Massive weight loss (MWL) is achieved by proper nutrition and exercise or as the result of bariatric surgery or from other forms of medical treatment. It has many benefits but it may lead to large amounts of heavy, loose folds of skin around the abdomen, arms, thighs, breasts, buttocks, and face. After massive weight loss, the skin often fails to shrink back to its former size and shape. This excess skin can lead to limitation in mobility, difficulty in choosing proper clothes and cause hygiene and medical problems. It can result in rashes, fungal infection in skin folds and sores that can lead to infection.
Often the only way to remove excess skin is through body-contouring plastic surgery and Plastic surgeon understands these special needs and can guide for further treatment.
Body contouring after massive weight loss (MWL) is an important and rewarding procedure to have a healthier, more proportionate body and it enhances body image and self-confidence.
The body contouring surgery is usually suggested approximately 18-24 months following the start of any massive weight loss program or bariatric surgery. This time allows the skin to shrink as much as possible and your nutrition to be stabilized and optimized.
The Plastic surgeon works in consultation with bariatric surgeon and team to determine the appropriate timing for body contouring.
- Adults of any age whose weight loss is stabilized for 3-6 months.
- Healthy individuals who do not have medical conditions that can impair healing or increase surgery risks.
- One must quit smoking a minimum of six weeks prior to surgery.
- Individuals with positive outlook and realistic goals
- Individuals committed to leading a healthy lifestyle
A consultation with Plastic surgeon is to completely understand the surgery and includes:
- The discussion of patient expectation and an evaluation of
- The options available in body contouring
- The likely outcomes of body contouring and associated risks
- The course of treatment and need for staged procedures if any.
The body contouring surgeries are most commonly performed under general anesthesia.
Massive weight loss (MWL) is achieved by proper nutrition and exercise or as the result of bariatric surgery or from other forms of medical treatment. It has many benefits but it may lead to large amounts of heavy, loose folds of skin around the abdomen, arms, thighs, breasts, buttocks, and face. After massive weight loss, the skin often fails to shrink back to its former size and shape. This excess skin can lead to limitation in mobility, difficulty in choosing proper clothes and cause hygiene and medical problems. It can result in rashes, fungal infection in skin folds and sores that can lead to infection.
Often the only way to remove excess skin is through body-contouring plastic surgery and Plastic surgeon understands these special needs and can guide for further treatment.
Body contouring after massive weight loss (MWL) is an important and rewarding procedure to have a healthier, more proportionate body and it enhances body image and self-confidence.
The exact plan for body contouring after MWL is individualized by the plastic surgeon as per patient need and expectation. A contouring of multiple areas can be planned together.
An "upper body lift" involves combination of surgeries to the arms, back, and breasts/chest.
A "lower body lift" involves combination surgeries to the hips, thighs, abdomen, and buttocks.
Most body-contouring procedures involve removing of excess skin and suturing the area with fine stitches to minimize scarring. With these types of procedures, scarring is unavoidable. The incisions are planned such that final scar lies in hidden and less noticeable area.
All body contouring procedures are safe when done by trained plastic surgeon in a good set up. However there are some side effects which need to be discussed on an individual basis with your plastic surgeon.
All surgeries are performed in the hospital under general anesthesia. There are tubes usually placed in the wound to drain excess fluid. The discharge from hospital can be expected once drains are removed. The usual stay in the hospital is from one to four nights.
A certain degree of soreness, swelling, and bruising for two to four weeks after surgery is normal. Most people can return to work after two to four weeks, but people with physically demanding jobs need to wait longer. During this recovery period, you will return to your doctor's office regularly to monitor your progress.
Usually other body-contouring procedures are considered cosmetic and not covered in insurance. Insurance company might consider panniculectomy as medically necessary. It is important for you to check your insurance benefits if you are considering body-contouring procedures. A cost estimate can be given as per the procedure plan.
The following areas are often treated through body contouring after MWL. The areas that are more bothersome are identified and addressed on priority.
Abdomen: Excess skin hanging down over the pubic region is often the distorting feature that most concerns and bothers patients. The surgical procedure to remove it is known as a panniculectomy.
Sometimes to provide improved contours on the waist, back and flanks, the plastic surgeon need to perform a belt lipectomy, (also known as a torsoplasty or a circumferential lipectomy). In belt lipectomy, the incision goes all the way around the patient's midsection at the level of the lower waist. Liposuction can also be combined to improve the contours of flank. The abdominoplasty and belt lipectomy incisions are placed so that the resulting scar is hidden in the bikini line.
Buttocks/upper thighs: This is usually performed as a continuation of an abdominal procedure. Lower body lift trims excess skin on the buttocks and thighs and can be achieved through belt lipectomy.
Thighs: A medial thigh lift is designed to tighten the thigh particularly the front and inner thigh. It involves an incision along the inner thigh starting at the groin and extending as far as the knee. It removes excess skin and redrapes the remaining skin before closing the long incision, leaving the patient with tighter and more attractive thighs.
Breasts: Breast lift or mastopexy can be accomplished with or without augmentation (using an implant) depending on need and expectation of patient. The breasts which usually droop to the umbilicus lifted to a more upright and full position by trimming excess of skin and reorienting breast tissue. Scars are anchor shaped with one scar going vertically down and the other is along the breast fold. It is always hidden inside the area covered by the bra.
Arms: The extra hanging skin on the arms of bariatric patients appears on the underside of the upper arms and is referred to as bat wings. Incisions are made from the armpit to the elbow to remove this excess of skin and create a more pleasing contour. The resulting scar is fairly well hidden. It is termed as brachialplasty and can be combined with mastopexy.
Face and neck: Face lift and neck lift procedure involves removing of excess skin around the face or neck after weight loss. It is similar to a traditional facelift, except that more skin is removed. The scar is placed in front of the ear and curves around the ear and into the hairline.