Here in Brazil, we call the Tommy-Tuck surgery as Abdominoplasty. This cosmetic procedure treats loose or sagging abdominal skin, leading to a protruding abdomen that typically occurs after significant weight loss. The ideal candidates for abdominoplasty are individuals in good health who have one or more of the above conditions and who have tried to address these issues with diet and exercise with little or no results.
It may be reductive, augmentation (Implants) and fixation (Pexia). In this topic we will deal with the reduction and pexia of the breasts. This procedure is designed for the removal of excess fat or mammary gland, as well as flaccid skin, making the breasts firmer, smaller and lighter. During the procedure the size of the areolae is also reduced in proportion to the size of the breasts. Reduction of breasts is also performed in men, either by excessive weight loss or by maintenance of the enlarged gland after adolescence, but we use the term Gynecomastia Correction.
The breasts are rigid right after puberty by the excessive amount of gland in relation to the proportion of breast fat. Over the years, there is a decrease in the amount of gland, an increase in fat and a tendency to fall in the breast (ptosis). Considering that once a gestation has occurred, with enlargement of the breasts, this will be an important factor in the acceleration of the mammary ptosis. The mammoplasty aims at reversing this condition by suspending the breast and removing excess skin and breast tissue. It is indicated for the reduction of bulky breasts and for the suspension of ptosed breasts. The procedure is also indicated for correction of asymmetries (disproportions) between the breasts.
In men there is the possibility of correction of gynecomastia with liposuction associated with removal of the residual gland by infra-areolar or periareolar incision in cases of mild to moderate gynecomastia. But for large gynecomastia only resection of the skin will allow adequate adaptation of the body contour.
Liposuction is a well-known technique for treating localized fat areas through the body, using small cannulas with holes distributed along it, coupled to different suction systems, with or without vibration. Removal of the fat reservoirs promotes definition of the body contour, it can help sagging because during the cicatricial process, the skin will react to the trauma produced and there will be some contraction, which should be properly conducted by a dermatological-functional physiotherapist. Liposuction should not be used for weight loss because it does not lend itself to this indication, producing unfavorable results in patients who are still obese.
Brachioplasty is a surgery that aims to remove the skin surplus generated by the sagging skin of the arm (triceps region) that gives the impression of displaying a flag unfurled when saying goodbye to someone. It is a procedure very sought after by women, especially after great slimming like the one generated by gastroplasty. This flaccidity is not old enough to appear. The triceps brachii muscle, the one that moves when doing good, even stimulated or piebald will not end to fill this sagging, because that would give a male aspect to the arm. Hard to hide sagging, except for clothing along the arm, but easy to treat. Through relatively simple procedures such as local liposuction (for mild cases), or with an incision along the arm (for larger cases), it is possible to restore dignity to the contour of this area.
Like brachioplasty, the thigh lift proposes to put an end to that unwanted sagging, but between the thighs. This procedure is sought by both men and women over 30 years or who have suffered great weight loss that have marked sagging in this region, without being obese yet, because excessive weight in this place can harm the end result. The procedure has benefits for the quality of life, since it eliminates the friction between the thighs, which causes that darkened aspect, folliculitis of repetition (inflammation of the hair), besides hindering walking (walking) and even intimate hygiene and activities sexual relations.
There are some technical variants regarding the design of the resection area, one along the groin (indicated only for minor flaccidity) and another that forms a T that encompasses the groin and inner portion of the leg, varying the extent according to the degree of sagging.
There are cases in which only a small local liposuction is able to remove the excess fat and produce the fibrosis necessary for the repositioning of the skin, however the difference between the facelift is that the lipo has as an exclusive purpose the aspiration of the volume between the thighs and the facelift is able to remove excess skin and repositioning it, promoting local improvement. It is clear that procedures can be associated for a better outcome.
Facial Surgery are performed too. We are still developing this area.