Last month, Dr Sanki’s patient Krishelle shared her mummy makeover body transformation on the hit TV show ‘This Time Next Year’, which showed her year-long journey towards the body of her dreams, compressed to a six-minute clip. Of course, for Dr Sanki and the Silkwood Medical team, there was much more to it than what you could see on TV. This is Dr Sanki’s diary of Krishelle’s mummy makeover including three major surgeries in one year…
The Belt Lipectomy (body lift)
Lights, camera, action. It is 3rd June, 2016, and I am marking Kris up for the first of her three operations, a belt lipectomy. The camera crew are peering over my shoulder, watching every purple texta line go onto Krischelle’s skin. Fortunately, I have mapped and planned Kris’ surgery in my head many times over and my hands go into autopilot. Kris has to lift her heavy tummy skin out of my way so I can mark her incision lines. She turns and poses in front of me.
We move to the operating theatre, where my anaesthetist gently drifts Kris off to sleep. A team of nurses, doctors and porters turn Kris to lie face down, so that we can start the operation by removing the loose skin at her lower back. I can see my team falling into their natural steps and movements- the scrub nurse has her set up perfectly laid out, my assistant is coating Kris’ skin in betadine, the anaesthetist is checking and rechecking that Kris is positioned properly and breathing ok, and I am looking at our preop photos one last time.
We remove huge wedges of skin and fat from Krischelle’s lower back. They weigh 1.5 kg in total. We start to close the huge gaps we’ve created with three layers of dissolving stitches. “My grandmothers were both tailors,” I tell the film crew. And Krischelle’s buttock is being tailored into a firm perky version of itself. You can see her entire lower body shifting up with every deep fascial stitch we put in. Kris’ skin comes together beautifully. Some people have lovely skin to stitch, and I am really happy with how her wounds look.
We round up the porters again and gently turn Kris onto her back to complete the operation. I look at the clock- two and half hours in, three and half hours to go. The film crew are still standing which is impressive. The camera looks heavy and I am surprised they cope so well with the blood and smell of the diathermy machine. We start the tummy tuck component of the full body lift. We cut out her belly button that is hiding in between the folds of her tummy skin. We then remove her lower abdominal pannus. Everyone in the theatre tries to guess how much the skin weighs. “It weighs 2kg, but looks so much more” our nurse declares.
It takes a full hour to complete the suturing to close Kris wounds. We joke that both the camera and surgical crews are completely exhausted, but Kris is lucky enough to be fast asleep. Our final step is to put soft silicone dressings on Kris’ wounds and gently wrap her tummy up in a binder. She wakes up smoothly and looks me straight in the eyes to hear me say everything went really well.
I often think that the surgery is the easiest part of a makeover. The patient is asleep for that part! The tricky bit arises in the next week as the patient has to manage their impaired mobility, wound care and of course, their new appearance. My favourite moment in the surgical process is seeing my patients the morning after surgery. I take off their binder the way an anxious child might unwrap a Christmas present. The look on Kris’ face when I take off her binder the morning after was priceless- the folds of shapeless skin were gone and replaced by a gorgeous, tight, washboard flat abdomen with a beautiful tiny waist. This is the body she was always meant to have.
The arm lift and breast lift
Fuelled by the great result Krishelle achieved from her body lift (belt lipectomy), we launch into stage 2 of her surgical transformation. In this operation our goals are to remove excess skin from her lower arms as well as restore a youthful shape and volume to her breasts. Krishelle has an active job and her arms really impair her ability to wear short sleeves comfortably. A lot of massive weight loss patients complain of difficulty finding clothing as their hanging arm skin does not comfortably fit into sleeves. What size clothing should you buy when your arms fit into a size 16 but your waist is a size 10?
Krishelle’s breasts had really suffered after her weight loss. They are both deflated and sagging. Her collar bone to nipple distance is 35cm. The normal value for this measurement is 21cm. We have talked about how difficult significant breast deflation is to correct in a one stage implant and lift operation, but we had a dead line to reach with her surgery, and we want to minimise her downtime from work and her family.
