The success and safety of your body contouring procedure depends very much on your complete candidness during your consultation. You'll be asked a number of questions about your health, desires and lifestyle.

Questions you will be asked:

• Why you want the surgery, your expectations and desired outcome

• The options available in body contouring surgery
• Medical conditions, drug allergies and medical treatments
• Use of current medications, vitamins, herbal supplements, alcohol, tobacco and drugs
• Previous surgeries

Dr. Gray will also:

• Evaluate your general health status and any pre-existing health conditions or risk factors
• Examine and measure your body, including detailed measurements
• Take photographs for your medical record
• Discuss your options and recommend a course of treatment
• Discuss likely outcomes of your surgery and any risks or potential complications

Body contouring is often performed in stages. Your particular condition and goals, as well as Dr. Gray's best judgment will all influence how she defines your customized surgical plan.

While it may have taken you two years or more to lose all the excess weight, it may take equally as long for the results of your body contouring to be complete.

Preparing for your surgical procedure you may be asked to:

• Get lab testing or a medical evaluation
• Take certain medications or adjust your current medications
• Stop smoking well in advance of surgery
• Avoid taking aspirin, anti-inflammatory drugs and herbal supplements as they can increase bleeding

Dr. Gray will also discuss where your procedure will be performed. Body contouring surgery may be performed in an accredited office-based surgical center, outpatient or ambulatory surgical center, or a hospital.

You'll need help

If a component of your body contouring surgery is performed on an outpatient basis, be sure to arrange for someone to drive you to and from surgery and to stay with you for at least the first night following surgery.

What will happen during your Surgical Body Contouring Procedure?
The procedures necessary to achieve your goals will be defined along with a plan for the timing of these procedures during your initial consultation with Dr. Gray. Plastic surgery procedures that may be recommended by Cynthia to achieve your objectives could include:

For Women

• Lower Body Lift to correct sagging abdomen, derriere, groin and thighs
• Breast Lift to correct sagging and/or flattened breasts
• Arm Lift to correct sagging upper arms
• Thigh Lift to correct sagging inner, outer and mid-thigh areas

For Men

• Lower body lift: to correct sagging of the abdomen, derriere, groin and outer thighs
• Gynecomastia, if necessary to correct over-developed or enlarged breasts
• Arm lift to correct sagging of the upper arms
• Thigh lift to correct sagging of the inner, outer and mid thigh
  

THE PROCEDURE
All body contouring procedures are performed in an accredited hospital setting and require incisions to remove excess skin. In many cases, these incisions may be extensive. Incision length and pattern depend on the amount and location of excess skin to be removed, as well as personal preference and Dr. Gray's surgical judgment.  Advanced techniques usually allow incisions to be placed in strategic locations where they can be hidden by most types of clothing, but this is not always the case.

Anesthesia
Medications are administered for your comfort during the surgical procedures. The choices include intravenous sedation and general anesthesia. Dr. Gray will recommend the best choice for you.

Body Lift
A complete lower body lift treats sagging buttocks, abdomen, waist, hips and outer thighs in one procedure or in staged procedures. Incision patterns vary, and may include a circumferential incision around the body to remove the "belt" of excess skin and fat.

Breast Lift

The incision patterns for lifting a woman?s sagging breasts will be determined based on the amount of excess skin to be removed. These may include one or a combination of incisions in a circular pattern around the areola, in a line extending from the areola to the breast crease, and horizontally along the breast crease. A breast implant also may be recommended to enhance breast shape and size.

Gynecomastia (for Men)

In cases where gynecomastia is primarily the result of excess fatty tissue, liposuction techniques alone may be used.

This requires insertion of a cannula, a thin hollow tube, through several small incisions. The cannula is moved back and forth in a controlled motion to loosen the excess fat, which is then removed from the body by vacuum suction.

There are various liposuction techniques that may be used; the technique most appropriate in your case will be defined prior to your procedure.

Excision techniques are recommended where glandular breast tissue or excess skin must be removed to correct gynecomastia. Excision also is necessary if the areola will be reduced, or the nipple repositioned to a more natural male contour. Incision patterns vary depending on the specific conditions and surgical preference.

*Sometimes gynecomastia is treated with both liposuction and excision. 

Any surgical treatment to correct gynecomastia will require incisions. While most incision lines are concealed within natural contours, some may be visible and are a necessary result of breast reduction surgery.

