How is plastic surgery after dramatic weight loss performed?
You first need to tell your surgeon your aesthetic goals. Your surgeon will then suggest the procedures that will help you reach your goals and give you a realistic picture of what those procedures can do for you. Sometimes your surgeon will recommend completing multiple procedures at the same time, while other times, your surgeon may recommend a staggered approach. Because each procedure can impact the outcome of the next, your aesthetic plastic surgeon will carefully plan out the order of surgical procedures to achieve the best possible results safely.
What are my plastic surgery options after my weight loss?
There are several different body contouring procedures that remove or minimize excess skin after a major weight loss. Of the body contouring procedures, panniculectomy and lower body lift are the most closely associated procedures with dramatic weight loss.
After a major weight loss or pregnancy, you may have overhanging skin in your lower abdomen (called the pannus). A panniculectomy removes the hanging pannus from the lower abdomen below the belly button; however, it does not remove excess skin and fat above the belly button. This procedure is typically for patients who are still significantly overweight but have troublesome skin irritation from hanging skin. Your health could be at risk if you have fat extending over your hips, around your back, or as low as your knees, and you may need to get a panniculectomy.
- The surgeon makes a horizontal incision at the pubic area and carefully removes excess skin and fat.
- The surgeon pulls, closes, and secures the remaining skin.
- Sometimes, your surgeon will insert a drain that requires home care for a while.
- Your surgeon will apply tape to all the incisions to aid in healing and prevent tearing.
- If you have any abdominal hernias or torn abdominal wall areas, your surgeon can often repair them simultaneously.
- After surgery, you will have fewer skin problems, but little improvement in your belly contour.
Liposuction, lower body lift, and tummy tuck are procedures related to panniculectomy.
Lower Body Lift (also known as belt lipectomy)
A lower body lift procedure reshapes the abdomen, waist, hips, thighs, and buttocks through an incision made around the body’s circumference. If you have loose skin in the buttocks, back of the thighs, hips, side of the thighs, front of the thighs, inner thighs, abdomen and relatively thin layers of fat below the skin in these areas, then a lower body lift may be a good option for you. See lower body lift for more information.
- Your surgeon makes incisions from the back around the hips to the front of the thighs.
- The surgeon removes loose skin and underlying fat tissue below the incision to allow the remaining tissues to stretch and smooth the lower body, especially the buttocks and thighs.
- The surgery begins in the back, but the surgeon repositions you during the surgery to address the hips, outer thighs, and front of the thighs.
- Your surgeon may combine this procedure with abdominal skin tightening if needed.
- If you’ve already had a tummy tuck, or don’t need a tummy tuck, your surgeon can extend the lower body lift to tighten your inner thighs.
Liposuction, tummy tuck, and panniculectomy are procedures related to a lower body lift.
Breast reduction, breast augmentation, and gynecomastia (male breast reduction) are other procedures associated with plastic surgery following dramatic weight loss.
After a dramatic weight loss, patients often get the following procedures. However, people who have never been obese also get these procedures.
Tummy Tuck (also known as abdominoplasty)
Abdominoplasty removes loose, excess skin and fat and tightens the skin tissue to remove stretch marks in the lower abdomen below the belly button. See tummy tuck for more information.
- Your surgeon removes most of the skin and fat between the belly button and pubic hair in a horizontal oval or elliptical shape.
- Your surgeon tightens the fascia (skin tissue) overlying the abdominal muscles with sutures.
- The surgeon then repositions the skin around the belly button, bringing the belly button out through a small incision and suturing it in its normal position.
- Your surgeon closes the incision with sutures, which typically run from hip to hip.
- Your scar will be along the natural crease within the bikini line. The length and visibility of the scar varies.
Liposuction (also known as lipoplasty)
Liposuction removes excess fat. Common liposuction areas include the hips, side body, chest, thighs, neck, upper arms, and knees. Many patients get liposuction in conjunction with other plastic surgery procedures following dramatic weight loss. See liposuction for more information.
- Your surgeon makes tiny incisions in the area where they will remove fat.
- They then insert a thin, hollow rod (cannula) through the incision to create tunnels through the fat.
- Suction forces the fat into the cannula and out a high-vacuum hose.
- After fat removal, the surgeon applies dressings and will likely put you into a compression garment.
Breast Lift (also known as mastopexy)
A breast lift addresses sagging and uneven breasts, decreased breast volume, drooping nipples, and stretched areolas, lifting and shaping your breasts to a more youthful appearance. Women who desire larger, smaller, or more rounded breasts may want to consider a breast augmentation or breast reduction along with the breast lift. See breast lift for more information.
- Your surgeon makes the incisions. Mastopexy incisions vary, depending on the amount of excess skin, the location of your nipples, your aesthetic preference, and your surgeon’s suggestions.
- Then the surgeon repositions and reshapes the breast tissue and surgically removes excess skin.
- Your surgeon will reposition the nipple and areola to a more youthful height. Nipples and areolas usually remain attached to underlying mounds of tissue, which may allow for the preservation of sensation and the ability to breastfeed.
- If needed, your surgeon can reduce the size of the areola by excising skin around the perimeter.
- Your surgeon then tightens the remaining skin while closing the incisions, layering the sutures deep within the breast tissue to support the newly shaped breasts.
- Your surgeon may use skin adhesives and surgical tape to help close and support the skin.
Upper Arm Lift (also known as brachioplasty)
With aging or dramatic weight loss, the upper arms can become loose and flabby. An arm lift removes excess skin and fat deposits, giving upper arms a more attractive and youthful contour. The incision length and pattern will depend on the amount and location of excess skin and the judgment of your aesthetic plastic surgeon. See upper arm lift for more information.
- Your surgeon makes incisions on the inside of your arm or on the back of your arm, and the incision may extend from the underarm (axilla) to just above the elbow.
- If you also want to remove fat, your surgeon will treat the area with liposuction.
- If you only have a small amount of extra skin, your surgeon may recommend a mini brachioplasty, where the incision is limited to the underarm area.
Thigh Lift (also known as thighplasty)
A thigh lift procedure removes extra skin and fat to give you tightened, toned, and better-proportioned thighs. Your surgeon can perform a thigh lift in combination with liposuction of the thigh and lower body lift. See thigh litt for more information.
There are several types of thigh lifts. Your plastic surgeon will suggest appropriate options for you based on the amount of excess fat and skin, skin quality, the areas to be treated, and your aesthetic preferences.
- An inner (medial) thigh lift is the most popular and involves incisions in the groin fold. This approach is best for people with a moderate amount of skin and fat in this area. In this procedure, your surgeon lifts up the thigh skin and tissue to tighten this area.
- A vertical thighplasty involves a vertical incision starting at the groin crease and extending to the inner knee. This approach is most appropriate if you have significant fat and loose skin. During a vertical thigh lift, your surgeon removes a wedge of skin from the inner thigh. The resulting scar is visible when the inner thighs are exposed.
- An outer thigh lift requires an incision that extends from the groin around the hip. This newer procedure is called the spiral thighplasty and targets the front, back, inner and outer thigh. The incision runs below the buttock fold and continues over the groin crease where the thigh and pubic area meet.