While there are different types of plastic surgery after weight loss, they all share one goal: To address contour deformity due to poor skin tone and “redundancy,” soft tissue laxity, and highly fibrous fats.
All body contouring surgeries for massive weight loss (MWL) patients will require direct excision, thereby the appearance of scar is an inevitable tradeoff if they want to achieve a near normal appearance and/or find relief from pain, irritation, and skin breakdown caused by the large folds of skin.
Below is the list of the most common types of plastic surgery after weight loss, according to California Surgical Institute website.
* Tummy tuck. While the standard technique uses a hip-to-hip incision, MWL patients typically require a longer flank-to-flank incision for further contouring. Despite the resulting scar, studies have suggested that it can result in high patient satisfaction due to notable improvements in the quality of life and body functions, as the redundant skin in the abdomen is the most problematic—i.e., it causes irritation and foul odor.
* Thigh lift. Depending on the location of redundant skin, it may involve incisions within the groin and gluteal crease, on the inner thigh that could be extended into the knee area, in the hips, or a combination of these incision patterns.
* Buttock lift. Most MWL patients require a horizontal incision on the upper butt cheeks.
* Lower body lift. This accomplishes the goals of tummy tuck, outer thigh lift, and buttock lift under one operation as it uses a belt-like incision.
* Arm lift. For MWL patients, it typically uses a long incision on the inner arm or somewhat more posteriorly (starting from the armpit to the elbow), depending on the location of redundant skin.
* Breast enhancement. Female patients may require breast lift and/or reduction, while males may need gynecomastia surgery to correct their woman-like breast caused by the excess skin and/or fat.
* Liposuction. As a stand-alone procedure, it does not provide optimal results for MWL patients who really require an excision-based body contouring surgery because this is the only way to remove the large folds of skin.
Liposuction for MWL patients is often needed for debulking, or removing large amount of excess “fibrous” fat, which does not respond to further weight loss. Most surgeons perform the procedure at least six months prior to an excision-based surgery.
While “simultaneous” liposuction is sometimes acceptable, MWL patients generally require a stage approach to minimize the amount of surgical trauma and to reduce the risk associated with fluid imbalance and bleeding.