Lower Body

Buttock Lift:

Many times, especially after massive weight loss there is excess skin that remains. This can cause self consciousness, discomfort, and often times can interfere with your day to day activities. There are several options to help with this condition and one of them is a buttock lift. When you have a buttock lift an incision is made across the lower portion of your back to allow access for Dr. Nuveen to excise the extra skin and tighten what is left. This procedure will smoothen and contour your buttock area and can result in a dramatic reshaping of the entire backside. If you are looking to not only tighten the buttocks but also add volume and projection you may be a good candidate for a buttock lift with implants. If you would like to combine buttock implants with this procedure and that can be further discussed in your one on one consultation.

As with any surgery there are risks associated with this procedure, common risks are breakdown of the incision, swelling, bruising, infection, and hematoma. As with any surgery, smoking greatly increases the risk for severe wound breakdown and we recommend you quit smoking prior to having the procedure.

Thigh Lift:

If the skin on your inner thighs is droopy or saggy then you may be a perfect candidate for a thigh lift. Many times patients who have had massive weight loss are left with unwanted skin that causes discomfort, insecurities, and can really interfere with day to day activities. A thigh lift is a way to get rid of excess skin and to smoothen and contour your thigh area. If you are in relatively good shape, are at a stable weight, and have excess skin that will not respond to diet and exercise than you are an ideal candidate for a thigh lift. It is important to note that if you intend to lose a lot of weight it is a good idea to wait until you are at a stable weight before having this procedure.

The thigh lift is performed by making an incision in the groin and inner thigh area, once the incision is made the excess skin is removed and then tightened.

As with any surgery there are risks associated with having a thigh lift, the most common risks are breakdown of the incision, bruising, swelling, hematoma, and infection. As with any surgery, smoking greatly increases the risk for severe wound breakdown and we recommend you quit smoking prior to having the procedure.

What to Expect in Recovery:

Healing:  How quickly and easily you will heal depends on a number of factors such as your genetic background, your overall state of health and lifestyle (exercise, diet, smoking, drinking, etc…).  Many people believe your doctor is solely responsible for the healing process, but no one person can make another heal.  Dr. Nuveen can facilitate (but not accelerate) your healing but you must also take an active role in that process.  Your cooperation and close attention is extremely important when it comes to your post-operative healing.

Another MAJOR factor in the course of healing is how well you follow the instructions that are given to you by Dr. Nuveen.  You will receive verbal instructions as well as written instructions after surgery and it is imperative that you follow those instructions. We set those guidelines for you to promote your healing process and to prevent the occurrence of any complications that can interfere with your recovery.  It is crucial that you recognize that you are a partner in this process and have a responsibility to follow instructions carefully.  The instructions we give you are designed to give you the best opportunity for healing without delay or surprise.

Your first 48 hours:

If you are going home, a family member or friend must drive you because you have been sedated.  Someone must stay overnight with you.  If you choose to stay overnight in our guest suite you must have an adult caregiver to stay with you or a caregiver can be provided for an additional fee.  

Activity:  Take it easy and pamper yourself.  Try to avoid any straining.  You may go to the bathroom, try to get up and move a little every hour, but take it easy.  No matter how good you feel please do not clean house, rearrange your attic, etc….We do not want you to bleed and cause any more swelling and bruising that is unavoidable.  Use common sense as your guide.

Ice packs:  We recommend using cold or ice packs for the first 48 hours to help reduce swelling, bruising, and pain.  Use frozen peas in the package or crush ice cubes and the ice into a zip-lock bag.  Using ice after your procedure should help, not hurt so if the ice feels too uncomfortable don’t use it as often.  Leave the ice in place no longer than 20 minutes per area.

Diet:  If you have any post-operative nausea, carbonated sodas and dry crackers may settle the stomach.  If nausea is severe, use the Phenergan suppositories you were prescribed.  If you feel normal, start with liquids and bland foods, and if those are well tolerated, progress slowly back to your regular diet.

Alcohol:  Alcohol dilates the blood vessels and could increase post-operative bleeding.  Please do not drink until you have stopped taking the prescription pain pills, as the combination of pain pills and alcohol can be dangerous.

Smoking:  Smoking may adversely affect wound healing and cause loss of skin and tissue death.  Smoking reduces arterial (blood) oxygen supply which is necessary for normal wound healing.  Exposure to second hand smoke has also been implicated in delayed or abnormal wound healing.  It is best to avoid smoking &/or exposure to second hand smoke in the post-operative period while your incisions are healing.  Nicotine causes blood vessels to constrict and may interfere with normal wound healing.  When blood vessels constrict there is less blood supply that can get to the wound which means less oxygen for normal healing to take place.  You should avoid cigarette replacements such as nicotine gum, patches or the inhaler during your post-operative period as these have similar effects as smoking and second hand smoke.

