to answer any questions that you have. Every patient is given a surgical planner describing their surgery and recovery in detail, so that you can be fully informed and prepared. There are some questions that patients often ask before they have seen us.
Yes. There is no effective, non-surgical machine or medication available to tighten large areas of lax skin. Skin becomes loose through stretching, gravity and ageing. The strength layer of our skin is called the “dermis”. The dermis is made of strong, stretchy proteins called collagen and elastin and the cells that make these two proteins, fibroblasts. This layer of our skin thins as we get older. Ageing also reduces the capacity of our fibroblasts to generate new collagen. In addition, our fibroblasts have mechanoreceptors that tell them to produce more collagen and more skin if they are stretched. People who lose a lot of weight don’t just have stretched skin, they have more skin. The older we are at the time of the weight loss, the more likely our skin will not spring back to its old position. It also makes sense that the areas of the body with the thinnest dermal support (upper arms, thighs, eyelids, neck) will sag the most.
Surgically tightening loose skin improves your appearance, but this is at the expense of a scar marking the location where the skin was removed. Most of the time, these scars can be placed into natural crease lines that are hidden under your clothing.
The most common operations requested by massive weight loss patients are abdominoplasty, and mastopexy (breast lift). Brachioplasty, thigh lift and face and neck lift surgery are operations that usually take an important second place to abdominal and breast procedures.We recommend that your operations be performed in segments that take less than six hours. After this point, it becomes increasingly difficult to prevent blood loss, hypothermia, pressure areas and deep vein thrombosis. Your surgeon will discuss with you the best combination of procedures. Ideally, operations that are combined involve adjacent areas of the body eg abdomen and breasts OR arms and breasts.
There are some procedures, such as belt lipectomy and thigh lift, that we recommend doing as stand-alone operations. These operations generate scars in locations of the body that make it difficult to move easily if another part of your body is also recovering from surgery.
People who experienced easy recoveries from other operations eg gastric sleeve, hernia repair, ceasarean section, can usually tolerate combination procedures well. Other predictors of a good recovery from longer procedures include a high pain threshold and positive attitude.
A typical plan for a massive weight loss patient would be:
Operation 1: Belt lipectomy
Operation 2: Brachioplasty and Breast surgery
Operation 3: Thigh Lift
Operation 4: Facelift
Most body contouring procedures are long operations and result in long scars and require at least two to four weeks of downtime. Feeling tired and swelling can persist for weeks after. It is easier to recover from shorter operations and operations that are in the upper half of the body (breasts, arms, face). Longer operations mean that a greater surface area of your body has to recover and heal. While you can only see the neat incision lines on the outside of your body, there is still a large surface area of healing tissue deep to this. Your immune system goes into over drive after the surgery to heal your body. This leaves you feeling tired for 2-6 weeks after your operation.
Most people return back to work three weeks after their surgery date and are able to exercise normally again after 6 weeks. You can make a rough estimate of your recovery time from your past experience with other significant operations.
Thousands of body and facial contouring operations are safely performed every day in Australia. The risk of most body and facial contouring operations in healthy patients is low as the surgery simply involves removing and shaping skin and fat. Plastic surgery does not involve deep organ cavities, and so has much lower surgical risk than neurosurgical, cardiac or bowel operations of similar duration. Your surgeon will explain the risks of your individual procedures and how these risks are modified by your other health issues. The benefits of any surgical procedure must be weighed against its risks.
Patient satisfaction following body and facial contouring procedures is over 90%. Plastic surgery is an effective strategy to improve the appearance of your body and face after massive weight loss and results in improved self-confidence. It is important to have realistic expectations of what can be achieved through plastic surgery and also what is normal for other men and women your age. Magazines and TV shows show us unrealistic images of men and women who lack wrinkles and natural movement. Our society is beginning to forget what natural beauty looks like. It is not possible to make a sixty year old woman who has lost seventy kilograms look like a twenty five year old! But it is possible to make her look and feel better than she has at any other point in her life. The happiest patients are those that have lost 20 to 40 kilograms to be close to or within a normal body mass index. These patients have the least degree of skin damage but still require body contouring to remove excess skin folds.
You can have your surgery in a private hospital even if you do not have health insurance. The fees from the surgeon and anaesthetist are unchanged, but you will have to pay the hospital for your theatre time and the amount of nights you remain hospitalized. Having private health insurance approximately halves the costs of your surgery.
Fortunately, Medicare continues to acknowledge the great impairment that massive weight loss patients face from their skin excess. This means that most body contouring procedures are “covered” by private health insurance. Private health insurance covers the cost of the hospital charges and a small portion of the surgeon and anaesthetist’s fees.
Cosmetic procedure eg breast augmentation, facelift are procedures that do not have a Medicare item number. This means that patients need to cover all of their own fees.
Our team will inform you fully about your expenses, and you will be given a comprehensive fee estimate before you make any commitments to surgery.
It is because the standards are different. We are very fortunate in Australia to have strict regulations regarding our health care system and its providers. Dr Sanki and Dr Kotronakis operate only in hospitals that use the best-trained staff and the most technologically advanced equipment. These standard mean that costs are increased. Patients who have their surgery overseas cannot properly develop a relationship with their surgeon beforehand and do not have appropriate follow up after their surgery. How can you assess the qualifications and competency of these surgeons or hospitals? It can be tough to try to find the “right” general practitioner or dentists in your own city, let alone a properly qualified and experienced plastic surgeon in another country!
It is inappropriate for plastic surgery to be marketed as a romantic or adventurous “holiday”. The risk of wound infection and blood clots are higher in patients travelling overseas for surgery. Your health is paramount and it is not worth taking undue risks by having surgery in an unfamiliar country.
Most Plastic and reconstructive surgeons are based in the capital cities of Australia, and it is common practice for people to travel within Australia to have the best surgical care. Ideally, patients should meet in person with Dr Sanki before their surgery so that she can properly assess what operations they require. A Skype consult can be organized for a further question and answer session (pre operative) consult. Patients should stay in Sydney for at least one week after the surgery before driving or flying home to reduce the risk of deep vein thrombosis and also for wound care advice. Further follow up is done by phone calls, email and skype. A formal follow up consult between 6- 12 weeks later is organized to check the result of surgery and discuss scar management.
Interstate travelers will be given advice about aftercare, travel and accommodation options.
Dr Sanki operates weekly at St George private hospital (Kogarah) and monthly at Kareena private hospital (Miranda) and East Sydney Private Hospital (East Sydney). She has a regular team at each of these hospitals. Most of her theatre lists involve an all- female team. Dr Sanki’s team have also been carefully chosen for their empathy and expertise.