Introduction
38 years old
laparoscopic gastric bypass
200-lb weight loss
BMI 37 1/4
3 weeks
12 1/2 lbs skin removed
sideways capital "H" incisions
The corset trunkplasty (or corset procedure) is a revolutionary new surgical technique for comprehensive contouring of the abdomen and waistline following significant weight loss. The procedure can be performed on a wide range of patients with various sized body frames and amounts of excess skin. It is designed to create an aesthetically-pleasing body shape which appears like that provided by a corset, yet it can be modified to highlight the waistline differently for women vs. men. In women, the design provides a very desirable hourglass figure; in men, it provides a nicely tapered torso.
Plastic surgeon, Alexander P. Moya, M.D., developed the approach in 2006 to better address the needs of his patients.
"I was looking for an alternative option to the most commonly performed trunk contouring technique, the belt lipectomy (lower body lift). I discovered that many of my weight loss patients were not good candidates for the procedure (had too many skin rolls or were still too heavy) or the procedure resulted in less-than-ideal overall abdominal and waistline shape (see photos below)."
"The belt lipectomy is not designed to address redundant skin along the upper abdomen and lower chest, which can negatively impact the overall waistline contour and leave many women with a shapeless figure. The corset procedure was developed to treat this mid-trunk region and can create a long-lasting feminine hourglass shape."
The corset trunkplasty requires several carefully placed incisions which interconnect and have the appearance of a sideways capital "H" (see top photos ). The incisions are customized to each patient to ensure the removal of as much redundant skin as possible.
"Performing all my skin markings while the patient is lying down on the operating table allows me to properly visualize and directly address areas of redundancy. Marking in a sequential fashion (each step completed prior to outlining the next area) allows me to individually tailor all of the incisions for maximal removal of excess trunk skin with a single procedure."
The corset trunkplasty has the added benefit of providing long term abdominal contour since it not only addresses the overhanging skin along the lower abdomen but also the often neglected loose skin of the upper abdomen. It can also remove excess skin of the lower chest, upper and lower back and hips as needed (see photos above).
"The abdomen is the most common area I treat following weight loss; thus it is not suprising that great long-lasting shape of this body area is of utmost importance. Removing as much surrounding flaccid skin as possible has a direct effect on stabilizing the abdominal contouring result. The corset trunkplasty, for the majority of patients, eliminates the need for a future secondary abdominal or waistline procedure due to relapse of overhanging skin."
Since the corset trunkplasty requires a patient to be positioned only once in the operating room and does not require a circumferential incision, it is easier to perform. For most patients the procedure can be completed in 4-6 hours. For those who have extensive skin rolls or larger frames, the procedure may take slightly longer.
BEFORE
31 years old
open gastric bypass
100-lb weight loss
BMI 41 1/4
"A corset procedure performed to its fullest extent can provide a 360 degree waistline improvement by removing the excess skin along the lower back (see photos) For many of my patients, this eliminates the desire to complete the belt lipectomy. Only 5% of them have pursued a posterior body lift (outer thigh/buttock lift) but 35% have undergone other forms of body contouring (arms to thighs)."
AFTER
6 weeks
back rolls treated
18 3/4 lbs skin removed
*combined with ventral hernia repair
"Since many of my weight loss patients seek the removal of excess skin from several body areas, a carefully formulated short- or long-term contouring plan is required for achieving the best overall results. Since the corset trunkplasty does not interfere with future body surgery (breast, chest or lower trunk), it can provide them with a strong foundation for additional stages of contouring success (see photos below)."
FIRST STAGE
CORSET TRUNKPLASTY
stable 360 degree full-length waistline improvement
10 1/2 lbs skin removed
SECOND STAGE
POSTERIOR BODY LIFT (combined with MEDIAL THIGHPLASTIES)
**AFTER
*BEFORE
56 years old
open gastric bypass
160-lb weight loss
BMI 33 1/2
second stage contouring
hip, outer thighs & buttocks treated
completes the lower body lift (back half)
5 1/2 lbs skin removed
The corset trunkplasty is usually performed on an outpatient basis, requiring just one overnight hospital stay, and the single drain used is usually removed the following day. Most patients experience less overall post-operative pain, resulting in a smoother recovery as opposed to the belt lipectomy.
For over three years, the corset trunkpasty has provided 80 patients with a slimmer body which now better reflects their weight loss. For many of them, the joy of finally looking and feeling normal overrides any concerns about scars. The procedure not only achieves its contouring goals, but also scores extremely high with overall patient satisfaction.
"Over the past several years, my patients have taught me that even though they may end up with lengthy and potentially visible scars, a normal body shape with a completely flat abdomen and full-length waistline is what makes them happy."
Alexander P. Moya, M.D.
Director, The Center for Weight Loss Body Contouring at Geisinger
