Pregnancy is a beautiful thing. But it can definitely take its toll on a woman’s abdomen, stretching out the skin and tissues. In younger patients or women who don’t gain significant weight during their pregnancy, the abdomen may be able to bounce back. However, with age, the body’s supply of elastin, which is what allows skin to stretch and retract, greatly diminishes. Furthermore, excessive weight gain that is maintained for a long period of time is going to permanently stretch the skin. An abdominoplasty is a fantastic procedure for lifting and tightening the skin, tissues and/or muscles in the abdominal region. But in cases where the skin has been severely compromised, such as with massive weight loss patients, adding soft tissue support can help ensure the longevity of your tummy tuck result.
For over 30 years, Dr. Bruce Van Natta has been an early adopter, always on the hunt for new techniques and innovations to help solve his patients’ problems. As such, he began using soft tissue support in his breast surgery procedures in order to create almost an internal bra of support made from the patient’s own collagen. He realized that this could easily translate to his tummy tuck patients, particularly those who had undergone massive weight loss. He created this site as a way to share his wisdom and experience with patients and fellow surgeons.
Benefits of Soft Tissue Support
Over the years, Dr. Van Natta has utilized a wide range of different absorbable scaffolds in his aesthetic procedures including:
- Vicryl – multifilament PLGA
- ADM – dermal matrix such as Allerderm & Stratis
- SERI – multifilament silk
- TIGR – combination of multifilament PGLATMC/PLATMC
- Galatea Scaffolds – poly-4-hydrozybuterate (P4HB)
A huge fan of soft tissue support in general, today, Dr. Van Natta exclusively uses the Galatea Scaffold’s collection due to the many benefits of P4HB. Not only does its initial strength exceed many of the other mesh products on the market, but, even more importantly, it retains 50-70% of this tensile strength at 4 months post operatively. P4HB also:
- helps provide wound support for up to 52 months
- is easily and gently absorbed by the body since it’s a naturally occurring biopolymer
- has a low rate of infection (Dr. Van Natta’s is zero)
- delivers long lasting results since it does not stretch
Soft tissue support works by promoting the patient’s own body to produce more collagen in response to the injury of the mesh. Over time, this collagen weaves in and out of the mesh product which eventually dissolves. What is left behind is a strong, durable scaffold of natural collagen support.
Soft Tissue Support in an Abdominoplasty
When a patient loses a large amount of weight, it is typically only one part of the solution. The fat is gone, but the patient is often left with folds of loose, draping skin and tissue. The goal of an abdominoplasty is to lift and trim the excess skin and tissue. Oftentimes, particularly in women who’ve had multiple children, you may need to tighten the underlying muscles as well. The end result is a smoother, flatter abdomen.
However, there can be a couple of problems maintaining these tummy tuck results in massive weight loss patients, particularly estrogen deficient patients such as men and postmenopausal women. They usually have:
- poor skin quality
- weak underlying fascia
This can lead to bulges, scarring and a recurrence of skin laxity down the road. The problem is that the skin and tissues are typically not strong enough to carry the entire burden of holding on to the lift over time.
Mesh Acts like Support Beams
Soft tissue support can act almost like the support beams in a house, creating an internal scaffold of support that provides strength to a superficial facial system that has maybe been weakened by:
- poor nutritional choices
- sun damage
- hormonal shifts
Dr. Van Natta encourages patients to think of it as an insurance policy against the need for revision surgery down the road. Soft tissue support in an abdominoplasty has the potential to be a total game changer as it allows you to create a long lasting result for your massive weight loss patients or anyone who has seriously compromised abdominal skin and tissues. One of the reasons that Dr. Van Natta is so excited about P4HB and soft tissue support in general is because its potential uses are potentially limitless.