We start the brachioplasty operation by sequentially removing the loose skin and fat from Kris’ arms. We start at the elbows and peel the skin and fat from the underlying fascial layer. We meticulously preserve her nerves and leave just enough skin to allow the wounds to be closed safely. The skin is closed in three layers of dissolving stitches.
Next we start the much more difficult task of a modified wise pattern breast lift and round 445g subepctoral implants. We decided upon round implants to maximise upper pole fullness and also to avoid long term issues with implant rotation from a tear drop implant. The subpectoral approach allows us to soften the upper pole of the breast by providing an extra layer of tissue coverage. The muscle will also act as a clamp to anchor the implant in place. Our main problem during the operation is the very long breast pedicle we require to keep the nipple and areola alive. A pedicle is a wedge of breast tissue that starts like a long tube from the chest and ends at the nipple. It feeds the nipple with its blood and nerve supply. Krishelle’s is so long that I am concerned that the blood supply to the nipple will be compromised. The breasts are reshaped the nipples stay a healthy pink colour- we’re going to be ok.
Over six hours later, my anaesthetist gently wakes Kris up, and I call her husband, Steven to let him know that everything had gone smoothly. Kris spends a few nights in hospital. She copes beautifully with her feelings of tightness and numbness in her arms. One year later, we are so pleased with the shape of her arms and breasts. Her arms scars are still a bit broad and pink and we are considering some laser treatment to help them soften. Kris now has arms that match her little waist and cleavage to restore her femininity and hour glass shape.
The best part of plastic surgery is how quickly we forget the problem that led us to see the surgeon in the first place. Kris tells me that she was emotionally overwhelmed when she stood behind stage at Channel 9 and saw her “before” arm pictures. We talked recently about how important it is to draw a line in the sand when your transformation is finally over. Krishelle can feel proud of what she has achieved and now move on to the next stage of her busy life.
The thigh lift
It’s the 11th November, 2016 and we are about to perform our last operation in Krischelle’s amazing makeover after losing 50kg following a gastric sleeve. The film crew have so much footage from the previous 12 hours of operating, that they decide not to watch this final stage of surgery. I am really excited to be doing Krischelle’s thigh lift. She responds so well to her surgery, and her tummy, breasts, hips and arms all look far better than I had hoped we could achieve.
Without the film crew watching us, we chatter comfortably about her recovery and expectations as I draw my incision lines on Kris’ thighs. She has so much loose skin at the inner aspect of her thighs that I struggle to grab it with my hands as I am marking her up. She is now well practiced with the markup process, and twirls around for me to cast a final important check on the lines I have drawn on her skin.
Kris is now very familiar with my theatre team. The team are so happy to see Kris again. They rarely get to see my patient “afters”, and it makes them proud to see the wonderful results of our hard work together. Kris is so calm. She climbs onto the theatre bed like it is her favourite couch, and drifts off to sleep for the third and final time.
I start Krischelle’s thigh lift by using liposuction to remove all of the fat from under the skin I have marked up. It is so satisfying to watch. We remove 1.3 litres of pure fat. My surgical assistant and I swear to never eat a chocolate bar again! The skin is now paper thin. The liposcuction takes an hour and a half to complete. I carefully incise along my markings and remove the skin. The skin alone weighs 800g for both thighs. The hardest part of a thigh lift is the meticulous metres of suturing I do to close the wounds. My head is stuck at a 45 degree tilt for an hour and a half while I stitch the wounds closed. But it is all worthwhile.
Once we have dressed Krischelle’s wounds, it requires two nurses and two doctors to get Kris’ garment on while she is still sleeping. The transformation is really magnificent. I am most proud of Kris’ thighs. It is traditionally an operation that is very difficult to get a good result in as we are using an incision in only one location to tighten the entire circumference of a cylinder. Many patients thighs can look like tree trunks after a thigh lift, but Kris has beautiful natural looking thighs. Every part of Krishelle’s body now matches. And her body now matches how she feels.
Watch Silkwood’s patient Krishelle and Dr Sanki on ‘This Time Next Year’ in the video below and call us on (02) 9387 3900 to book a consultation with Dr Sanki.