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Body Contouring After Massive Weight Loss Growing in Popularity

Body Contouring After Massive Weight Loss Growing in Popularity


For many who are morbidly obese, bariatric surgery can be a life saver. Yet the rapid weight loss that is possible through procedures such as gastric bypass and LAP-BAND® System gastric banding surgery leaves most patients with extreme amounts of excess skin that is virtually impossible to eliminate – at least without the help of an experienced plastic surgeon.

“There have been dramatic improvements in bariatric surgery in the last five years,” said Dr. John K. Long, a Houston-based plastic surgeon who specializes in treating patients after massive weight loss. “As the bariatric surgical procedures have improved so have the results.”

Dr. Long said that many of the patients who benefit from these improved results seek body contouring plastic surgery as the next logical step to help them look, feel, and live better. Indeed, according to the American Society of Plastic Surgeons (ASPS), nearly 56,000 of the more than 106,000 body contouring procedures reported in 2004 were performed on patients who had experienced massive weight loss.

For many bariatric surgery patients, some of whom have lost half of their original body weight or more, body contouring is not viewed as the opportunity to achieve the perfect body. Instead, these patients wish to look and feel more like the new person they have become under all of their excess skin.

For others, however, the removal of excess skin is a matter of medical necessity. Some post-bariatric patients have so much excess abdominal skin that it hangs down, forming an apron of skin called a panniculus. In addition to making exercise difficult and fitting into smaller-sized clothing next to impossible, this excess skin can cause discomfort and chronic medical problems.

“These patients experience frequent skin infections, foul odors, and pain,” said Dr. Long. “All of these symptoms dramatically impact the individual physically and emotionally.” A procedure called a panniculectomy, in which excess abdominal skin is surgically removed, is the only long-term treatment for these symptoms.

Fortunately, plastic surgeons are responding to the increased demand for body contouring after massive weight loss by incorporating body contouring procedures, such as the panniculectomy, into their practices.

And the major plastic surgery associations – the American Society of Plastic Surgeons and the American Society for Aesthetic Plastic Surgery - have held conferences in recent years to make plastic surgeons aware of the increasing demand for post-bariatric plastic surgery.

Beyond the Tummy Tuck

A tummy tuck is just the best-known of the options available to patients who want to look and feel better after massive weight loss. Although body contouring procedures have long been used to combat the signs of aging, the use of such procedures for patients after massive weight loss is just emerging as a specialty in plastic surgery.

Abdominoplasty (tummy tuck) and panniculectomy – Abdominoplasty, also known as a tummy tuck, is performed to eliminate excess abdominal skin and tighten the underlying abdominal muscles to create a more contoured appearance. However, patients who have so much excess abdominal skin that it hangs to cover the genitals, thighs, or even the knees will need to have a panniculectomy..

Although most body contouring procedures are not covered by insurance, some companies are beginning to cover the cost of a panniculectomy when it is necessary to treat medical conditions such as chronic skin infections.

Breast lift – For women, breast lift can be an important part of feeling and looking better following massive weight loss. During the procedure, excess skin is removed, and the breasts are lifted.

Upper arm lift (brachioplasty) – After massive weight loss, patients can be left with excess skin that hangs down from the upper arms. Brachioplasty, or upper arm lift, involves the removal of this extra skin to achieve natural contours to the upper arms.

Buttock lift and thigh lift – The thigh lift restores more natural contours to the thighs and hips, and is sometimes combined with a buttock lift for optimal results.

Liposuction – Some patients have stubborn pockets of fat that cause irregular body contours after massive weight loss. Your plastic surgeon can use liposuction to selectively re-contour the abdomen, thighs, back, and other areas of the body.

Body lift – The most comprehensive procedure – the full body lift – addresses the upper and lower body at the same time and may include several of the above procedures. The body lift can also focus on the lower body or the upper body. The exact procedures and techniques involved in body lifts vary among doctors, so it is important to speak with your plastic surgeon about your body lift options.

Face lift – In addition to the body, massive weight loss also takes its tool on the face. A face lift tightens facial muscles and reduces the appearance of drooping skin and jowls.

What You Should Consider Before Body Contouring Plastic Surgery

If you have recently experienced massive weight loss and are considering body contouring plastic surgery, it is important that you select your plastic surgeon very carefully. You should make sure that your surgeon is experienced in performing the procedures you are seeking and that they understand how to care for the needs of post-bariatric surgery patients. Most importantly, you should choose a surgeon who is available to answer all of your questions and with whom you feel comfortable.

It is also important that you have realistic expectations about what body contouring after massive weight loss can achieve. The procedures are typically more invasive and require a longer recovery period than weight loss surgery. And even though surgeons take precautions to reduce the appearance of scars, some scarring is inevitable. However, most patients consider the scars and extra surgery a fair trade for getting rid of the excess skin that is concealing their healthier, trimmer selves.

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