Aesthetic surgical interventions on the body are a special challenge for every surgeon. In order to embellish the body contour, sometimes it is necessary to remove a subcutaneous fat tissue (liposuction) or to fill in the defects (lipofilling).

Sometimes it is necessary to correct a loose skin of the abdomen (abdominoplasty) remaining after the pregnancy or weight loss. In order for returning the volume of the gluteus or lower legs, it is desirable to insert the implants specially created for these regions.

Colic Hospital is the only clinic where total body lift is performed, a comprehensive surgery after a massive weight loss, by which an excess skin on the entire body is eliminated.

Objective

Re-shaping the body by removing fat deposits from various body parts, such as hips, thighs, back, upper and lower abdomen, “saddle-bags”, internal part of the thighs and knees, lower legs, ankles and inner part of the upper arms. The removed fat tissue may be filtrated as needed and put back into those body parts where there is a need for it (bumps, dimples, natural wrinkles, lip, cheekbone, bottom enhancing, etc.)

Operative technique

Through a minor skin prick, with special instruments (cannulas) inserted under the skin, aspiration of the fat tissue is performed. The cannulas should have various sizes and shapes (2-6 mm in diameter) in order to extract the fat evenly from all the layers. The aspiration process can be previously facilitated with inserting (infiltration) of the physiological solution with adrenaline for prevention of bleeding, as well as possible ultrasound breaking of the fat tissue.

Duration of procedure and anaesthesia

Depending on the affected regions, the liposuction can last 1–5 hours and is usually carried out in the peridural anaesthesia along with analgo-sedation.

Recovery

Return to normal activities after 5-7 days. Right after the intervention the patient puts on the corset that should be worn for at least three weeks for shrinkage of the excess skin.

Rare complications

Transitory appearance of bruises, suffusions (haematomas), as well as swellings that gradually withdraw within up to two weeks; transitory skin sensibility disorders, as well as possible smaller bumps, due to which an early post-operative massage and lymph drainage are recommended.

Objective

Improvement of shape and achievement of fullness of thin lower legs, as well as correction of lower leg asymmetry occurred as a consequence of some diseases or traumas. Similarly, the upper legs can be corrected.

Operative technique

The incision of 3 cm in length is made in the interior side of the knee, where, under the muscle fascia on the interior side of the lower leg, the space is formed in which the spindly silicone implant is later placed.

Duration of procedure and anaesthesia

The surgery is performed in peridural anaesthesia and lasts 1 hour.

Recovery

The sutures are removed after 10–14 days, and physical activities that require efforts of leg muscles, in terms of long walk or running, should be avoided for 3-4 weeks.

Rare complications

Swelling of the lower leg and rare haematomas; mild pain and other unpleasant sensations at long standing and efforts can sometimes last up to two months.

Objective

Enhancing, or lifting of the gluteus region or the bottom is performed by means of silicone implants or with the own fat tissue. Reduction and lifting of the same region is performed by liposuction described under body liposculpture or by bottom lifting (tanga lift).

Operative technique

The implants are inserted through a small vertical incision in the upper part of the gluteus fold, immediately under the pelvic bone, and that incision is common for both sides. The prostheses are inserted through it into the space between the gluteus maximus and middle muscle. A simpler way is to enhance the bottom with the own fat tissue previously extracted by liposuction from the region where it is in surplus (cellulite correction).

Duration of procedure and anaesthesia

The surgery is performed in the peridural blockade and lasts around 1.5 hours.

Recovery

Sitting difficulties in the first days after the surgery, the sutures are removed after seven days.

Rare complications

Swelling and discomfort at sitting in the first weeks following the surgery, as well as the implants positioned too high. Fast fat absorption or formation of small cysts is possible due to a large quantity of the fat tissue that has to be inserted.

Objective

Reduction of the upper arm perimeter by removing the excess skin an the subcutaneous fat tissue

Operative technique

The operative approach can be from the armpit, along the inner side of the upper arm or, as needed, in both places. By the previously marked drawing planned in detail, the removal of the excess skin and subcutaneous fat tissue from the mentioned region is performed. The drainage is usually not needed. In some cases, the reduction of perimeter can be achieved only by liposuction of that region or by combination of these two techniques.

Duration of procedure and anaesthesia

The surgery is performed in total anaesthesia and lasts around 1.5 hours.

Recovery

The sutures are removed between the day 10 and 14 after the surgery. Wearing of an arm fastener for up to 2 weeks is necessary.

Rare complications

Swelling, bruises, mild numbness of the arms.

Objective

Removal of the excess skin and subcutaneous fat tissue on all the body parts occurred as a consequence of a massive weight loss. For this operative intervention, the patient should be well prepared, should have had a stable body weight for the last six months and should not suffer from other severe illnesses.

Operative technique

Due to the large volume, this surgery is most frequently performed in two acts. The first act is significantly larger and includes abdominoplasty or removal of the sagging abdomen with strengthening the muscles of the anterior abdominal wall, removal of the excess skin from the hips and the back with shaping of the sitting region which gets a more rounded contour, as well as reduction of the perimeter of the thighs by lifting the skin and liposuction. In the same or in the next act, brachioplasty or lifting of the upper arms is performed, as well as possible liposuction of the lower legs. In the second act, several months later, a correction of the breasts is performed by reduction of the excess skin and adding the volume by silicone implants if necessary. In the same act secondary corrections of smaller irregularities are performed remained after the first surgery.

Duration of procedure and anaesthesia

The surgery is performed in total anaesthesia and lasts 6 to 8 hours. The patient usually remains in the hospital 3 to 4 days, and up to one week if necessary, in order to be under constant medical surveillance. The autologous blood transfusion is almost always applied in this period, due to a comprehensive surgical intervention, as well as administration of other preparations and strong antibiotics necessary for faster recovery. The sutures are usually removed in two weeks’ time, while the elastic corsets are worn for one month approximately.

Complications

Decline of the blood count values in the immediate post-operative course that is solved by quick blood transfusion; swelling bruises, irregularity of scars, slow healing of some parts of the wounds are usual, but rare complications of each surgical intervention.