Congratulations on your weight loss! Significant weight loss is hard to achieve, whether through diet and exercise or surgery. A frustrating part of weight loss is the excess sagging skin that comes with it. I see many patients who still feel large because of loose skin. They tuck the skin into their underwear, wear baggy clothing to hide the folds, and can’t work out because of loose flapping skin.
Major weight loss affects all areas of the body: from the face, to the breasts, to the abdomen, to the buttocks, down to the thighs.
A common course would be extended abdominoplasty and liposuction at one surgery, followed by breast and thigh lift at a second surgery. Again, it is tailored to your body and needs.
After major weight loss frequently your breasts will droop. The question is what do you do? Almost all women will need a breast lift. But do you need a breast reduction? Do you need to add volume with an implant? Below are questions to consider when trying to decide.
Know your skin has been stretched and generally the elasticity does not recover. This means your skin is more prone to stretching again in the future.
Just like the breasts, the abdominal skin stretches out over time. Most women tend to carry more of their weight up front in their abdomen than in their back side. For this reason, I tend to do an extended abdominoplasty more often than a lower body lift, as it allows me to remove more abdominal skin than you can when doing a full body lift. An abdominoplasty also is shorter, outpatient, easier-to-recover-from surgery than a body lift.
See my page on abdominoplasty to understand more of what happens to tighten the skin & muscle and recovery. TUMMY TUCK
As with breast surgeries, your skin elasticity is poor, so your skin can stretch out over time.
Major weight loss loosens skin all over the body. Unfortunately skin tone is not something diet, exercise, lasers, or creams can improve. A body lift primarily improves the abdomen, buttocks, and outer thighs. It goes 360 degrees around the body, incorporating an abdominoplasty, a lateral thigh lift, and a buttock lift. The scar runs low in the front near the pubis, and then curves up a little higher along the back. (Imagine a string bikini line.) Recovery is two to three weeks.
A body lift is a significant procedure. It requires 5 hours in the operating room and a 2 night stay in the hospital following surgery. During this procedure skin and fat are removed from the waist, outer thigh, and abdomen. The buttocks are repositioned. The abdominal muscles are tightened. Liposuction is used where needed for fat removal and to aid in contour.
Sometimes an extended abdominoplasty is a better surgery, due to smaller scar and easier recovery. There is no right answer. Decision making depends on your goals and your body shape. How toned do you want to be? What amount of scar is okay? What amount of surgery is okay? How is your health? You’ll want to discuss all this with your plastic surgeon.
"I went to Dr. Greenberg after losing 190 pounds and she has done a wonderful job at removing all the wrinkles caused by my weight loss." - M.B., San JoseView More Testimonials*Individual results may vary
Many of the gastric bypass, gastric stapling, or gastric sleeve procedures result in poor nutrition and absorption of nutrients.
Before considering surgery, consult with your primary care doctor and have basic labs checked for your blood level and nutrition.
You want your weight to be stable. With weight loss you may find you lose weight at a steady pace and then you get stuck. This is called a plateau. You work out, eat well and just. can’t. move. past. this. point. This can be a good time to use surgery to get you over the hump.
While you are actively losing weight take advantage of that momentum. When you have surgery, during your healing time you will not be able to work out for about one month. If you continue to lose weight after the surgery, it will loosen up the tightening from the breast lift or tummy tuck.
Stable weight for six months is ideal.
Future pregnancies. This gets to be tricky for me. If you are far away from baby making or don’t know if you are going to have kids, then I can see doing the surgery now. But otherwise know that babies change the breasts and abdomen a lot. It’s great to fix it all at once after pregnancy.
Quick note on it here, but weight loss affects so many areas:
Please see the corresponding pages for more information.