After major weight loss, body contouring makes it all worth it
- Posted on: Aug 4 2017
The increase in bariatric or weight loss surgery has had a direct effect on the increase in body contouring procedures. In 2014, nearly 45,000 patients who experienced massive weight loss opted to undergo plastic surgery to reshape their bodies, according to data from the American Society of Plastic Surgeons (ASPS).
Procedures specifically associated with massive weight loss, including tummy tucks, thigh lifts, breast lifts and upper arm lifts, grew at their fastest rate in four years, according to 2014 data from ASPS.
“It’s always a wonderful accomplishment to lose that much weight. With that, comes improved health and an overall sense of increased energy,” says plastic surgeon Dr. Orna Fisher. “It is life-changing and highly rewarding for most people to finish the process with the surgeries that decrease the excess skin and allow improvement in body contour and confidence.”
Developing an expertise in the post massive weight loss body contouring field, Dr. Fisher treats patients who have lost anywhere from 50 to 150+ lbs. from bariatric surgery or sustained lifestyle changes.
What to Consider Before Post-Massive Weight Loss Surgery
When considering post weight loss surgery, Dr. Fisher first recommends that the weight of a body contouring candidate be stable for at least six months prior to surgery. “At some point the weight loss plateaus and there is often considerable loose skin in various areas of the body. That’s when it’s time to start planning for body contouring surgery,” suggests Dr. Fisher.
She also recommends that patients be in good health. “The amazing thing about massive weight loss is that it actually cures multiple medical conditions and diseases. Patients are typically healthy by the time they get to me, many of them have been cured of their diabetes, high blood pressure, sleep apnea, and/or joint problems,” explains Dr. Fisher.
Surgery planning is a big step as there are many possible options for post massive weight loss procedures. Any area where there is hanging skin can be lifted. The spectrum of procedures may include abdominoplasty (tummy tuck), arm lift, thigh lift, back lift, breast lift, facelift, necklift, and some others. Just like with individual patterns of weight gain, weight loss happens in different distributions too. “The areas where people can have loose skin vary from person to person. For example, some people have hanging or loose skin on the abdomen and arms, but not the neck or the thighs, while others may be bothered by hanging back rolls, chest, and thighs,” explains Dr. Fisher. “It just depends on the person’s problem areas and priorities as to the combination of procedures they will need.”
The post massive weight loss body contouring procedures are then scheduled in stages. “I typically start with what bothers the patient the most. If there are a couple of areas that bother the patient then I determine if those are procedures we can do at the same time,” explains Dr. Fisher. “If we are going to be doing their legs, for example, they need to be able to use their arms, so we can’t do the arms at the same time. Also, doing surgery on multiple areas at once can increase the risk of having healing complications, so we also need to weigh what combination of procedures should or should not be done at once for each individual.”
Staging the procedures is important not only for reasons of recovery but also because patients can’t or shouldn’t be under general anesthesia for as long as some surgery combinations may require while in an outpatient setting.
Recovery After Body Contouring
Standard recovery time between operations is three months so it could take up to a year or more for a patient’s body contouring procedures to be completed. Although it takes three months for recovery between procedures, preliminary recovery can vary from four to eight weeks. “They will see results right away because their excess skin is gone immediately. We aren’t talking about a little bit of tissue, we are talking about a lot of tissue that hangs down so as soon as that surgery is over, it’s gone,” says Dr. Fisher.
Setting realistic expectations is one of the most important pieces of advice that Dr. Fisher dispenses regarding body contouring. “Certainly, the results are life changing and there is a huge improvement from body contouring surgery but expectations must be realistic,” she cautions. “I have met with people who had unrealistic expectations and thought that once they lost all their weight that their skin could be made to completely conform to the shape underneath. That just isn’t true and it’s important to understand that.
“There is a typical way in which the tissues look and feel in somebody who has undergone massive weight loss. At some time during weight gain, the skin stretches beyond a certain point, where it can’t recoil back and it is no longer elastic. No matter what we do, people who have lost massive amounts of weight permanently lose these elastic properties in their skin. As a result, as tight as we do the surgery, there is always a recurrence in some of the laxity. One can never have the skin or contour of a billboard model even if the tone underneath is ideal.”
Laxity of the skin is not the only issue with regards to realistic expectations. Patients also need to be able to consider the tradeoffs of scarring. “With any of the body contouring procedures, and, in fact, any plastic surgery, you are trading in poor shape, poor contour and excess tissue for an improved contour, better shape and scars. Regardless of what procedure it is, there are always going to be scars. The tradeoff should be worth it, and in the case of massive weight loss, it seems to always be worth it,” notes Dr. Fisher.
In the end, all the hard work spent losing weight, undergoing procedures, and getting a few scars should not dampen the excitement of such a major accomplishment. “Body contouring is sometimes a long undertaking performed in stages, and it’s important to be positive and optimistic about just how much it changes your life,” concludes Dr. Fisher. “And once it’s done you can celebrate the weight loss achievement even more and move forward with life in your new body!”