Total Body Lifts

            There is nothing as disheartening to a person that has fought and struggled to lose massive amounts of weight than the skin that still may be hanging around their body. I have had numerous patients who, through dieting, exercise and perseverance, have managed to lose 80, 90 and at times, more than 100 pounds. While they look excellent in clothing, the failure of the skin to shrink to their new proportions, puts a significant damper on their efforts.  Some have even achieved terrific physiques, only to be frustrated that they cannot get the skin to shrink.

The sad fact is, once the skin has been damaged by being forced to stretch beyond it's normal elastic limits, stretch marks result as an indicator of this. These stretch marks are actually internal scars in the skin where actual disruption in the skin structure has occurred. Happily, there are plastic surgical procedures designed to tailor the skin.

Tummy Tuck Plus

The ideas originated with performing abdominoplasty, or tummy tucks.  The inability of the skin to shrink in this area causes either a hanging apron of skin or a very rumpled appearance to the surface of the skin. Persistent fat collections may also be present in spite of the extreme weight reduction and exercise. In some cases, there may have even been a disruption in the positioning of the abdominal muscles that act as an anatomic girdle around the mid section. To correct this anterior problem, combinations of liposuction to remove the excess fat, skin tightening, and where necessary, muscle repositioning, have been performed. While this totally improved the abdominal area, the sides and back were even more out of proportion as a result of the abdominal area looking taut.

            There was a gradual extension of the surgery to include the sides and excise the flank fullness. Eventually, this progressed to extend totally around the body to elevate the sagging buttocks and the slack tissue of the thighs. In this way, all the redundant tissue is removed around the entire body with the lower fullness lifted and the upper fullness tightened to meet in the center of the body. The excess skin is removed and the upper and lower edges are brought together, giving a scar that looks like the person worked for a magician and got sawed in half.

            Done properly, this is more than just removal of hanging skin. The abdominal covering is freed to the ribcage and brought down tautly. The skin of the buttocks and thighs are also detached to allow it to heal smoothly in a more suspended manner. The sagging of the buttocks is eliminated by re-suspending the muscle fascia.

Fat Goes First

First, the excess fat is undermined, lifted off the muscle, and further lifted and elevated. Stitches are placed in several layers of the Superficial Facial System (SFS) from below, and attached to, the SFS above. This acts as a scaffolding or foundation beneath the skin that holds the fat and skin onto the body. When tacked up, the tissues stay in position. All the while, wrinkles are removed as the skin is tightened. Another great benefit of the procedure is that there are no visible scars. The incisions are completely hidden within the natural skin creases that will not show, even in a posing suit. 

While this can be attempted in a single operation, I find it is beneficial to recuperation to do the surgery in two stages. This allows faster recuperation and return to normal activity. The back is usually done first and a period of healing allowed. After six weeks, the abdomen can be tightened and whatever adjustments may be necessary performed to the back.

            Recuperation for each stage is about one week before non-strenuous activity is comfortable. Non-impact aerobic activity can be started at three weeks and resistance training at six weeks.

            The surgery allows people to finally realize the appearance they worked so hard to achieve. It eliminates that residual skin and drooping deformity that no amount of exercise could ever achieve and finally relieve the resultant dissatisfaction and frustration.

Dr. Nadler's website is http://www.drnadler.com/. He can also be reached by e-mail at This e-mail address is being protected from spam bots, you need JavaScript enabled to view it or by phone at 1-800-445-0505.