Body Contouring After Major Weight loss
What is Body Contouring?
Dramatic weight loss has many benefits. But after weight reduction surgery, or any substantial amount of weight loss, the skin and tissues often lack the elasticity to conform to the reduced body size.
Surgical body contouring following major weight loss removes excess sagging fat and skin while improving the shape of the underlying support tissue. The result is a more normal appearance with smoother contours.
Is it right for me?
Body contouring procedures may include:
- Facelift: sagging of the mid-face, jowls, and neck
- Breast lift: sagging, flattened breasts
- Tummy tuck: apron of excess skin hanging over the abdomen
- Lower body lifts: sagging of the abdomen, buttocks, groin, and outer thighs
- Medial thigh lift: sagging of the inner, outer and mid thigh
- Brachioplasty (arm lift): sagging of the upper arms
In general, good candidates for body contouring are:
- Adults whose weight loss has stabilized
- Healthy individuals without medical conditions that impair healing or increase risk of surgery
- Individuals with a positive outlook and realistic goals
- Individuals that are committed to leading a healthy lifestyle with proper nutrition and fitness
Consultation and Preparing for Surgery
During your consultation be prepared to discuss:
- Why you want the surgery, your expectations, and desired outcome
- Medical conditions, drug allergies, and previous medical treatments
- Current medications, vitamins, herbal supplements, alcohol, tobacco, and drug use
- Previous surgeries
Your plastic surgeon will:
- Evaluate your general health and any preexisting health conditions or risk factors
- Examine your body and take detailed measurements
- Take photographs for your medical record
- Discuss your options and recommend a course of treatment
- Discuss likely outcomes of body contouring and any risks or potential complications
Prior to surgery, you may be asked to:
- Get cleared for surgery by your bariatric surgeon or primary care doctor
- Get a lab test
- Take certain medications or adjust your current medications
- Stop smoking well in advance of surgery
- Avoid taking aspirin, anti-inflammatory drugs, and herbal supplements as they can increase bleeding
Body contouring surgery should be performed in an accredited office-based surgical facility, a licensed ambulatory surgical center, or a hospital. If your body contouring is performed on an outpatient basis, be sure to arrange for someone to drive you to and from surgery and to stay with you for at least the first night following surgery.
Be sure to ask questions. It's very important to ask your plastic surgeon questions about your body contouring procedure. It's natural to feel some anxiety, whether it's excitement for your anticipated new look or a bit of preoperative stress. Don't be shy about discussing any concerns with your plastic surgeon.
The procedures necessary to achieve your goals will be defined along with a plan for the timing of these procedures. Plastic surgery procedures that may be recommended by your physician include:
- Lower body lift: to correct sagging of the abdomen, buttocks, groin and outer thighs
- Breast lift: to correct sagging, flattened breasts
- Arm lift: to correct sagging of the upper arms
- Thigh lift: to correct sagging of the inner, outer and mid thigh
Step 1 - Anesthesia
Medications are administered for your comfort during the surgical procedures. The choices include intravenous sedation and general anesthesia. Your doctor will recommend the best choice for you.
Step 2 - The incision
All body contouring procedures require large incisions to remove excess skin. In many cases, these incisions may be extensive. Incision length and pattern depend on the amount and location of excess skin to be removed, as well as personal preference and your doctor's surgical judgment. Advanced techniques usually allow incisions to be placed in strategic locations where they can be hidden by most types of clothing, but this is not always the case.
Body contouring is often performed in stages. Your particular condition and goals, as well as your plastic surgeon's best judgment, will all influence how your doctor defines a surgical plan. While it may have taken you two years or more to lose all the excess weight, it may take equally as long for the results of your body contouring to be complete.
A complete lower body lift treats sagging buttocks, abdomen, waist, hips and outer thighs in one procedure. Incision patterns vary, and may include a circumferential incision around the body to remove the "belt" of excess skin and fat.
Risks and Safety
The decision to have body contouring surgery is extremely personal. You will have to decide if the benefits will achieve your goals and if the risks and potential complications are acceptable. You will be asked to sign consent forms to ensure that you fully understand the procedure and any risks and potential complications.
- Fluid accumulation
- Poor wound healing
- Skin loss
- Blood clots, deep vein thrombosis (DVT) and pulmonary embolism
- Excessive or widened scars
- Numbness or other changes in skin sensation
- Anesthesia risks
- Unfavorable scarring
Residual skin laxity or contour irregularity These risks and others will be fully discussed prior to your consent. It is important that you address all your questions directly with your plastic surgeon.
