Weight loss is an important step to regaining your health. Chronic medical conditions such as high blood pressure, diabetes, heart disease, and arthritis can all be alleviated by maintaining a healthy weight and healthy lifestyle. There are many methods of weight loss, including diet and exercise, as well well as bariatric surgery. Support groups likened to 12 step recovery groups play a vital role in the maintenance of a healthy lifestyle for the person who has lost weight.
Despite all of the important positives of weight loss, many people are left with hanging, excess skin that just will not go away with exercise. This can leave a person who has done so well with improving their health feel slighted and even embarrassed because of the excess skin. Cosmetic surgery after weight loss helps to remove the excess skin and contour the areas of concern. Dr. Trussler offers cosmetic options from head to toe for the patient who has lost a significant amount of weight.
What Are My Plastic Surgery Options?
Cosmetic surgery after weight loss is becoming very popular in the advent of bariatric surgical weight loss. The techniques often combine reconstructive and cosmetic procedures to tighten, lift and contour sagging areas of almost any body part. Medical indications for some procedures include chronic neck and back pain, difficulty finding supportive garments, and hygiene issues like rashes that won’t go away. The cosmetic surgery options for the patient who has lost weight includes:
Cosmetic surgery after weight loss can help tighten and contour areas which have sagged and flattened. Patients, both men, and women should be healthy, non-smoking and at a stable weight for greater than 6 months prior to considering any cosmetic procedure. The extent, location and condition of the excess skin all factor into the decision of the procedure and scar pattern for any of the above cosmetic procedures after weight loss. Liposuction may be used in any of these procedures to help shape, define, and contour areas though most patients with a significant amount of excess skin require excisional procedures which remove, lift and tighten the skin through a differing incision and scar patterns. The scar is the most difficult factor to accept when approaching any body contouring procedure. Dr. Trussler will give his honest opinion on the right scar pattern for your individual post-weightloss contouring procedure and with time and active scar care these scars will fade.
Many patients do inquire about combining body contouring procedures at the time of consultation. Dr. Trussler will discuss possible combinations of cosmetic procedures after weight loss that are safe and effective at addressing multiple areas of excess skin.
For more information on male body contouring after weight loss see our blog on the belt lipectomy.
Realistic expectations are important when considering cosmetic surgery after weight loss. Dr. Trussler will listen to your goals and factor into the extent and location of sagging, excess skin to help come up with a contouring procedure that is right for you. No matter what incision pattern is performed there will be a scar. Scar quality and how the scar heals depends on what is done before, during and after cosmetic surgery. Choosing the right incision type for your procedure and Dr. Trussler’s surgical experience to help with scarring, but good nutrition, smoking cessation, avoidance of sun, limiting activity, and active scar care all help to improve the healing process. Dr. Trussler will provide detailed instructions for your cosmetic procedure after weight loss.
Gaining or losing weight after body contouring procedures can affect the long-term results, so patients should undergo these procedures when they are comfortable with their weight and lifestyle. Patients must remain committed to maintaining their health after cosmetic procedures, through a healthy diet, regular exercise, and maintenance of their support group. With a positive outlook and realistic goals, patients are able to regain confidence in their body and reap the rewards of their hard work in weight loss.
Cosmetic surgery after weight loss can take approximately five to six hours under general anesthesia depending on what procedure is performed and the extent of excess skin, fat, and soft tissue laxity. Dr. Trussler does recommend at least one night in the aftercare unit to help make the recovery safe and comfortable. The areas of skin excision and the incision placement are typically marked during the pre-operative appointment. Dr. Trussler may perform one or more of the following procedures for patients after weight loss:
Neck Lift is designed to remove and tighten the hanging skin under the chin which commonly is the most visible and concerning area after weight loss. This surgical procedure which tightens skin removes fat and repairs muscle through a small incision under the chin and incisions on either side of the face hidden around the ear.
Arm Lift (Brachioplasty)
Arm Lift (Brachioplasty) utilizes an incision on the lower aspect of the arm to remove hanging skin from the elbow to the armpit which leaves a linear scar at the bottom of the arm. Ideally, this scar is not visible with the arms down to the side or raised to 90 degrees.
Upper Body Lift
Upper Body Lift combines the linear incision from the elbow along the bottom of the arm similar to the full brachioplasty but then extends the incision down along the outer side of the chest to help contour the back and outer chest. The scar is similar to a full brachioplasty but crosses the armpit and arches down along the outer chest. This procedure can be combined with a breast enhancement procedure in women such as a mastopexy, or a male chest contouring procedure.