Driving:  Please do not drive while taking prescription pain pills.  Please be advised that all medications may impair judgment and the ability to drive or operate heavy machinery.

How to Care for Your Scars After Surgery:

Our practice is dedicated to making your entire surgical experience enjoyable. Healing is the Great Variable!!!  The same procedure can be performed on a thousand different patients using the same surgeon, tools, and approach. Even with these constants, some scars will heal better than others.  Incision care post-operatively can increase the appearance of your scar.  We are dedicated to utilizing evidence based practice in providing you with the most up to date information, to ensure you get the results you are looking for.

What is a scar? Think of scarring as a visible healing act. In the beginning stages of recovery — usually the first two to three months — your scars may be very apparent and pronounced. This is normal healing. As time goes by the scars will slowly become smaller and less visible. It may take up to two years for skin to fully heal from surgery. By then, scars are considered "mature" and you will see their final outcome.

What can you do to improve the appearance of your scars?  In the initial stage post-operatively, do not pick at the area, or rub abrasively.  There may be skin glue along your incision.  This can last for several weeks post-operatively.  It will begin to slowly come off on its own.  Nearly all sutures are self dissolving.  Keeping the self dissolving sutures moist with Vaseline will help them dissolve faster.  After the skin glue is off and the area is fully closed, a scar cream needs to be applied to improve the color and appearance of the incision.  Maintaining a well balanced diet with an emphasis of Vitamin E and C will prepare your body for healing.

What scar cream to use?  We recommend over the counter scar creams (Mederma, Scar Guard, etc.) and Dermatix, which we sell in our office.  Mederma is a good product for scars on the hands or face.  Dermatix is recommended for larger incisions on the body, such as those from breast augmentations, breast lifts/reductions, tummy tucks, and brachioplasties. Dermatix, from Valeant Pharmaceuticals is a transparent, self-drying silicone gel that will significantly reduce the appearance of scars. Dermatix flattens, softens and smoothes scars, relieving the itching and discomfort, as well as reducing discoloration.

Variation in healing?  There are many factors that go into how a person will scar. A few examples include age, location, genetics, and lifestyle.  Exercising, eating a well-balanced diet, and abstaining from smoking all assist in healthy blood flow, which ultimately plays a significant role in scar healing. Our practice would like to give you the information and products that you need to have the very best results possible.

Family and Friends:  Support from your family and friends is very helpful during your recovery.  But because they may not understand what is normal in your post-operative care, their comments may unintentionally create emotional turmoil for you.  You can trust that we will tell you honestly how your progress is and what we expect your results to be.  Please trust in our knowledge and experience when we evaluate your progress.  We know it is difficult not to compare your recovery with other people you may know who also had cosmetic surgery, but it’s imperative to remember progress varies greatly patient to patient and everyone has a different recovery.

Cosmetic surgery has certainly become less taboo in the past decade,  but your friends may still be reluctant to bring it up and discuss it because they think it may be a private matter to you.  Patients occasionally feel upset that “no one noticed” or “said anything.”  If you are comfortable discussing your cosmetic procedure then you should do so openly.  When people ask how you are, respond saying “I feel wonderful. I just had cosmetic surgery and I’m recovering.”  This lets people know that they may talk freely with you.  Often if you will open up about your procedure you will find that your friends and acquaintances are very interested in discussing it with you.

One potential drawback after surgery that can take places is that quite frequently patients experience a very brief period of “let down” or depression after cosmetic surgery.  Some may subconsciously have expected to instantly look and feel better, even though they rationally understand that this will not be the case. You will be told what to expect during your recovery but the incisions can still come as a shock sometimes to see the initial results. Patients commonly question their decision to have surgery during the first few days after surgery because it’s hard to imagine the incisions once they are healed and everything has settled into place.  As the healing occurs, these thoughts usually disappear quickly.  If you feel depressed, understanding that this is a “natural” phase of the healing process may help you to cope with this emotional state. Just try to remember it’s a process and there are stages for each process we go through, healing from a surgery is no different.  Your incisions may come as a shock in the beginning but try to remember that over time those incisions will heal and the scars will decrease and the final outcome will be much different than what it looks like right after your procedure.