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Body Contouring After Weight Loss
 The obesity epidemic across the United States and the rest of the world has led to many programs centered on lowering Body Mass Index (BMI) for the well-being of the individual. However, significant amounts of weight loss cannot ignore the physics of the real world. Bodily entities like the skin and fat deposits that have made huge changes in tension and size from the loss of volume do not always adjust themselves accordingly after weight loss. Bariatric (weight loss) surgery has caused many individuals to meet their BMI goals and develop healthier life s, but it has also created the need for much of the body contouring necessary from weight loss.
The aim of body contouring is to rearrange and excise this surplus tissue for both cosmetic and functional purposes. Aesthetically speaking, large surface areas of skin hanging off a conversely small frame could be considered just as unsightly as the taut surface of a morbidly obese individual. Daily activity can be hampered by this misshapen body due to frequent chafing between the functional skin and excess skin. This can cause significant discomfort and possible skin infections from excessive irritation.
Although it is possible to perform a full body lift in one lengthy session, most doctors prefer to break up body contouring surgeries for the safety and comfort of the patient. The body contouring procedures are split up into a few of the most common areas operated on:
- Arm Lift/Brachioplasty
- Body Lift
- Thigh Lift
Arm Lift/Brachioplasty
 Brachioplasty, commonly known as an arm lift, attempts to procure a more natural and youthful look by removing the fat and excess skin hanging down from the underarms. This is most commonly requested by aging women, but some men opt to have this procedure as well. An arm lift is often performed on post-bariatric surgery patients who have lost huge amounts of weight in a short amount of time. The procedure helps to relieve patient's self consciousness in wearing short sleeves or otherwise showing their arms.
How is the procedure performed?
During the arm lift procedure, the incision is made beneath the arm and can extend from the elbow to the armpit, varying upon how much skin must be removed. The skin is then cut away from the rest of the arm and pulled taut around the extremity.
What is recovery from brachioplasty like?
This procedure is very likely to leave a scar that could be very noticeable. Most doctors can adjust where they make their incision so that the cut runs either underneath the arm or on the inside surface. These are less visible in normal poses and can improve over time as the scar fades. However, most patients need to be firmly aware that they are essentially trading "Å“skin for scars" with this procedure.
The initial recovery time for this procedure is short, as the patient may return to light work within a week or less. However, exercise must remain off limits for two weeks. The results will be immediately obvious, but will show apparent improvement over the next two weeks as swelling subsides. The scars will heal and mature over the next six months, possibly fading from sight entirely.
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Body Lift
A body lift, also known as a belt lipectomy, is performed to remove excess skin or fatty tissue on the body that results from age or extreme weight loss. More extensive than just a tummy tuck, the body lift is performed on the lower torso and upper legs and resculpts the abdomen, hips, back, buttocks and outer thighs.
Who is a good candidate for liposuction?
People who have lost a large amount of weight, either through gastric bypass surgery, intestinal bypass surgery, or change in nutrition and fitness habits, may have excess skin on their bodies and are excellent candidates for a body lift. Other people who are unable to lose 30 or 40 pounds through diet or exercise may also opt for body lift surgeries. A body lift is also an option for normal-weight women who have given birth and want to remove remaining skin and tissue after losing post-pregnancy weight.
How is the procedure performed?
The steps of the body lift procedure differ depending on the needs of the patient. In most cases, however, the surgeon will operate on the stomach first, removing excess skin from the belly button to the pubic area and then tightening the abdominal wall muscle. This is the area that is most often loosened by pregnancy or excessive weight loss. The fat and skin from above the belly button is pulled down and sutured in place, and the belly button is pulled out to its normal position.
The procedure continues with the buttocks and thigh areas, with the incisions being made as inconspicuous as possible. In cases that require the removal of fat, liposuction is often involved. The entire body lift procedure takes 3 to 7 hours and is performed under general anesthetic.
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Thigh Lift
 A thigh lift is performed to tighten the skin around the inner thigh to form a more aesthetically pleasing frame. The outer thigh is generally not targeted in a thigh lift as liposuction and a butt lift tend to produce better results in that area of the leg.
How is the procedure performed?
This procedure requires a surgical incision of varying size based on how much skin must be removed. The location of the incision is usually on the medial side of the thigh and can be adjusted based on clothing preference or overall reduction of visibility.
After surgery, the patient is dressed in a compression garment to limit swelling. Discomfort is generally minimal in smaller lifts, but when large amounts of skin are removed, an overnight stay in the hospital may be required. In either case, pain medication and anti-inflammatory methods will be utilized.
What is recovery from the thigh lift procedure like?
Light labor is normally possible after less than two weeks, while most physical activity is permissible at four to six weeks. All symptoms should be gone and scars maximally faded within six months.
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