STATUS POST GASTRIC BYPASS, MOMMY MAKEOVER, TOTAL BODY RECONSTRUCTION
The patient below presents with a 125-pound weight loss after a laparoscopic banding procedure leaving her with severe asymmetry, grade 3 ptosis (right breast significantly larger than the left with asymmetry), a significant abdominal pannus, skin laxity, rectus diastasis and lipodystrophy of the hips. The patient is now two months postoperative with 500 cc high profile Natrelle saline implants placed in the dual plane technique, formal mastopexy or Wise-pattern skin excision was performed, creating a tightening procedure of bilateral breast, as well as a full abdominoplasty with plication tightening of the rectus sheath and liposculpturing of the muffin-top area was accomplished. Preoperative photos show severe asymmetry requiring slightly different volume implant placement (right smaller than left in terms of volume of implant size) and bilateral complete mastopexies reducing the large areola to 4.2 cm. Notice the right areola preoperatively was approximately 9 cm wide. She also has skin laxity in the lower abdomen which requires a full abdominoplasty with plication of the midline muscles of the rectus sheath. Her oblique views show excellent contouring with nice fullness to the upper pole of her breast associated with the high profile saline implant. She has good nipple positioning without skin laxity along the inframammary fold. The lower abdomen shows nice concavity with tightening of the rectus muscles, excellent definition of the midline and smoothing out of the hip region. Patients who undergo gastric bypass surgery from Rouen-Y procedures, gastroplasties or laparoscopic banding, once they have lost a significant amount of weight, reaching the baseline, will do well with reconstructive surgery of both the breast and abdominal areas, as this patient is an excellent example.