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As the science of weight gain is better understood and as the role of inflammation, sugar, and hormones such as insulin has on fat, extreme weight loss is obtainable for nearly everyone. In the last 20 years, the advent of surgical weight loss procedures such as gastric sleeve and gastric bypass surgery has literally resulted in the emergence of an entire subspecialty within plastic surgery comprising body contouring after massive weight loss.

What is body contouring after weight loss?

In many individuals, massive weight loss in one of life’s ultimate achievements. It is a giant leap towards health, wellness and longevity. With extreme weight loss, the incidence of having deflated, loose, redundant skin folds is almost inevitable. Extra skin on the stomach, breasts, lower back, arms and thighs is not only frustrating aesthetically, but can result in chronic chafing, fungal infections, self-consciousness and in some cases, depression.

Body contouring in Charlotte NC after massive weight loss is designed to address both the functional problems from having excess skin, as well as the aesthetic ones.

After Massive Weight Loss Surgery Charlotte NC

Tummy TuckAbdominoplasty, or tummy tuck, removes excess fat and skin from the belly, smoothing and flattening the stomach while tightening the underlying six pack muscles.

Liposuction – The role of liposuction in massive weight loss is slightly different. Liposuction in this setting is used to debulk or deflate areas where fat loss may have plateaued or is still inadequate. Subsequent skin removal is maximized when liposuction is used to deflate areas such as the arms or thighs prior to skin removal.

Arm lift – An arm lift is performed to sculpt and trim the upper arms, removing unwanted fat and skin for a more streamlined, beach-ready appearance. The incision is well hidden on the inside of the arm between the elbow and the armpit.

Thigh lift – Redundant skin along the inner thighs and knees is a common occurrence with massive weight loss. Removing this skin helps to minimize contour irregularities and bring a more uniform shape to the lower extremities.

Breast lift – This surgery is helpful in treating breast ptosis, or excess sagging. It can help remove droopy skin and restore the nipple to a more visually pleasing position. Breast lift can be performed in tandem with breast augmentation if the breast lacks sufficient volume. 

Panniculectomy – Although not usually associated with weight loss, a panniculectomy is used to describe the removal of a what is typically a large, burdensome wedge of skin and fat in the lower abdomen. Removing this skin apron (also known as a pannus) helps alleviate chronic skin infections, moisture problems, low back strain, and hygiene issues. A panniculectomy is reserved for people not suitable for a tummy tuck but needs relief of the heavy tissue burden to improve quality of life. This is strictly a debulking operation, not a contouring one. Because of the potential source of post-operative infection, the belly button is typically removed during a panniculectomy.

Before & After

FAQ

I’ve had gastric sleeve surgery and need body contouring. How do I know when the timing is appropriate?

An 18-month interval between bariatric surgery and body contouring surgery is typical, however patients that have reached their goal weight or plateaued may undergo body contouring surgery earlier provided that their bariatric surgeon approves of an earlier intervention.

I had gastric bypass surgery and my anatomy is now different than most people. Is your anesthesia provider familiar with patients like me?

Absolutely. Both Dr. Pratt as well as the anesthesia providers are familiar with bariatric surgery patients. Dr. Pratt’s anesthesia personnel also work in the operating rooms of the area hospitals were gastric bypass surgery is done routinely. During his general surgery residency, Dr. Pratt performed dozens of gastric bypass surgeries, so he is quite knowledgeable about the anatomical variations associated with these procedures.

I think I need my entire body lifted. In what order do you prefer to do your surgeries for massive weight loss patients?

Patient preference is always taken into consideration, however based on the extent of contouring, Dr. Pratt will develop a stepwise plan that makes the most logical sense for both the operating room as well as your ability to effectively recover.

Does my tummy tuck incision need to go all the way around? I’ve seen a couple of plastic surgeons and I’ve gotten mixed messages.

Quite often, in plastic surgery, there can be more than one correct answer. This “shades of grey” outlook and different approaches amongst surgeons is inherently part of the artistic freedom seen in plastic surgery but tends to create more confusion for prospective patients. Following your comprehensive consultation with Dr. Pratt, he will assess whether or not a circumferential tummy tuck (also known as a belt lipectomy) is indicated to become the best version of yourself. Although usually not mandatory, if sagging skin is present over the lower back and buttocks, a belt lipectomy brings about a more uniform, harmonious, neater appearing mid-section. Although the incision length is slightly longer, this typically does not mean a lengthier recovery.

My insurance company said they would pay for a portion of my surgery. Does Dr. Pratt take insurance?

