Body Contouring after Massive Weight Loss

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The obesity epidemic across the United States and the rest of the world has led to many programs centered on lowering Body Mass Index (BMI) for the well-being of the individual. However, significant amounts of weight loss cannot ignore the physics of the real world. Bodily entities like the skin and fat deposits that have made huge changes in tension and size from the loss of volume do not always adjust themselves accordingly after weight loss. Bariatric (weight loss) surgery has caused many individuals to meet their BMI goals and develop healthier lives, but it has also created the need for much of the body contouring necessary from weight loss.

As individuals metabolize their fat, they begin to not only weigh less but also occupy much less physical space. In most cases, severe and swift weight loss results in loose skin and fat that literally hangs off the body because the mass upon which it rested has been suddenly removed.

The aim of body contouring is to rearrange and excise this surplus tissue for both cosmetic and functional purposes. Aesthetically speaking, large surface areas of skin hanging off a conversely small frame could be considered just as unsightly as the taut surface of a morbidly obese individual. Daily activity can be hampered and chronic skin irritation can develop due to frequent chafing between the functional skin and excess skin. This can cause significant discomfort and possible skin infections from excessive irritation.



Although it is possible to perform a full body lift in one lengthy session, most doctors prefer to break up body contouring surgeries for the safety and comfort of the patient. The body contouring procedures are split up into a few of the most common areas operated on:

The arm lift (or brachioplasty) procedure attempts to procure a more natural and youthful look by removing the fat and excess skin hanging down from the underarms. This is more commonly seen in women, but can also occur in men who have lost significant weight. The incision is made beneath the arm and can extend from the elbow to the armpit, depending on how much skin must be removed. However, most patients are satisfied with the results and believe trading “skin for scars” is worthwhile.

The breast lift (or mastopexy) reshapes the breasts and repositions the areolas. The skin below the breast is generally removed and the nipple is moved higher while skin above the breast is pulled around to create a swell. This procedure is usually combined with breast augmentation (enlargement) either at the initial lift or as a secondary procedure so as to better fill the empty space vacated by the fat loss. The areolas can also be resized if necessary. Most of the scars associated with this procedure are hidden by a normal bra.

The tummy tuck (or abdominoplasty) tightens the abdominal walls and removes excess skin to create a flatter contour of the abdomen. This procedure is performed under local or general anesthesia and begins with an incision along the bikini-line and the removal of the navel. Once the abdominal walls have been repositioned, the skin flap is pulled down, stretched and cut for the new navel fixture.

A body lift, also known as a belt lipectomy, is a procedure that improves your appearance by removing excess fat and skin from a certain section or the entire body. Unlike specific area treatments like an arm lift or thigh lift, a body lift treats larger areas or combines several different treatments in one procedure.

Most patients seek a lower body lift to correct sagging and folds of the abdomen, outer thighs and buttocks.

This procedure is performed under general anesthesia and can take four to seven hours depending on the type of lift desired. For a lower body lift or circumferential abdominoplasty, Dr. Stephan begins by making a horizontal incision along the back and buttock area to create a buttock lift and elevate the lateral thighs. The patient is then flipped over and an incision just above the pubic area is made, similar to an abdominoplasty and connected to the previous incisions, to remove excess skin and fat. Other body lifts focus on loose skin of the upper back, sides and breasts. A body lift can also be combined with liposuction to receive optimal results.

Loose skin in the upper thigh area, especially on the inner side, can sometimes be very difficult to completely correct with diet and exercise. If you have lost a significant amount of weight, you will notice that excess skin can be present all the way down to the knees. A thigh lift is performed to remove excess skin and fat along the inside of your leg while lifting and tightening the skin in this region. Incision lines are usually located along the groin crease and sometimes extend along the inseam of your thigh for a variable distance depending upon how much skin needs to be removed. A thigh lift can be combined with liposuction to achieve a smoother overall appearance. This procedure is usually done under general anesthesia and is often combined with an upper arm lift, tummy tuck or breast lift.