Breast Lift (Mastopexy)
Breast Lift (Mastopexy) is performed to reverse the changes created from weight loss and return a youthful shape and lift to your breasts. In all breast lift procedures, the incisions are made around the nipple areola to reduce its size and facilitate the ability to move it upwards. A breast implant may be used to help add volume and shape to the breast, or an auto-augmentation can use your own breast tissue to provide an implant-like shape.
Abdominoplasty (Tummy Tuck)
Abdominoplasty (Tummy Tuck) is designed to recontour the entire abdomen and can tighten skin above and below the belly button. The abdominal muscle is typically tightened and the belly button is repositioned. The incision is kept in a very low position though typically extends to the hips.
Buttock Lift is an excisional technique commonly combined with a body lift. The procedure lifts and removes excess skin in the sagging buttock through an arching upper buttock incision. The buttock can be shaped with internal stitches and the incision pattern. Buttock Lift with Auto-augmentation is a combination procedure that utilizes the buttock tissue typically removed in a buttock lift to fill areas of volume deficiency. The procedure utilizes the similar incision as the buttock lift through a body lift is usually not combined with this procedure.
Outer Thigh Lift
Outer Thigh Lift is commonly performed in conjunction with a buttock lift and the incision is placed along upper buttock border and wraps around the upper hip region. This back and side incision can be joined with the abdominoplasty incision to form the circumferential incision of a body lift. After the outer thigh skin excess is pulled up and removed, the outer thigh lift incisions are closed with two to three layers of absorbable sutures, as well as deep supportive stitches.
Inner Thigh Lift
Inner Thigh Lift utilizes an incision on the “in-seam” aspect of the inner thigh to remove the skin from the groin to the knee which leaves a linear scar along the inner thigh. Ideally, this scar is not visible with the legs in a standing or sitting position.
Lower Body Lift (Extended Abdominoplasty)
Lower Body Lift (Extended Abdominoplasty) is designed for the patient with excess, lax skin in the abdomen and outer hip region. The incision is commonly made circumferentially in the lower waistline to lift and contour the buttocks, hips, and abdomen.
Liposuction can be included as part of the cosmetic procedure after weight loss to contour areas not responsive to diet and exercise such as the inner and outer thighs, or to sculpt the abdomen and hips as part of a tummy tuck. It is uncommon that liposuction alone would be effective at sculpting the post-weight loss abdomen because the skin and/ or muscle is commonly stretched which is not improved with liposuction alone. Liposuction may make the excess skin and protuberant abdomen more pronounced if those structures are left untreated.
In the majority of these cosmetic procedures after weight loss, Dr. Trussler closes all incisions with deeper supporting stitches and then aligns the scars with stitches under the skin. Drains are often placed in these procedures to help collect fluid that accumulates after the operation. A compression garment is placed at the conclusion of the operations to hold the contour in place and avoid collections of fluid.These procedures may be performed separately or at the same time depending on the location and extent of correction required. Dr. Trussler will provide detailed instructions for your surgical procedure(s).
After Care & Recovery
After any cosmetic surgical procedure, patients will likely experience mild soreness and swelling for a few days. Dr. Trussler advises at least a one night stay in the aftercare unit to encourage early ambulation and make the first night after the surgery comfortable.Mothers have two or more people to worry about at home, but in the first week after any cosmetic surgery, it is important to have enough help at home so moms can focus on their own healing and recovery.
- Dr. Trussler does make it easy to recover after surgery by limiting the amount of care needed on the incisions and surgical areas for the first week.
- In general, a compressive garment is kept on the abdomen and extremities depending on the procedures, and the torso may be flexed to protect the abdominal incision.
- After the first week, drains and stitches are removed and the compression garments are downsized.
Most patients will be able to return to caring for their children, work and light exercise within two weeks, although vigorous exercise and other strenuous activity should be avoided for about a month. Heavy lifting greater than 30 lbs is limited for 6 weeks. Dr. Trussler will provide you with specific instructions for your individual recovery.
The results of any cosmetic procedures after weight loss are visible immediately after surgery and will continue to improve as swelling subsides and scars fade. Your shape will evolve over a three month period. Scar treatment will be initiated at the 3-week visit and may be continued for 3 to 6 months after the operation, or until the scars soften and fade.
Whether you have a question or would like to set up a cosmetic consultation, Dr. Trussler and his staff are here to help. Please fill out our contact form, or call our office at (512) 450-1077 to schedule an appointment. Start your journey to not only looking but feeling better today!