In very extreme cases, some insurance companies may cover skin removal for infectious and inflammatory conditions related to skin redundancy. Insurance may cover a procedure such as panniculectomy, but invariably will not cover a more aesthetically oriented procedure such as a tummy tuck.

What should I expect from recovery?

  • Massive weight loss and the associated contouring that follows produces some of the most incredible transformations in our field. Since the amount of tissue removed can be excessive in many instances, swelling following surgery is also significant. Elevation of the extremities while lying down, longer use of compression garments, lymphatic massage are encouraged following body contouring surgery to help expedite recovery.
  • Follow-up appointments are essential to monitor your progress, as incisions and any associated surgical drains are checked frequently.
  • Walking after your Charlotte NC body lift is important to help prevent the risk for clots forming in the deep veins of the legs. In some instances, Dr. Pratt may prescribe a self -administered injectable blood thinner to further reduce this risk.

Why choose Dr. Pratt in Charlotte for post bariatric surgery?

The transformational change with massive weight loss goes far beyond numbers on a scale or a new wardrobe. Reversal of conditions such as high blood pressure, diabetes, and sleep apnea can literally add decades to a patient’s life. The impact that weight loss has on our health, self- esteem, and our loved ones cannot be overstated. The surgeon’s approach to body contouring following massive weight should reflect the importance of this final step and outline plan that exclusively caters to you. Variables such as the distribution of your weight loss, quality of skin, the need to modify certain procedures to suit your needs, and proper staging are among many things to consider.

Dr. Pratt philosophy that the goal of any aesthetic surgery is to restore youth, shape, and function. Achieving these goals consistently involves understanding the many nuances of post-bariatric surgery. The difference between simply removing a bunch of skin versus being intentional about its removal can be the difference in; healing, scar quality, and scar positioning.

Dr. Pratt’s plan for you will be precise, calculated and comprehensive. He recognizes this milestone in your life and will seek to sculpt the best version of your new and improved self.

Dr. Pratt graduated from the University of Florida College of Medicine then went on to complete a general surgery residency at Carolinas Medical Center in Charlotte, NC. Upon completion of general surgery residency, he went on to the University of North Carolina at Chapel Hill to complete his fellowship in plastic and reconstructive surgery.

His private practice is in beautiful south Charlotte, NC right in the heart of Ballantyne. Dr. Pratt and Bespoke Plastic Surgery are exclusively an aesthetic surgery practice dedicated to surgery of the breast, body, and face.

We are open and seeing patients!

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WE ARE OPEN AND READY TO SEE YOU AGAIN!!

We recognize the anxiety and concerns surrounding the coronavirus (COVID-19) outbreak. Rest assured that our patients’ health and well-being have and always will be our primary concern.

We are doing everything we can to protect one another from spreading the virus. Our intention and promise to our patients are to respect the guidelines and recommendations set forth by health care professionals regarding hygiene and social distancing. To that end, we would like to share some of the additional steps we are implementing as a practice to help protect you as well as our team members

  • Anyone entering our office will be pre-screened for symptoms of acute illness and have their temperature taken at the front desk
  • All staff member will wear masks when interacting with patients or family
  • We have increased the frequency and extensivity of our office cleaning routines
  • Hand sanitizer is readily available throughout the office
  • We will continue to offer virtual consultations as well as virtual follow-up visits when appropriate
  • We request that anyone with fever, respiratory symptoms such as cough or shortness of breath reschedule their appointment.
  • We are limiting outside vendors from elective visitation
  • We are limiting our waiting room occupancy to fewer patients and request that any family or friends do not accompany patients inside the office
  • Patients that prefer to wait in the car prior to their appointment may do so. Please text the practice on our SMS line (704) 256.3732 when you have arrived to let us know that you are here. We can send you a text message when we are ready for you to come in.

While the COVID-19 situation and response remain fluid, please know that we are doing everything we can to limit your exposure and risk. As our response adjusts based on recommendations set forth by relevant medical experts, we will keep you updated on our website as well as social media.

Sincerely,
Broc L. Pratt, MD

COVID-19 A Message from Dr. Pratt

We are open and seeing patients!

In response to the challenge for patients caused by the current pandemic Dr. Pratt is now offering safe and private Tele-Health services for consults. There is no charge for this service. Simply call our office at 980-375-9959 to request an appointment. We will give you specific instructions on how to schedule a virtual visit with Dr. Pratt and his patient coordinator, Ashleigh. We are pleased to be able to offer these appointments and hope this option meets your needs and helps fulfill your desired timeline.

Sincerely,
Broc L. Pratt, MD

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