Body Contouring After Weight Loss

Congratulations on achieving your weight loss goal. Many patients, like yourself, seek plastic surgery consultation to correct the excess skin and residual fat deposits that remain following significant weight loss. Although they are not physical scars, many weight loss patients believe these are constant reminders of their past. For the patients we have treated, body contouring procedures have allowed them to finally realize the true extent of their weight loss achievement. As physicians, it has been great to share in the personal successes of our patients as they radiate a new sense of self-esteem and self-confidence. At Belmont Plastic Surgery, we consider it is a privilege to participate in your weight loss journey and we are committed to helping you realize your goals.

We offer comprehensive care for our significant weight loss patients and your safety is always our first priority. We work closely with bariatric surgeons, physicians specializing in weight loss, bariatric coordinators, nutritionists, primary care physicians, and weight loss support groups to ensure this goal.

Following significant weight loss, you lose weight to varying degrees in many parts of your body. You may be left with residual fat deposits that despite your incredible hard work remain problem areas. A common problem to all of these areas is the excess skin that remains from when you were at your maximum weight. This skin has been severely stretched and damaged and has lost its elasticity. This excess skin can both hamper the performance of daily activities and cause serious hygiene issues. The only way to improve the appearance of these areas is to have this skin surgically removed resulting in an improved contour.

Plastic surgery following significant weight loss is a relatively new field within our specialty. Because of our experience with patients that have lost significant weight, we feel comfortable performing these technically challenging procedures and dealing with any potential complications that may occur. We also continue to contribute to this growing field. We have been the authors of five book chapters and at least ten peer-reviewed articles related to body contouring after significant weight loss. It is this experience and commitment that allows us to perform the most current techniques under the safest possible conditions for our patients.

In the following sections, you will find information describing the common body contouring procedures performed by our practice:

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Lower Body Lift (with Buttock Autoaugmentation)          

A body lift is a combined procedure that addresses the contour of abdomen, the lateral thighs and the buttocks. It is essentially an abdominoplasty (tummy tuck), a lateral thigh lift and a buttock lift. It leaves a lengthy scar that goes completely around the waistline; however, we design the incision to be hidden beneath underwear or a bathing suit. This procedure is also commonly referred to as a lower body lift, a circumferential body lift or a belt lipectomy.

It is important to realize that all plastic surgeons do not perform this procedure in the same fashion. A circumferential excision can sometimes result in the loss of buttock projection and the appearance of a “flattened” buttock if all of this tissue is discarded. To preserve this desired buttock contour, we use the existing excess tissue that is normally discarded and shape it into a tissue flap that is rotated inferior in a way that will preserve projection or add volume to enhance your buttock contour. This is called buttock or gluteal autoaugmentation. At the time of your consultation, your surgeon will discuss whether your anatomy and goals are appropriate for this procedure.

Extended Abdominoplasty (Tummy Tuck)       

An extended abdominoplasty or tummy tuck is procedure that is in between an abdominoplasty (tummy tuck) and a body lift. The incision for an extended abdominoplasty extends onto the back, but does not go completely around the torso like the body lift procedure described above. An extended abdominoplasty allows for the complete excision of larger abdomens and their extensions into the flank region, as well as some lifting of the lateral thighs (but to a lesser extent than a body lift).

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Panniculectomy

A panniculectomy is a functional operation that removes a large hanging apron of skin (pannus) from the abdomen. Patients requiring a panniculectomy often have severe hygiene issues that have resulted in excoriation, ulceration or infection. These patients have failed medical management and require surgical removal to correct these problems. Although we take aesthetic considerations into account for all of our procedures, this is not considered a cosmetic procedure.

Liposuction

Liposuction is the removal of fat through multiple small incisions using suction. Liposuction removes fat, but it will not correct the excess skin problems facing many significant weight loss patients. We commonly use liposuction as a complementary technique to the other procedures described on this page to achieve the desired contour.

Breast Lift

There are often considerable changes in both size and shape to a woman’s breasts following significant weight loss. A breast lift will reshape the breast and lift the nipple to a more youthful position. Many women also have a significant lateral breast roll that blends into their back. In select patients, this lateral skin can be elevated and rotated into the breast to help autoaugment the size of your breasts. This technique allows us to make your breast size bigger without the use of breast implants. In patients that still desire a larger breast size, breast implants may be required (breast augmentation). Some patients retain significant volume in their breasts despite their excellent weight loss. A breast reductionmay be required in patients that desire smaller breast size.

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Brachioplasty (Arm Lift)

The goal of an arm lift is to remove the excess skin that hangs from the inferior aspect of the arm (sometimes referred to as “bat wings”). It will also help contour the area around the axilla (armpit). The incision line for this procedure lies on the inside of the arm so that when the arms at your side, the incision is not noticeable. Liposuction of the posterior arm is frequently used as an adjunct procedure to provide the optimal arm contour.

Thigh Lift

A thigh lift improves the contour of the medial thigh regions, as opposed to a body lift which will address the outer thigh. Correction of both the inner and outer thighs will require both procedures. For all thigh lifts, there is an incision that lies within the groin crease. Depending on the degree of inner thigh laxity, a vertical incision line will extend from the groin crease down to the level of the knee. The incision line is hidden on the inside of the leg and is well hidden from the casual observer.

Upper Body Lift (Back Lift)

An upper body lift is necessary in a subset of patients that have significant back rolls that they desired corrected. In females, we will often hide this incision beneath the bra-line. In males, incision line placement is often dictated by the position of the back rolls.

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Mons Rejuvenation (Mons Lift)

Following significant weight loss, both female and male patients often have fullness and sagging of the tissue that lies over the public bone. This region is call the mons and it is often covered with pubic hair. Fullness and sagging of this region can cause difficulty with urination, sexual function and satisfaction, and clothes fitting. Although this area may be a source of embarrassment, we commonly address this area during abdominal contouring. This area will be debulked and elevated to provide a more youthful appearance.

Gynecomastia (Male Breast Reshaping)

Following significant weight loss, men are often left with residual fat and breast tissue with varying degrees of skin excess. For men who have minimal skin excess or in young men with good skin tone, liposuction alone may be sufficient. The majority of men, however, have significant excess skin that requires excision. For these patients, an incision line is placed along inferior border of the chest and the excess skin is removed. The nipple is then repositioned to a more youthful position on the lateral border of the chest muscle.

Face/Neck Lift

Changes to the face and neck are variable in patients after significant weight loss. A face/neck lift will help correct the deep creases besides the mouth, the jowls, and will remove the excess skin on the face and neck. It will also tighten the muscle layer of the face and neck. This procedure will give you a rejuvenated look making you appear years younger.

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