Have you lost a significant amount of weight but still dealing with loose skin? A series of plastic surgeries called body contouring can help trim excess skin from several places on your body.
Sometimes people believe removing extra skin after bariatric surgery or significant weight loss is a purely cosmetic procedure. But it also has a practical health purpose.
“The medical reason to remove the skin is to prevent rashes and discomfort from the extra skin chafing,” says plastic surgeon Raymond Isakov, MD. “So, we usually recommend removing extra skin, as long as it’s going to be safe, reasonable and the patient is a good fit for the surgery.”
5 places where body contouring may help
The standard body contouring procedure for your belly is an abdominoplasty. The plastic surgeon removes the extra skin and tightens the muscles to make the entire stomach area look better and tighter.
“In some of the patients who’ve had a significant amount of weight loss, we actually go all the way around their body in a procedure that we call a circumferential or belt lipectomy,” says Dr. Isakov.
Also known as a lower body lift, the procedure reshapes the patient’s abdomen, hips, thighs and buttocks.
2. Chest area
Both men and women may require breast surgery to remove extra skin hanging from the chest.
For women, the procedure is similar to a breast lift operation. For men, the plastic surgeon performs a gynecomastia procedure also used for men who develop breasts because of a hormone imbalance.
3. Upper arms
Patients often complain of deflated arms or what is known as a batwing deformity, because there’s so much extra skin hanging down it looks like a batwing. It is a safe, specialized operation, but it will leave a scar, according to Dr. Isakov.
“All of these operations trade off scars for shape,” he says. “But they usually heal very well in time, and these patients don’t mind the trade-off.”
A plastic surgeon can remove extra skin on your thighs, but it can be a more difficult procedure. It depends on how heavy the thigh still is and the anatomic location of the skin, Dr. Isakov says.
Removing extra skin from your face is the phase of the body contouring process often left until last. It typically requires a fair amount of work, Dr. Isakov says.
Staging the operations
According to Dr. Isakov, the plastic surgeon can do some of these procedures at the same time, but this works best with ideal candidates with a lower body mass index (BMI) who are very healthy.
Usually, however, the surgeon performs the procedures in multiple stages. Each requires several months of rest and recovery. Patients must be at their plateau for weight loss for at least three months before beginning the procedures, Dr. Isakov says.
“Before each procedure, you have to be mentally prepared for a surgical recovery, motivated and have realistic expectations,” he says. “I also have many patients supplement their protein intake prior to surgery.”
Be ready to commit time and money
Patients must take ample time off from work for the procedures and recovery. Covering the cost of the procedures is another concern for many patients.
“People think the insurance companies are going to cover all of this, and they don’t,” says Dr. Isakov. “Therefore, some people just can’t afford to have them done.”
While most patients select the operation that they want or need the most, the best thing to do is talk with your doctor, he says.
“Each patient needs a thorough medical consultation to assess their risk, what they need, what they’re capable of getting, how many procedures they’re capable of doing at one time, and what they can afford,” he says.
Is body contouring different from coolsculpting?
Body contouring procedures and coolsculpting™ are very different. Coolsculpting is a nonsurgical tool that targets fat cells underneath the skin with controlled cooling. It only works on patients with good skin quality.
Bariatric surgery patients who have experienced substantial weight loss generally are not candidates, according to Dr. Isakov.
“Post-bariatric body contouring is a more involved surgical procedure for our patients who need large amounts of skin surgically excised,” he says.
Coolsculpting™ is a registered trademark of Zeltiq Aesthetics, Inc.