减肥后隆胸

Dr. 琼斯: So you've been very successful at achieving your weight loss goal. 祝贺你. 但你不会再把胸罩填满了. 这是怎么回事？?

Most women who undertake a significant weight loss through diet or through 减肥手术 希望减肥吗. That's the part of the body that we don't need so much. We don't want to lose a lot of muscle when we do a weight loss thing. 但大发娱乐身体的某些部位主要是脂肪, 那就是大发娱乐的乳房, and weight loss may lead to a body change that isn't welcome. 那么大发娱乐能做些什么呢?

今天，在虚拟的Scope工作室里，我和 Dr. 科里阿加瓦尔. 她是犹他大学的整形外科医生，专门从事美容和重建手术, and she has an interest in helping women find the body that they're looking for.

我有一些问题, 因为这是一个非常有趣的话题对于那些真正经历了身体基本转变的人来说, 不管是30磅还是50磅, 或者他们失去了婴儿体重，然后他们喂养婴儿，所以他们的身体不一样了. 在体重大幅减轻之后, women may find their bodies change in ways that they hadn't anticipated. Can you talk about weight loss and how it affects breast structure?

Dr. 阿加沃: 我认为当人们开始减肥时，这是一个被忽视的话题. 他们真正关注的是健康，让自己感觉更活跃. 当这种负面影响特别是在乳房上时，有时会让人感到惊讶.

乳房, 正如你之前提到的, 是由相当多的脂肪组织组成的吗, 这确实因人而异. 但我想说的是，大多数女性，尤其是随着年龄的增长，乳房的脂肪比例越来越高. 所以当你 lose weight all over your body and you lose fatty weight, naturally some amount of that is going to come off of the breasts. 直到你亲身经历了才知道. 所以，对一些女性来说，这只是一个很小的影响. And for some, it's completely deflated after the weight loss.

Dr. 琼斯: 哦,放气. 我的意思是, it's hard enough getting older and if you've had babies, but to have . . . even that word deflated, that would have me rushing to you to get some help.

Dr. 阿加沃: 我想说的是通货紧缩，从两个方面来考虑它很重要. 有体积的损失, so the loss of this fat where you really just lose the size of your breast. 然后是通货紧缩, 乳头向下的皮肤松弛，所有的东西都向下伸展.

And those two we really think of separately and independently. When we talk what options there are for rejuvenating and filling the breasts, we really think of the sagging and the loss of volume separately, 因为 not every individual has as much sagging or as much loss of volume.

Dr. 琼斯: 当你说减肥过程中有两种不同的变化, 先是松弛，然后是体积, 你打算怎么做? What are the procedures here that you're going to undertake with this woman?

Dr. 阿加沃: 有两个主要目标. And one is to fill the volume to the size that was lost. 对于一些女性来说，她们想要比开始时小一点. 有些人想要更大一点. 为了把体积填满，为了恢复被压缩的体积，主要的操作是 隆胸那就是在乳房肌肉后面植入植入物来恢复乳房的体积.

然而, 如果皮肤同时松弛, 通常都是这样, 在这个过程中, there needs to be a skin tightening procedure done at the same time. 这就是所谓的乳房固定术或乳房提升术.

这些可以独立完成. 有人可能只是想搭便车. They might like the size that they've ended up, but everything's just droopy. 所以大发娱乐要做 乳房提升. 更常见的是, 大发娱乐将大发娱乐提供并推荐一种带植入物的提升, 因为对大多数人来说, 我认为这两个过程都在发生. 这是非常个性化的, but I think it's important to think of those two separately, 提升和增强.

Dr. 琼斯: 所以, 而不是一些人认为他们只是在某个地方做一个小切口然后把一些东西塞进去，然后泵起来之类的, you're really going to have to remove some skin and maybe lift the nipple.

Dr. 阿加沃: 正确的. I think that's often a surprise for women 因为 they think, “嗯, 这就像一个泄气的气球. 我要把气球装满," but they haven't really noticed how far things have stretched. 大发娱乐真的需要开诚布公地谈一谈移植后会是什么样子, or if you really want or would recommend a lift along with that implant.

Dr. 琼斯: So what are the options for women who would choose breast surgery? 你称之为审美还是美容, 或者在这种情况下, is it really reconstructive and is it paid for by insurance?

Dr. 阿加沃: 这是非常重要的, 在整形和重建手术的世界里，很多东西都是模糊的. A lot of things that we do that are reconstructive really are also cosmetic, 这是一条模糊的界线, 尤其是在乳房上.

So when we talk about the words cosmetic and reconstructive, what we're usually getting to is "Will insurance pay for it?“因为如果保险公司把它看作是装点门面, then even if we think it's really truly a reconstructive thing, 重塑你的身体, 大发娱乐只能称它为化妆品. 可悲的事实是，大多数下垂或下垂的乳房几乎一直被保险公司认为是美容，不包括在内.

Dr. 琼斯: 好吧, 对于那些在减肥过程中变得非常活跃的女性来说, and now they have breasts that don't want to stay where they want to put them, 这最终阻碍了他们成为一个积极运动的人如果他们想要保持减肥效果的话.

