Seattle, Bellevue I’ve lost 50 pounds and want to know what surgeries are available to someone like me, with excess, sagging skin. A friend had liposuction, but I’m not sure it’s the right thing for me. What are some other options I can look at? SueEllen M

Hi SueEllen, congratulations on your weight loss.  For the extra skin and stretched stomach muscles, a tummy tuck or abdominoplasty, can be recommended.  This surgery flattens the abdomen by removing extra fat and skin, and tightening muscles in your abdominal wall.  However, if you’re planning to have children, then you may want to postpone a tummy tuck until you’re done having them.  Reason being that during surgery, your vertical muscles are tightened, and future pregnancies can separate those muscles.  You may want to discuss scars after the tummy tuck – scar placement and length, should be discussed with your surgeon.  If the weight loss has left you with an “apron” of skin, a panniculectomy   can be considered. This is when a pannus is surgically removed (excess skin and adipose tissue), or an “apron” that hangs down over ones genitals and/or thighs.  Liposuction can be an add on procedure while you’re having either the abdominoplasty or panniculectomy – this will be to remove any excess fatty deposits.

Seattle, Bellevue What are the benefits of laser liposuction? Cathy V.

Hi Cathy, a mild laser is run all over your body that melts the fat and converts it into liquid form, so that it can be drained from the body through the small dissections with the help of a vacuum pump. Laser liposuction, differs from traditional liposuction in that laser technology is used to remove fat under the skin whereas in traditional liposuction, more intrusive surgery is used. Liposuction can either be internal or external. In internal liposuction, laser is attached to a suction device which is then inserted in the area to be operated using a fiber optic probe. External liposuction on the other hand involves the use of a laser pen or pad outside the body. Laser liposuction is less intrusive when compared to traditional liposuction. Patients therefore experience less trauma on areas here the procedure is applied and this means less scaring and a shorter recovery time. Laser liposuction coagulates blood in the areas where the procedure is being carried out. This means that patients do not lose a lot of blood during the operation. Blood coagulation also eliminates excessive swelling normally associated with this procedure. And the fact that small incisions are made during laser liposuction reduces the likelihood of infection.

Seattle Bellevue – Who is a good candidate for Blepharoplasty Surgery? China Doll

Hi China Doll, more than the physical criteria of who would benefit most from this type of procedure, the psychological factor that counts the most is that one has realistic expectations about eyelid surgery. Although the procedure improves your appearance, enhances your self-esteem you should not hope that eyelid surgery will make other people treat you differently. It’s important to remember that this procedure will not necessarily improve your looks to match your ideals.  You need to be in fairly good physical shape and psychologically stable, inspite of being annoyed with drooping upper lids and puffiness of lower eyelids. There are no gender or racial/ethnic limgeneral itations for candidates to have eyelid surgery performed. But most tend to be 35+ years, but since drooping eyelids can be an inherited  condition, there are those that might consider blepharoplasty at a younger age if droopy eyelids and puffy bags under their eyes run in their family. You have to be very realistic about surgery results.

Seattle, Bellevue How does Rhinoplasty Surgery work? Joseph Z.

Hi Joseph, rhinoplasty reshapes a patient’s nose by making incisions to access the bones and cartilage that support the nose.The incisions are usually made inside the nose so that they are invisible after the surgery. Depending on the desired result, some bone and cartilage may be removed, or tissue may be added (either from another part of the body or using a synthetic filler). After the surgeon has rearranged and reshaped the bone and cartilage, the skin and tissue is redraped over the structure of the nose. A splint is placed outside the nose to support the new shape of the nose as it heals.  Rhinoplasty may be done using general or local anesthesia.  Often performed as an outpatient  procedure but sometimes requires a 1-night stay in the hospital.  . Rhinoplasty can change the size, shape, and angle of your nose and bring it into better proportion with the rest of your face. It can also correct structural problems with the nose that cause chronic congestion and breathing problems. The results of rhinoplasty are permanent.  Cosmetic surgery  should only be done on a fully developed nose, at around 15/16 for females and 17/18 in males.  If surgery is done before this time, continued development of the nose can alter the surgical results and possibly cause complications.

Seattle Bellevue How do I know if I’m a good candidate for liposuction? Gina S.

Hi Gina, thank you for your question.  The best candidates for liposuction are those in good health, over 18 years of age, have good skin tone and whose skin is elastic (i.e., can be moulded into new contours).  Those who are not good candidates are those with blood flow problems like coronary artery disease, diabetes, a weak immune system, those with seizure disorders, excessive bleeding and/or a history of deep vein thrombosis (blood clots in the legs) or pulmonary embolisms (blood clots in the lungs).  Also at risk are those taking certain medications like aspirin, non-steroidal ad inflammatory drugs or anticoagulants.  But the most important characteristic of a good candidate for liposuction, is one who has realistic expectations, because while liposuction can provide substantial improvements, the results are rarely perfect.  You will be disappointed if you expect liposuction to be an effective means to lose weight permanently. Liposuction is not proven to be an effective treatment for obesity.