Dr. Marcelo Wulkan

Body Contour After Massive Weight Loss: Wulkan-Hurwitz Center For Plastic Surgery

Body contouring surgery can help to restore a more normal contour by removing and tightening large amounts of skin. If you have undergone dramatic weight loss either through diet and exercise or bariatric surgery, and you are at your ideal weight loss goal, you may be a good candidate to have this procedure.

Dr. Wulkan’s technique was learned at Harvard and University of Pittsburgh as well as with Brazilian renowned plastic surgeons. Dr. Wulkan became the exclusive representation in Brazil and South America of one of the most experienced center for body contour after massive weight loss: The Hurwitz Center for Plastic Surgery (www.hurwitzcenter.com). Dr. Hurwitz is a surgeon of more than 25 years in the field of plastic surgery and has created many post- bariatric surgery body contour procedures including Total Body Lift. This partnership is unique and lead to the creation of the Wulkan-Hurwitz Center for Plastic Surgery in order to help patients from the US, Brazil and around the world to have a state-of-art and complete treatment for their goals.  

Body contouring is often used for patients who have successfully lost considerable weight and have excess skin and fat in target areas (e.g. post bariatric surgery). We consider body contour as the last step of a long journey for helping the ex-obese patients. After significant weight loss, patients present less symptoms and lower risk of weight-related disease; however, a side effect emerges as excess skin hanging loose over a slimmer body. About 16-24 months after bariatric surgery, it’s the time for post-bariatric plastic surgery. Dr. Wulkan waits for this time to ensure that physiologic changes and weight loss have been stabilized. A comprehensive medical work-up is always performed and the treatment plan can change depending on a patient’s health appropriateness.

Body contour after massive weight loss is the only way to lift and contour sagging skin of arms, breasts, abdomen, buttocks, thighs or other areas. Although usually it’s a trade-off scar length x contour, Dr. Wulkan’s patients usually believe it’s a worthwhile and life changing procedure.

Welcome to your new body! Welcome to the Wulkan-Hurwitz Center for Plastic Surgery.

Body Contour Procedures for the Massive Weight Loss Patients

• tummy tuck (abdominoplasty) • panniculectomy: is a more functional operation that is designed to remove only the overhanging skin below the infra-abdominal fold.

• arm lift

• breast lift

• breast augmentation

• breast reduction

• male breast reduction

• thigh lift

• liposuction

• buttock augmentation (“brazillian effect”)

• face

Total Body Lift

Dr. Hurwitz has created a standardized surgery to treat most of the body areas at the same time: it’s the Total Body Lift.  Our most successful total body lift patients are those who have lost substantial weight recently and have retained excess skin that sags. The body lift is an excellent option that is proven to create exciting results. Likely candidates are those who need improvement in the areas of the abdomen, thighs, back, and breasts.

As with all of Dr. Hurwitz’s and Dr. Wulkan’s surgical procedures, the total body lift will be customized to meet your individual needs. In most cases, two horizontal incisions are made. One incision will be made along the waistline and another will be made just below the breast line, at which point the entire skin flap is lifted. Dr. Wulkan will be sure to discuss their method in detail with you to ensure that you are a good candidate for this procedure and if your needs and concerns are addressed.

Combined procedures

Multiple procedures at the same setting are usually possible and patients can benefit from shared recovery times and cost. Patients may be submitted to any of the procedures listed above, but the most common combined procedures are Lower Body Lift and Upper body Lift.

Lower Body Lift and Upper body Lift.

The classic procedure for post-bariatric body contouring is the Lower Body Lift, also known as Circumferential Abdominoplasty, or Trunk Lift, or Extended Abdominoplasty. This procedure involves a traditional tummy tuck for the anterior abdomen, but also excision of excess fat/skin in the hip area extending into the back (above the buttock area). It also lifts the lateral thigh/buttock area at the same time, to create a more balanced contour.

Lower Body Lift and Upper body Lift.

The classic procedure for post-bariatric body contouring is the Lower Body Lift, also known as Circumferential Abdominoplasty, or Trunk Lift, or Extended Abdominoplasty. This procedure involves a traditional tummy tuck for the anterior abdomen, but also excision of excess fat/skin in the hip area extending into the back (above the buttock area). It also lifts the lateral thigh/buttock area at the same time, to create a more balanced contour.

Body Contour After Massive Weight Loss– What to Expect

• Anesthesia – body contour is performed under general anesthesia on inpatient basis.

• Surgery Length – because of the custom nature of this sort of surgery, exact times cannot be given. Dr. Wulkan will be able to give you a better estimate at the time of your consultation.

• Surgical Setting – body contour procedures are performed only in Joint Commission International (JCI) hospitals, the most important healthcare certification group. This accreditation focuses on patient safety and continuous quality improvement.

• Medication – pain medication is prescribed and typically used for 2 or 3 days after surgery. Antibiotics are used for 7-10 days.

• Post Surgery – Dr. Wulkan’s technique uses mostly internal sutures so there will be few stitches to be removed after 7-14 days. Sometimes he may choose to use tissue adhesive and/or surgical tape to aid the healing process. Bandages are applied right after surgery to minimize movement. Patients may shower the second day after surgery because Dr. Wulkan is optimistic with reduced recovery time for his patients. Dr. Wulkan has observed that this helps his patients to feel refreshed and able to move up and about. Once the bandages are removed, a specialized compressive garment will need to be worn for several weeks. The result is immediate and there will be swelling that will subdue in 2-4 weeks. Drains are placed and remain for 1-2 weeks. Bruising, crusting and slight changes in the operated areas are also common; numbness and firmness may persist for few weeks but do not affect appearance. Light exercise is permitted at 6 weeks and vigorous exercise can be resumed 6 to 8 weeks after surgery. It requires a patient with a positive attitude and desire to follow instructions, and a surgeon dedicated to meticulous and very gently surgical techniques. For security reason, as a foreigner patient, you´ll be able to take an airplane back to your house after 14-21 days and as long as you are in perfect conditions. Please contact our office to know more details about your case. Dr. Wulkan requires that we are put in touch with a local physician that will be willing to help take care of you with our recommendations, once you return home.