Corset Trunkplasty

A corset trunkplasty is a plastic surgery procedure designed to help patients who have had massive weight loss of more than 50 pounds through diet, exercise, or surgery. It is an operation specifically tailored to these patients. The corset trunkplasty adjusts both the anterior (frontal area) of the abdomen and the back side of a patient by removing excess skin as well as providing a lift in the buttock and thigh area.  

It is similar to a tummy tuck in terms of what is happening on the anterior side. However, a corset trunkplasty extends around the back in order to get the desired results. There is also an additional incision in some patients who have laxity in the anterior portion of the abdomen that will not be affected by just removing tissue at the bottom. They require a vertical extension of the incision called the fleur-de-lis pattern in the central portion of the abdomen.

IDEAL CANDIDATES

Patients who have lost more than 50 pounds and have been weight stable for several months are the best candidates for the surgery. It is typically not for patients who have lost 20 pounds or who had a baby and just want to snap back. It is best for patients who were morbidly obese at one point and then lost a significant amount of weight. Patients who wish to receive a corset trunkplasty must optimize their nutrition. The goal of this procedure is to rejuvenate the abdomen area after the post weight loss deformity sets in on the patient.

BODY LIFT COMPARISON

When performing a corset trunkplasty, some doctors make a separate incision in the upper portion of the abdomen, and others do not. It is an incision like one of a tummy tuck, plus the vertical extension in order to help contour the anterior abdomen, and then a circumferential incision.

A body lift really focuses on removing the excess skin and bringing up the lateral thighs. Depending on the surgeon, they might be doing these things at the same time. The most important thing for patients is to go to a board certified plastic surgeon and discuss their plans and specific goals because what one doctor calls a corset trunkplasty might be considered a body lift by another doctor. There are specific risks that need to be addressed in order to get the best outcome possible.

MINIMALLY INVASIVE ALTERNATIVES

There are not really any minimally invasive alternatives when it comes to corset trunkplasty. Think of a balloon that loses air and never returns to the same shape as when it came out of the package. The same thing happens in the skin. Minimally invasive procedures, such as liposuction with skin tightening, have a limit of what can be successful. In a patient that has a deformity after losing more than 50 pounds, it is unlikely for liposuction to correct those things alone.

SAFETY FIRST

Safety is obviously the first concern with any patient. There are parts of the technique that limit unnecessary or over-excision of the skin. The surgeon starts with serial strip excisions as they go from one point to the other to make sure they are removing a safe amount of skin. The surgeon does not commit to both sides of an incision before he has an idea of how much can actually be pulled and closed. After the operation, patients have a fair amount of swelling. Taking too much skin and pulling the incisions too tight can cause significant wound healing problems.

RISKS

One of the biggest risks is DVT, or deep vein thrombosis. This can lead to a pulmonary embolism and that can be a fatal complication. Infection, bleeding, fluid collections, and wound breakdown after surgery are also potential complications.

RECOVERY

A trunkplasty is a long operation that takes about 6-8 hours depending on the size of the patient. In most cases this requires an overnight stay in the hospital to make sure that the patient is adequately hydrated, walking around, and can be monitored for early postoperative complications such as bleeding.

It takes about six weeks before the skin is about 50% of its normal strength. If there is any work in terms of correcting a diastasis recti or abdominal muscle laxity, those areas also need about six weeks before the patient is ready for more aggressive exercise and motion.

It takes about a month and a half before patients start to do almost all of their daily activities. Patients that do manual labor such as working in a factory will be off for several weeks until they can tolerate regular work duty. People doing a desk job that does not require them to perform heavy lifting can go back as soon as they are off the pain medications.

RESULTS

If a patient re-gains weight, there is a chance that the skin will stretch once again. This why weight stability prior to as well as after surgery is very important.

After the surgery, the patient might gain weight in other places and it might not necessarily be proportional. Patients need to make sure their nutrition is optimized to prevent wound healing problems that might impact the final results.

SCARRING

The biggest trade-off in these types of surgeries, and in all of body contouring, is that the patient is trading skin for scar. The scars are made in places that can be covered with pants. A one piece bathing suit will suffice if there is a midline scar to cover.

FINAL THOUGHTS

Only an experienced plastic surgeon can determine who is an ideal candidate for body contouring procedures after massive weight loss.  Thankfully many patients who have lost a lot of weight also decrease the amount of co-morbid conditions they have such as diabetes and hypertension. This makes them a better candidate for future surgery, but they need to make sure they are medically optimized prior to surgery. They will have to schedule a consultation with a board-certified plastic surgeon to make sure they are an ideal candidate for the procedure. It is best for a patient to wait until they are medically optimized prior to undergoing any plastic surgery procedure. 

Written by Cosmetic Town Editorial Team- MA

Based on an exclusive interview with Jacob Bloom, MD in Northbrook, Illinois