Lipectomy is a cosmetic surgery procedure to correct sagging skin and muscle after severe weight loss, pregnancy or quite simply, years. It can be worn on the stomach, thighs, arms or other areas of the body.

Lipectomy consists of removing excess skin and / or damaged skin (by stretch marks, scars, irregularities linked to fat deposits) and tightening the skin. It is in a way a facelift that corrects sagging skin and sometimes muscle.

One of the most common lipectomy procedures involves the stomach. This is called abdominal lipectomy, or called abdominaplasty or abdominal plasty. It also makes it possible to act on the muscular chain in the event of distension called diastasis of the rectus muscles (that is to say a relaxation of the abdominal strap) of congenital origin or following a pregnancy.

The posterior part of the arms (brachioplasty), the inner side of the thighs can also undergo a lipectomy.

Liposuction often complements lipectomy to remove excess fat.

The operation takes place under general anesthesia. It lasts 1 to 2 hours.

The surgeon first of all draws the incisions, carried out according to the location and the volume of the damaged skin:

• for an abdominal lipectomy, the incision can be circular, i.e. running around the abdomen if the sagging skin also affects the back, or in an inverted T-shape, flush with the pubis, if it does not concerns that belly. In the case of high-tension abdominoplasty, a first horizontal scar is made at the level of the pubic hair, a second around the navel;
• for arm lipectomy, the incision is located on the inner and posterior side of the arm and extends from the elbow to the armpit;
• for thigh lipectomy, liposuction of the inner thigh is usually done first before making an incision in the groin and below the buttock.

The skin, fat and superficial fascia are then lifted, the excess removed (dermolipectomy) and the skin tightened.

In the event of significant sagging skin in the belly, with the presence of an “apron”, the surgeon proceeds to a complete abdominoplasty called “abdominoplasty with umbilical transposition” (the navel being moved to be put back in its place). It eliminates the excess skin forming the apron, then straightens the remaining skin downwards. To improve the result and the maintenance of the skin, he can use the technique known as high-tension abdominoplasty: it performs a kind of padding of the skin on the muscles.

The scars are sutured by intra-dermal suture, with absorbable suture, and a modeling dressing is positioned around the belly, sometimes associated with a compression sheath.

Lipectomy is intended for people who have lost much weight, following bariatric surgery (obesity) for example, women after pregnancy, or even elderly patients whose skin has stretched and sagged with the weather.

In certain situations (history of bariatric surgery, twin pregnancy), abdominal lipectomy may be partially covered by social security.

Operative suites

The pain will be calmed by analgesics.

Bruising and edema are common after the operation.

In the event of abdominal lipectomy, wearing a compression garment is prescribed for two weeks. Wearing a sheath is recommended for 4 to 6 weeks for muscle repair, 2 to 3 weeks in other cases.

A work stoppage of 2 to 4 weeks is prescribed depending on the professional activity. It is not recommended to carry heavy loads during this period. 

The results

The result is appreciated after 3 to 6 months after the operation, the time necessary for the resorption of the edemas, but it takes a year to obtain the final results of a lipectomy, in particular at the level of the scars. These remain visible, the patient should be aware of them. Small imperfections in the scars can sometimes be retouched surgically, from the 12th month after the operation.

To maintain the results of a lipectomy, especially abdominal, it is important to maintain a healthy lifestyle (balanced diet, regular physical activity).

Complications

Some rare complications exist:

• phlebitis, prevented by wearing compression stockings and administering anticoagulants;
• an infection ;
• hematoma ;
• skin necrosis (favored by smoking which impairs the healing process).