Recovery After Surgery
Following surgery, dressings or bandages will be applied to your incisions. Small, thin tubes may be temporarily placed under the skin to drain any excess blood or fluid that may collect.
You will be given specific instructions that may include how to care for the surgical site(s), medications to apply or take orally to aid healing and reduce the potential for infection, specific concerns to look for at the surgical site or in your general health, and when to follow up with your plastic surgeon.
You may be instructed to avoid bending, straining, or lifting for several days to weeks. Where tightening of the abdomen or thighs is involved, your plastic surgeon may also instruct you to avoid standing fully upright and stressing any internal sutures as they heal, and to sleep with pillows elevating your knees.
To minimize the risk of DVT (blood clots in the legs) you will need be up and walking as soon as possible, and drinking plenty of fluid. Follow all instructions carefully - this is essential to the success of your outcome.
Follow all instructions carefully – this is essential to the success of you outcome.
Be sure to ask your plastic surgeon specific questions about what you can expect during your individual recovery period.
- Where will I be taken after my surgery is complete?
- What medication will I be given or prescribed after surgery?
- Will I have dressings/bandages after surgery?
- When will they be removed?
- Are stitches removed? When?
- When can I resume normal activity and exercise?
- When do I return for follow-up care?
You'll need help. If a component of your body contouring surgery is performed on an outpatient basis, be sure to arrange for someone to drive you to and from surgery and to stay with you for at least the first night following surgery.
The results of body contouring following aggressive weight loss are visible almost immediately; however, it can take two years or more to see the final results. Visible scars are something you must accept in your goals to achieving a body contour that matches your new weight and proportion. The results of body contouring are generally long lasting, provided that you maintain a stable weight and general fitness. As your body ages, it is natural to lose some firmness. However, most of your initial improvement should be relatively permanent.
Although good results are expected from your procedure, there is no guarantee. In some situations, it may not be possible to achieve optimal results with a single surgical procedure and another surgery may be necessary.
Following your physician's instructions is critical to the success of your surgery. It is important that the surgical incisions are not subjected to excessive force, swelling, abrasion, or motion during the time of healing. Your doctor will give you specific instructions on how to care for yourself.
Cost is always a consideration in elective surgery. Prices for body contouring procedures can vary widely. A surgeon's cost for body contouring procedures may vary based on his or her experience, the type of procedure(s) used, as well as geographic office location. Many plastic surgeons offer patient financing plans, so be sure to ask.
Cost may include:
- Surgeon's fee
- Hospital or surgical facility costs
- Anesthesia fees
- Prescription medication
- Post-surgery garments
- Medical tests
Health insurance may not cover body contouring surgery or its complications.
Your satisfaction involves more than a fee:
When choosing a plastic surgeon for body contouring, remember that the surgeon's experience and your comfort with him or her is just as important as the final cost of the surgery.
Plastic surgery involves many choices. The first and most important is selecting a member of the American Society of Plastic Surgeons (ASPS) surgeon you can trust. ASPS member surgeons meet rigorous standards:
- Board certification by the American Board of Plastic Surgery® (ABPS) or in Canada by The Royal College of Physicians and Surgeons of Canada® 17
- Complete at least six years of surgical training following medical school with a minimum of three years of plastic surgery residency training
- Pass comprehensive oral and written exams
- Graduate from an accredited medical school
- Complete continuing medical education, including patient safety, each year
- Perform surgery in accredited, state-licensed, or Medicare-certified surgical facilities
Do not be confused by other official sounding boards and certifications.
The ABPS is recognized by the American Board of Medical Specialties (ABMS), which has approved medical specialty boards since 1934. There is no ABMS recognized certifying board with "cosmetic surgery" in its name. By choosing a member of The American Society of Plastic Surgeons, you can be assured that you are choosing a qualified, highly trained plastic surgeon who is board-certified by the ABPS or The Royal College of Physicians and Surgeons of Canada.
This procedural information is intended strictly for educational purposes. Only models are depicted in these procedural information pages. It is not intended to make any representations or warranties about the outcome of any procedure. It is not a substitute for a thorough, in-person consultation with a board certified plastic surgeon.