Dramatic weight loss can be an amazing source of pride and accomplishment for you. The health benefits of moving from morbidly obese to relatively normal weight are innumerable. Your organs work at a higher efficiency level; your joints no longer suffer from undue stress; your self-esteem skyrockets; and you feel empowered. Truly, the only downside to your metamorphosis is that your birthday suit is now many, many sizes too big. Thankfully, there is the corset trunkplasty procedure, which tailors your new body to fit your new frame. In the hands of an experienced, board-certified plastic surgeon, who performs this surgery, you can once again love the skin you are in. While traditional abdominoplasty with rectus plication (tightening of the abdominal muscles) entails the removal of the excess, stretched skin from the lower abdomen, the removal of the subcutaneous fat from the abdomen, and the repair of the separated abdominal muscles. A corset trunkplasty also allows for removal of excess skin from the center of the abdominal wall from the ribs to the pubic region.
Am I a good candidate?
Good candidates are men or women in relatively good health who may have had post-bariatric surgery or have lost a significant amount of weight through a comprehensive lifestyle change in diet and exercise. Corset trunkplasty patients CANNOT be smokers. Smoking compromises healing and poses a tremendous risk of complications for the patient.
This procedure involves three incisions to maximize skin removal and improve overall body shape. The midline incision has the greatest impact on reducing the size of the waist, while the lower chest (beneath the breasts) incision enhances the upper waistline contour and the lower pelvis/hip incision (abdominoplasty incision) enhances the lower waistline contour. Once your surgeon removes the excised skin and subcutaneous fat, he will tighten your abdominal muscles. If you choose the 72-hour timed-release analgesic, Exparel, that we offer, your doctor will inject it into your soft tissue prior to closing your incision with dissolvable sutures. This significantly helps to decrease the initial post-operative discomfort. As your incisions are closed, the skill and artistry of your plastic surgeon comes to task. Your skin is sutured so your result is a taut, contoured torso. One, sometimes two, drains are placed and come out at the end of the incision site so that any excess serous fluid that accumulates post-operatively can be removed. Corset trunkplasty surgery takes approximately three to four hours depending on the size of your frame and the amount of excess skin. Since the procedure directly removes any excess fat along the treated areas, no liposuction is required for contouring. Results are immediate and improve over time.
Recovery from corset trunkplasty is much like that of an abdominoplasty, with the first 24-36 hours being the most uncomfortable. Immediately after surgery, the OR nurse will fit you into an abdominal binder, which you will wear for the next 6 weeks. This binder helps minimize swelling and maintain your shape as you heal from your surgery. If you chose to have Exparel, the timed-release local anesthetic injected into your abdominal muscles during the surgery, you will find those first 24-36 hours much more tolerable. Your abdomen will feel tight, and walking a bit hunched over for the first few days also helps alleviate that tight feeling. After first week, you should walk with your normal posture. You must take it easy in terms of strenuous or physical activity for the first two weeks post-op. Strenuous or physical activity increases your heart rate and blood pressure, which may cause bleeding which would require additional surgery. Your drains typically stay in 10-14 days. As your recovery progresses, you may perform more of your daily routine. After three weeks post op, there is little risk of bleeding. At this time, you may begin to incorporate more of your regular routine. Once you have passed the 6-week mark, you should be able to resume all of your pre-operative activities.
Terms to Know
Exparel – a time released pain medication that is injected into the tissue during the tummy tuck, with the goal of minimizing the discomfort from the procedure. If you have friends that had a tummy tuck without Exparel they probably described it as extremely painful. We have found that with the Exparel, our patients are far more comfortable following the tummy tuck surgery.
Rectus Plication – During pregnancy or for those with large bellies, the two abdominal muscles can separate, resulting in an abdominal bulge. Many patients almost look somewhat pregnant despite diet and exercise, because of the abdominal wall spreading. No amount of sit-ups or exercise will correct this. During a tummy tuck or a corset trunkplasty, the surgeon will tighten the abdominal wall. Loose underlying tissue and muscle are sewn together to give the patient that flatter stomach she had pre-pregnancy. The suturing of the abdominal wall muscles is called a rectus plication.
Will I lose weight after my corset trunkplasty?
Corset trunkplasty is not a weight loss procedure. With that said, you can expect to lose a few pounds from the excision of excess skin and fat.
Is corset trunkplasty covered by insurance?
No, corset trunkplasty and other elective surgeries are not covered by insurance because they are not considered medically necessary. What may be covered by insurance is called a lipectomy, which is only the removal of the excess skin if it is causing chronic infection or irritation. Insurance will not cover the cosmetic component of contouring the area, tightening the abdominal muscles or recreating an aesthetically pleasing belly button as you would have with the corset trunkplasty or tummy tuck.
Why is it preferable that plastic surgery patients are non-smokers?
Smokers have impaired capacity for wound healing and propensity for skin necrosis because oxygen flow to the tissues is decreased. Smoking deprives the body of the much-needed oxygen required to repair and build cells. Oxygen also kicks off energy production and to put it simply, oxygen helps to prevent infection in open wounds and is the foundation for the rebuilding of the skin tissues. Smoking also decreases blood flow to the tissues which also results in impaired wound healing.