15839 Excision, excessive skin and subcutaneous tissue (includes lipectomy); other area

Name of the Procedure:

Excision, excessive skin and subcutaneous tissue (includes lipectomy); other area
Common names: Skin excision, Lipectomy, Body contouring surgery

Summary

The procedure involves the surgical removal of excess skin and subcutaneous fat from various parts of the body. It’s commonly performed to address sagging skin resulting from significant weight loss or aging.

Purpose

This procedure addresses issues of excess skin and fat which can cause discomfort, skin irritation, and self-esteem concerns. The goal is to improve the contour and appearance of the affected area, alleviating physical discomfort and enhancing the patient's quality of life.

Indications

• Significant weight loss resulting in loose, sagging skin
• Skin redundancy from aging
• Skin irritation or infections due to excess folds
• Patients who are at a stable weight and in overall good health
• Individuals seeking to improve body aesthetics after weight loss or bariatric surgery

Preparation

• Patients may need to fast for a certain period before the surgery.
• Blood tests and a physical examination are typically required.
• Patients may need to adjust medications, especially blood thinners, as per the doctor's advice.
• Smoking cessation is advised several weeks prior to surgery to promote better healing.

Procedure Description

1. Anesthesia is administered to ensure the patient is comfortable; this may include general anesthesia or local anesthesia with sedation.
2. The surgeon makes careful incisions in the predetermined areas.
3. Excess skin and fat are excised.
4. The remaining skin is repositioned and sutured to achieve a smoother, tighter appearance.
5. The incision sites are closed with sutures, and sometimes drainage tubes are inserted to prevent fluid accumulation.
6. Surgical dressings are applied to protect the area and support healing.

Tools and equipment: Surgical scalpel, sutures, drainage tubes Anesthesia: General or local with sedation

Duration

The procedure typically takes 2-5 hours, depending on the extent of the surgery and the areas involved.

Setting

The procedure is performed in a hospital or an accredited surgical center.

Personnel

• Surgeon
• Anesthesiologist
• Surgical Nurses
• Surgical Technicians

Risks and Complications

• Common risks: Scarring, infection, seroma (fluid accumulation), hematoma (blood accumulation)
• Rare risks: Deep vein thrombosis, pulmonary embolism, complications related to anesthesia
• Management includes appropriate wound care, antibiotics for infections, and monitoring for signs of complications.

Benefits

• Enhanced physical appearance and body contour
• Relief from physical discomfort caused by excess skin
• Improved self-esteem and confidence
• Benefits are usually observed within a few weeks post-surgery as swelling decreases

Recovery

• Patients may need to stay overnight or go home the same day, depending on the extent of the surgery.
• Post-operative care includes dressing changes, management of drainage tubes, and medication for pain and infection prevention.
• Physical activity restrictions for several weeks, wearing compression garments may be recommended.
• A follow-up appointment is necessary for monitoring healing and suture removal.

Alternatives

• Non-surgical options: Laser therapy, radiofrequency treatments, which may offer minimal improvement.
• Pros: Non-invasive, minimal recovery time.
• Cons: Less effective for significant excess skin and fat.

Patient Experience

• During the procedure, patients will be under anesthesia and should not feel pain.
• Post-procedure, patients may experience discomfort, swelling, and bruising.
• Pain management typically includes prescribed medications.
• Full recovery and return to normal activities take several weeks to months, with gradual improvement in the surgical area.