Dr. 阿加沃: 正确的. 大发娱乐确实试图向保险业提出这些论点, 但我认为这超出了大发娱乐所能宣称的乳房医学必需的范围. 乳房下垂的原因有很多. Pretty much anyone who has gone through a pregnancy and nursed a baby, 即使只是年龄, 乳房几乎100%都是下垂的. 所以 I think that's just beyond what we can argue for insurance to cover.

Dr. 琼斯: Knowing that many people who lose weight gain it back again, 有没有建议等体重稳定一段时间再考虑隆胸? 我的意思是, we've all watched the successes and failures on "The Biggest Loser," and some people are back right where they started from within a year or two. 那么你如何建议人们什么时候应该考虑重建?

Dr. 阿加沃: I think as a general rule of thumb after a lot of weight loss, we'd like people to maintain their weight for about six months. 如果只是快速节食，那就很严重了，也许他们会在几个月后迅速恢复 . . . 但经过六个月的持续减肥，大多数人的体重都相当稳定. So that's the general recommendation, but of course, it's very individualized.

Dr. 琼斯: 正确的. 这个手术能否成为更大手术的一部分? 你肯定知道有人做了减肥手术减了150磅, 现在她们下垂的不仅仅是乳房, 而是整个皮肤, 全身上下, which becomes a significant issue in just terms of staying healthy. 你能在做乳房手术的同时做多余的皮肤切除手术吗, 或者这些是在不同时间上演的?

Dr. 阿加沃: 我认为两者都适用于每个人. 当大发娱乐考虑减少皮肤的时候, 减肥后皮肤紧绷, 安全是首要任务. We want to limit the amount of time under anesthesia for any individuals. 所以如果他们进来说, "I want my breasts and my belly and my thighs and my back,“大发娱乐真的必须放慢速度，说, “好吧, 大发娱乐最重要的是什么? 大发娱乐能把它和别的东西结合起来吗?"

We try to limit the surgery time somewhere between three and six hours. 所以 we can do sometimes breast work with something else, 但这取决于哪些领域是优先考虑的, 这是很常见的.

但这是大发娱乐在了解病人并了解他们的健康状况之后才会进行的对话, 他们为漫长的恢复做好了怎样的准备. 所以它可以是双向的.

Dr. 琼斯: 所以当你 say how healthy they are and how emotionally prepared, it's hard when you have just a few minutes to get to know someone. And I know that sometimes before people undergo bariatric surgery, 他们可能会去看行为心理学家. 但是你如何去了解人们，让他们知道这对他们来说是正确的事情，他们不是在寻求一些真正无法获得的东西? How do you set realistic expectations about what they're hoping for?

Dr. 阿加沃: 这一点非常重要. 大发娱乐花了很多时间 . . . 第一次拜访通常需要一个小时. 在这段时间里，有一部分是关于手术和评估的. But a big part of it is talking about how they've gotten to that point, 他们的感受, 他们的期望是什么, 然后是社会支持. 我认为社会支持对于熬过这样一个大手术来说至关重要. 所以大发娱乐要确保他们真的想清楚谁需要大发娱乐他们, 有人来帮忙照顾孩子, 一个能大发娱乐自己和工作的人. 第一次拜访时，大发娱乐会花很多时间去了解对方.

你是对的, 这只是一次访问, 但通常在手术前大发娱乐还会有一到两次拜访来真正了解这些关键的问题他们是否想清楚了是否得到了对方的支持. 有些人将不得不设定现实的期望, 之后你就不会有20岁的身材了, 但你会有这个，不会有那个. 所以大发娱乐尽量现实一点，而不是粉饰它，或者让它看起来比实际情况更好或更容易.

Dr. 琼斯: 正确的. 好吧, I would think that most people having gone through . . . 尤其是当你的体重明显减轻时, they've been with this body for a while and they know what they're looking for, 我敢打赌，它们大多都很真实. They're not coming in with perfect breasts hoping for more perfect breasts.

Dr. 阿加沃: 我希望每个人都是这样. I think there are certainly a lot of women who are exactly in that category, 但还是有很多人 . . . 也许是因为有很多电视节目, 但有一种想法是，有一些神奇的事情发生了，还有一些ps. 我确实认为，如果他们看到的东西不真实，大发娱乐有时必须让他们禁足, 因为 . . .

Dr. 琼斯: 我看过一些YouTube上的视频, 之前和之后, 我看着后面说, “她怎么能减掉150磅，还能有这样的胸和腿呢？? 这是真的吗?"

Dr. 阿加沃: 完全. So you have to take a lot of it with a grain of salt, and so that's the job. 我想这就是咨询. 在见到你的外科医生并了解手术效果之前你是不会知道的.

Dr. 琼斯: I want to thank you 因为 I hadn't really thought about this one. 当然，多年来我也有病人想做减肥手术, 我并没有把所有的步骤都告诉他们，当你到达那里时，这将会发生. 你会到达那里，但之后可能会发生这种事. 可能不会. 所以我想感谢你给了大发娱乐一些见解.

对于那些已经迈出了一大步，通过减肥在身体上做出了巨大积极改变的女性来说, there are sometimes still steps to take to feel like yourself again. You're not alone and there are options and procedures that can help.

我想谢谢你，博士. 感谢阿加瓦尔加入大发娱乐. 感谢收看《大发娱乐》节目的各位.