Q: Dr. Eppley, I am a 35 year old woman. I have attached some pictures for your reference. I would like you to give me your opinion on what you could do to make my shape more curvy. (widen hips, increase buttock projection and decrease waist, back and arms size) I think liposuction to the abdomen, flanks and back plus re-distribution to the buttock and hip area is certainly something I would like to consider.
As you can see in my pictures I also have had a breast augmentation and have been told that these are polyurethane, so they may be hard to remove. I would like your thoughts on what you may do to make my breasts slightly smaller and less projected, but more natural and rounded.
Could you tell me how long I would need to stay in hospital, then in the area before I fly home ( and details of how soon I can fly) Thanks!
A: Thank you for sending your pictures and providing your body contouring objectives. I believe you are correct in the approach to improving your body shape through a combination of aggressive liposuction of the abdomen, waist, back and arms with redistribution of the fat aspirate to your buttocks. That combined procedure has a name and is the well known Brazilian Butt Lift with assured body contouring benefits from the fat harvest and buttock augmentation from the liposuction ‘discard’.
In regards to your breast implants, these are harder to remove than smooth silicone shell implants but let’s not confuse harder with impossible. Most likely they have some degree of encapsulation which makes them look very ‘stuck on’ and firm due to the encapsulation. Removing the implants and their capsule with a slightly smaller volume implant should make them softer and a little less projected. It would ultimately be helpful to know what the implant volume is when planning their replacements and I would probably drop the volume down by about 50cc.
This type of body contouring surgery is done in my private surgery center, not a hospital, where the costs are much lower. Given that you are from afar, I would keep you overnight but you could go back to the hotel the next day. I would anticipate you flying home within 5 to 7 days after the procedure at most.
Dr. Barry Eppley
Q: Dr. Eppley, I had a stomach stapling done in June and have lost 56 pounds. I have had a tummy tuck, breast reduction and a brachioplasty ten years ago but have obviously ruined that. But now I’m on a healthy eating plan for life. I’m 64 years old and wondering what you would recommend for my body contouring. I have attached some pictures of how my disgusting body looks now.
A: Since you have all the scars from the prior procedures, you may as well take advantage of their existence and use them for skin and fat removal and overall tightening of the areas for your body contouring surgery. For your abdomen you need a fleur-de-lis extended tummy tuck to get rid of the loose skin in all dimensions. (horizontal and vertical) Thuis would need to extend around the flanks to chase the loose skin/dog ears. You would also benefit by a major breast lift, keeping all your existing breast tissue and lifting and tightening the breast mounds back up onto the chest wall. You can just use the breast scars that you already have. For the arms (which seem to have the least amount of excess and sagging skin) a repeat arm lift would be needed.
Most of these body contouring issues are fairly straightforward. The real question at age 64 is to not overdo any single operation and stress your body too much. While in younger patients I would do all three body contouring procedures together, that would be a lot for you to go through at your age. Thus I would recommend only the extended tummy tuck combined with at the breast lifts. These two procedures target the biggest problems that I see (and what most weight loss patients focus on the most) and would yield the single greatest body change.
Dr. Barry Eppley
Q: Dr. Eppley, I have never been terribly overweight, however, I can’t lose the belly fat. I would also like to take a few years off my face. Most people tell me I look to be about 45, I’m actually 56. My looks probably matter more to me than most people as I currently work in a very visible public position so I feel I need to look my best so I can stay in this business until I retire. I would like to know what I can get done and not have to be off work any long periods of time. I am very interested in liposuction of my stomach/butt/thighs/ and arms, possible facial work later.
A: Since body contouring in your primary focus for now, I will keep my comments to that area. The most important question based on your inquiry is what is the best treatment for your body fat concerns. The abdominal area is always the one body area where the debate is between liposuction and a tummy tuck. It has been my experience that most people assume that liposuction can do too much, that it can magically remove a lot of fat and tighten up a lot of loose skin. While liposuction is a very good fat remover, it can do little for excess skin. Thus whether it is an appropriate surgical method for your abdomen, arm, thighs and buttocks issues will require a physical examination to answer. My concern for you is that the desire for great body contour changes and little time of work often do not go together very well.
Dr. Barry Eppley