Individuals who have lost massive amounts of weight through dieting or bariatric surgery frequently have both functional and aesthetic problems related to redundant soft tissue. Every individual is unique in terms of how their body responds to significant weight fluctuations, and some have significant amounts of redundant tissue in a variety of anatomic areas, while others may have more limited areas of tissue excess.
When the degree of tissue excess is extreme, functional problems such as skin irritation, back and joint pain, and problems with movement and balance can result. Body contouring surgery can significantly improve these functional problems. In addition, surgery can greatly improve the aesthetic appearance of problematic areas and allow individuals to wear clothing that they could not wear otherwise. The procedures are modified in many cases to accommodate the more extreme degrees of tissue excess found after massive weight loss.
Abdominoplasty or panniculectomy (tummy tuck)
With an abdominoplasty or panniculectomy, excess skin and fat is excised from the abdominal area and the deeper fascial tissues are tightened. More extensive incisions are used than when the procedure is used for individuals with more limited degrees of tissue excess. They generally extend from hip to hip and often include a vertical component as well to maximize skin excision. During a consultation, the pros and cons of the procedure will be discussed and a recommendation can be provided as to what type of procedure will provide the best results for you.
Individuals who have experienced large weight fluctuations often have redundant skin and fat that is more generalized and not confined to the abdominal area alone. Individuals with this problem can benefit from a body lift. In a body lift, excess skin and fat is removed through an incision that extends circumferentially around the entire body. Again, a vertical abdominal incision is also sometimes utilized to maximize contour improvement. During a consultation, the pros and cons of this more extensive procedure can be discussed in relation to your specific shape.
Mastopexy (breast lift)
A significant decrease in breast size, as occurs after significant weight loss, can cause breasts to droop or sag. This change can affect the fit of many types of clothing and sometimes makes the breasts less attractive. The degree of droop, or ptosis, is determined by the relationship of the nipple to the crease underneath the breast (inframammary crease). If the degree of droop is limited, and the nipple remains at or above the level of the inframammary crease, an augmentation mammoplasty may correct the problem. When the degree of droop is more extreme, a mastopexy is required to re-establish a youthful breast contour. With a mastopexy, excess breast skin is removed, and the breast tissue is often repositioned, in order to re-create a more youthful breast contour. This procedure generates scars around the areola and generally on the lower portion of the breast. The specific type of incision varies depending on the individual and their particular problem. During a consultation, you will have the opportunity to discuss the pros and cons of the procedure and what type of procedure will be best for you.
Thigh lift and brachioplasty (arm reduction)
Individuals who have experienced significant weight fluctuations often have redundant skin and fat in the arms and inner thighs. The excessive tissue in the inner thigh area can be removed with a thigh lift, and excessive tissue in the upper arms can be addressed with a brachioplasty. Incisions for a thigh lift are sometimes confined to the groin crease, though vertical incisions extending down the leg are also frequently needed after massive weight loss. Brachioplasty incisions are positioned in the armpit and posteriorly on the arm between the armpit and the elbow. Occasionally, additional incisions are needed for more extensive problems. During a consultation, the pros and cons of these procedures can be discussed in relation to your particular contour.