Removal of excess skin and fat from the lateral chest wall
Overstretched skin around the torso as a result of obesity, followed by deflation caused by weight loss, results in multiple functional and aesthetic irregularities in the lateral chest wall area. Irregularities typical of post-bariatric patients include inelastic, sagging skin (dermatochalasis) with scattered stretch marks and folds susceptible to continuous irritation. In addition to skin loosening, deep connective structures are damaged and muscles relaxed. Moreover, fat deposits may persist. Of course, the natural ageing process, with or without weight loss, contributes to a progressive loss of skin elasticity in this area. Correction of these deformities is essential to improve the lateral breast contour as the definition of the lateral mammary region is lost in both men and women, especially after extreme weight loss.
The torsoplasty procedure is made up of two phases:
- excision of the excess, loosened skin
Liposuction allows removal of fat deposits and contouring of fat tissue in neighbouring areas (liposculpture). It also seeks to minimise intra-operative bleeding and save lymphatic and blood vessels intact; these structures would be damaged if incorporated in a full-thickness excision. Liposuction allows fat removal and skin-only excision.
Skin excision is performed by removing a triangle of skin from the lateral chest wall. This results in a “J” –shaped scar, which runs from the underarm downwards, along the lateral breast contour in women and along the lateral pectoralis muscle contour in men. Scars run at the bottom of natural grooves, so are less conspicuous. Prior to careful application of a skin suture, the underlying connective fascia is tightened and secured to the ribs with a deep sturdy suture. This avoids postoperative scar descent, due to gravity, so the final result will be more stable in functional and aesthetic terms. Only deep, dissolvable sutures are used.
Skin tension on the scar will be minor, which is essential to achieve better scar development.
Torsoplasty is performed under general anaesthesia (the patient is asleep) with a one-night hospital stay after the surgery.
Careful administration of pain-killers during and after the surgery ensures that post-operative pain and discomfort are kept to a minimum.