The 3-Day Detox

If you’re feeling sluggish or like you’re having trouble sticking to a healthy eating plan, sometimes you just need a reboot.

In her book “Detoxification”, Linda Page points out that “A detox is one of the best ways to remain healthy in today’s world.” 

The following cleanse reportedly helps clear your liver of toxins. It makes sense because your liver plays a vital role in balancing your hormones and ridding your body of toxins, and this cleanse is a sort of “liver purge”. Give this 3-day cleanse a try:

After waking:

Squeeze one lemon into eight-ounces of water and drink. For added benefit, add a few drops of herbal extracts known for aiding digestion (such as dandelion root, cardamom, or orange peel).

Breakfast: One eight-ounce glass of carrot/beet/cucumber juice or organic apple juice. One eight-to 12-ounce bowl of miso soup.

Midmorning: One eight-ounce glass of vegetable juice (such as low-sodium V8). Or, you can mix a green superfood powder (spirulina, barley grass, or chlorella) with water or vegetable juice.

Lunch: One eight-ounce glass of carrot juice or organic apple juice.

Midafternoon: One cup of peppermint or dandelion-root tea.

Dinner: A cup of cooked brown rice; a cup of steamed, organic veggies; and a glass of mixed vegetable juice or carrot juice.

Before bed: Another glass of lemon juice in water (one lemon in eight-ounces) or papaya or pineapple juice.

3 days of this and you should feel that boost in energy and mood you’ve been craving to keep you moving forward with your weight loss and healthy lifestyle goals!

The Corset "Trunk-Plasty"

This procedure is often best for massive weight loss patients who want the best abdominal contour possible and are willing to have extra scars in order to get it.  While the Fleur-de-lis has a corset effect, the corset effect of the Trunk-plasty is even more dramatic.

Like the Fleur-de-lis abdominoplasty, there is the traditional, lower horizontal scar, a midline vertical scar, and also a horizontal scar that is just under the breasts or chest, making the appearance of the letter I. 

The overall skin removal is much greater than in the Fleur-de-lis. (See Red Shaded area in Figure below) By making a horizontal incision along the bottom and the top, a sort of “open book” is created.  These upper and lower incisions are extended slightly along the sides of the body toward the back. The skin at the sides of the abdomen and some of the back skin (Purple Shaded area below) is then pulled forward like a corset around the body (pull is in the direction of the Green Arrows below).

The Corset Trunk-plasty after massive weight loss

Similar to other abdominoplasty procedures, the rectus abdominis muscles (figure below) are tightened in the midline of the abdomen (see abdominoplasty post above for details). 

Repair of separated Rectus abdominis (Abs) muscles

The corset trunk-plasty not only addresses the excess skin along the lower abdomen, but also the sides of the abdomen/waist and the upper abdomen, creating a very good contour. It typically also improves excess skin in the back and that extra “roll” just below the side of the breasts.  

The Fleur-de-lis Tummy Tuck

This is a little more extensive than a standard abdominoplasty, as it also removes skin using a vertical incision (Purple arrows in Figure Below) in addition to the traditional horizontal skin removal (Red arrows). 

The benefit to using this procedure is that it typically gives a very good contour to the waist, especially in those with excess skin along the upper abdomen and along the waist, such as after massive weight loss. Removing the skin along a vertical (up-and-down) axis over the abdomen creates a nice pull from the waist, similar to a corset effect. The negative is that it does leave a vertical scar in addition to the traditional horizontal tummy tuck scar. This is best for someone not as concerned about scarring as much as having a good overall body contour.

Traditional Abdominoplasty or "Tummy Tuck"

The traditional tummy tuck procedure is performed by excising the skin and fat from the belly-button down to the pubic bone (red arrows in Figure below). This skin and fat is removed and the Green Shaded area is then undermined, meaning the skin and fat here is lifted up to the level of the ribs. This allows all of the Green Shaded skin to be pulled downward and sutured to the lower portion of the incision (So the 2 purple lines can be sutured together). 

Abdominoplasty

While the Green Shaded area is lifted, the underlying abdominal muscles (the Rectus Abdominis) are exposed. These are your “6 pack” or Abs muscles and they are often stretched so that instead of being side-by-side, they are separated in the midline. This commonly occurs due to age, pregnancy, or previous weight gain/loss or a combination of all of these things. (See Figure below) These muscles can be tightened to bring them back into the midline. After this tightening with stitches, the Green Shaded skin is pulled down.

Rectus Diastasis

An incision is made within the Green area for your belly-button to be placed in its new home.

The resultant scar is typically hidden within the underwear line (Blue Line in the Upper Figure)

This procedure works well for those that have lost moderate amounts of weight or who have lost larger amounts of weight but have had strong skin retraction. It is also commonly used as part of a ‘Mommy Makeover’ after having had children. The ‘Mommy Makeover’ is a breast augmentation +/- breast lift and a tummy tuck.  

Body Contouring After Massive Weight Loss: Where to start

Many people have had success with massive weight loss rather rapidly with the increase in surgical weight loss procedures. Many find that after losing 50 lbs or more that their skin does not contract fully, leaving them with excess skin over various areas of the body.

There are often several areas that need to be addressed, and many patients feel overwhelmed and aren’t sure where to start.

Typically, most start with the procedure that will give the ‘biggest bang for your buck’ or the procedure that will make the most difference. This typically is via an abdominal contouring procedure, such as a “tummy tuck”. But there are many modifications of the tummy tuck that can be used to address specific needs.  The following posts break down common body contouring procedures and the various sequencing that can occur for each.