Arm Lift

Sagging skin in the upper arms is treated with an incision from the underarm area extending along the inside or back of the upper arm. Additional incisions on the arms may be necessary anywhere excess skin has formed sagging pockets.

The smoother, tighter contours that result from upper arm contouring are apparent almost immediately, although initially obscured by swelling and bruising. In addition, skin quality is dramatically improved in both appearance and texture.

Thigh Lift

Reshaping of the thighs is achieved through incisions in the groin that can extend downward to the knee along the inner portion of the thigh.  Improving contours of the outer thigh may require an incision extending from the groin around the hip. Through these incisions Dr. Gray will tighten tissues for a smoother, better toned thigh.

Important facts to know about the safety and risks of Body Contouring Surgery following major weight loss include:

• Unfavorable scarring
• Bleeding (hematoma)
• Infection
• Fluid accumulation
• Poor wound healing
• Skin loss
• Blood clots
• Numbness or other changes in skin sensation
• Anesthesia risks
• Skin discoloration and/or prolonged swelling
• Fatty tissue found deep in the skin might die (fat necrosis)
• Major wound separation
• Asymmetry
• Recurrent looseness of skin
• Pain, which may persist
• Deep vein thrombosis, cardiac and pulmonary complications
• Persistent swelling in the legs
• Possibility of revisional surgery

You will be given specific instructions that may include: How to care for your surgical site(s) following surgery, medications to apply or take orally to aid healing and reduce the risk of infection, specific concerns to look for at the surgical site or in your general health, and when to follow-up with Dr. Gray.

Common questions that are asked during the initial consultation and/or when planning the surgery include:

• Where will I be taken after my surgery is complete?
• What medication will I be given or prescribed after surgery?
• Will I have dressings/bandages after surgery?
  • When will they be removed?
• Are stitches removed? When?
• When can I resume normal activity and exercise?
• When do I return for follow-up care?

When you go home

If you experience shortness of breath, chest pains, or unusual heart beats, seek medical attention immediately. Should any of these complications occur, you may require hospitalization and additional treatment.

The practice of medicine and surgery is not an exact science. Although good results are expected, there is no guarantee. In some situations, it may not be possible to achieve optimal results with a single surgical procedure and another surgery may be necessary.

Be careful

Following Dr. Gray's instructions is key to the success of your surgery. It is important that the surgical incisions are not subjected to excessive force, abrasion, or motion during the time of healing. Cynthia will give you specific instructions on how to care for yourself.

The final results and longevity of Body Contouring after Massive Weight-loss
The results of a body contouring following aggressive weight loss are visible almost immediately.

However, it may take as many as one to two years or more for the final results of all the recommended body contouring procedures to fully develop. Visible scars will remain, but the overall results are long lasting, provided that you maintain a stable weight and general fitness.  As your body ages, it is natural to lose some firmness. However, most of your initial improvement should be relatively permanent.

• Areola: Pigmented skin surrounding the nipple.
• Arm lift: A surgical procedure, also known as brachioplasty, to correct sagging of the upper arms.
  
• Breast implants: Medical device placed in your body to enhance an existing breast size or to reconstruct your breast. Breast implants can be filled with either salt water (saline) or silicone (elastic gel).
• Breast lift: Also known as mastopexy, surgery to lift the breasts.
• Breast contouring: A surgical procedure following massive weight loss to improve shape and tone and remove excess fat and skin.
• Circumferential incision: A surgical incision around the body to remove the "belt" of excess skin and fat and additional incisions that may resemble a bikini bottom pattern.
• General anesthesia: Drugs and/or gases used during an operation to relieve pain and alter consciousness.
• Hematoma: Blood pooling beneath the skin.
• Intravenous sedation: Sedatives administered by injection into a vein to help you relax.
• Local anesthesia: A drug injected directly to the site of an incision during an operation to relieve pain.
• Lower body lift: Surgical procedure to correct sagging of the abdomen, buttocks, groin and outer thighs.
• Macerated skin: Excess skin that hangs and becomes wet or infected underneath.
• Medial thigh lift: A surgical procedure to correct sagging of the inner thigh.
• Outer thigh lift: A surgical procedure to correct sagging of the outer and mid-thigh.
• Sutures: Stitches used by surgeons to hold skin and tissue together.