Trish: I’m here today with Dr. Tim from Cosmetic Culture, and they’re based in Penrith, Pyrmont and Lane Cove, in Sydney. Thank you so much for taking the time to talk to us today today.
Dr. Tim: Thank you for having me.
Trish: We’re going to talk about body lift. It’s one of the procedure I’m passionate about. Can you tell us a little bit about the body lift. What actually is the body lift procedure?
Dr. Tim: In a nutshell, the body lift is really just taking out a tyre, if you like, of tissue, which is skin fat around the body. You can either take a tyre that’s very low on the body so that you’re lifting up more of the buttock or you can take a tyre a little bit higher up that’s giving you a better waistline. It’s really taking a tyre of tissue right off the body and then re-opposing the two edges of the skin and tissues.
Trish: Like the tree rim.
Dr. Tim: Yeah, it’s like a tree rim.
Speaker 1: Who is this procedure good for? Who is the best candidate for it?
Dr. Tim: It’s typically aimed for patients who have bariatric surgery. Whether they’ve had a a gastric sleeve or whether they’ve had lap banding, or in patients who’ve actually been very very disciplined; been really good with diet and exercise and they’ve had a massive weight loss. By definition, over 20 kilograms, and we have patients who’ve lost up to 70 to 90 kilograms so half their body weight. What they’re generally left with is a lot of excess skin that drapes like an apron over their mons pubis. Sometimes halfway down their knees and it’s pretty hard to get around like that.
Trish: With the massive loss weight patient, is there any help with Medicare. I know for a fact that it’s one of my passions, the massive weight loss, because I am that person, but is there … I speak to women all day that have got band infections under there… their skin’s hanging over… Is there any help with Medicare?
Dr. Tim: Yeah. Medicare at the moment, the item numbers are constantly evolving, and as you know they’ve made it much more difficult now for women to have abdominoplasties or tummy tucks. The current guidelines are: that if the patient has intertrigo rashes underneath an apron, that also may affect the skin integrity so they may lose further skin either due to maceration or due to infection, that’s been unrelieved with at least 3 months of medical treatment; it affects activities of daily living; and the fact that the weight’s been stable for about 6 months; then they may be eligible for a Medicare item number at the moment.
Trish: If they’re eligible for an item number that means they’re covered by a certain portion of it?
Dr. Tim: Yeah. It depends whether they’re self funded or whether they’re in a health fund and what grade of health fund they’re in and so forth. They can get that. They can get an estimate of the costings based on not only the item number but how long the procedure takes. The procedure varies because the bigger you are the more weight you’ve lost, then generally the longer the time it takes to actually take off that excess tissue. For me, a body lift, because I do it pretty much all by myself, takes 6 hours. In some instances it can take up to 9 hours to do.
We also do, in other patients who we don’t really do body lifts but we do what’s called panniculectomies. They are really big patients who can’t exercise or they are unable to have bariatric surgery because they aren’t fit for it. They might have health issues, they may die under the anaesthetic. In those patients what we do is we just amputate the apron. That can take a long time as well. I had one patient where I took 36 kilograms off just doing that alone.
Trish: Wow. I’ve seen pictures of some of the work you’ve done. It’s amazing. How long is a patient in hospital for?
Dr. Tim: The patients, usually around a week. Sometimes we’ve had patients who’ve got out a little bit earlier, about 5 days, but generally I would say about a week before they go home.
Trish: Is there any preparation before that would be … I just recently had surgery myself and I took lots of vitamins before and I recovered like that. Is there any preparation that …
Dr. Tim: A lot of patients who’ve had bariatric surgery can actually be nutritionally deficient or anaemic. What we do in those cases, we either send them to the GP or we send them to a physician, who whether it’s a haematologist or endocrinologist to make sure that their hormones, their iron levels are up to scratch and that they have adequate healing capacity, so they might put them on multivitamins and so forth. Yeah, we do all that before hand.
Trish: I would advocate for not traveling overseas for any sort of surgery as far as I’m concerned. Can you tell us, especially with a body lift, why you would … tell me about your aftercare… what you don’t get if you travel. What would you care for aftercare in Australia for body lift?
Dr. Tim: Well, body lift is a big procedure obviously, so one of the highest risks of body lifts is having a deep vein thrombosis and pulmonary embolism, so we take certain measures to stop that. For example we have stockings on the patient, calf compressors until they’re fully ambulant. We give them anticoagulants, we have our theatres relatively warm and also give the patient ambulant the next day, pretty much with the physiotherapist and so forth. We pay very close attention to all that, which is physio and so forth.
The way we deal with body lifts is that we keep a very close eye on them. We do the operation, we see the patient during the hospital stay and we also see them a week later. Generally, we see them weekly for their dressing changes but I’ll probably see them at 3 weeks in a little bit more detail, then at 6 weeks, 3 months, 6 months, year. Then they’re part of your practice for a long time, and you’ve got to be on their back that they don’t change their diet. They continue to exercise and look after themselves, because they’ve invested so much money and time. It’s the time that’s your biggest currency nowadays, not so much the money, that you really want to maintain for as long as possible.
Trish: The effort to lose all the weight, to get to that point in the first place.
Dr. Tim: Absolutely.
Trish: Right. Thank you so much for taking the time today.
Dr. Tim: It’s been a pleasure Trish.
Trish: My pleasure.
Dr. Tim: Thank you for having me.
Trish: Thank you. Bear in mind if you’re looking or having a procedure like this, it’s a big thing. I’ve recently spoken to a lady who’s had one and her recovery after it was huge, and I can’t even imagine what that would have been like overseas. Do your research and if you want to know some more info, drop us an email at firstname.lastname@example.org. Thank you.
Dr. Tim: Thank you.