Makeover Surgery after Massive Weight Loss
Patients undergoing massive weight loss (80 – 300+ lbs.) from lifestyle change or bariatric surgery represent a unique subset of patients seeking aesthetic surgery. The enormous fluctuation in weight gain and loss creates an alteration in skin elasticity often coupled with redundant skin and fat of the arms, abdomen, flanks, and thighs. The breasts are generally deflated and very droopy. Loss of facial fat and sagging tissues can create an impression of premature aging.
Surgical correction of droopy, redundant skin and residual fat is intended to improve body and breast contour, restore normal anatomic relationships, improve hygiene, and restore self-confidence. Patients undergoing breast and body surgery after massive weight loss generally required a staged approach given the complexity of the corrective surgery, time required, extent of the tissue removal, and potential blood loss.
Typically, two surgical stages are required with a third stage needed for facial rejuvenation. For example, corrective arm surgery (rhinoplasty) may be coupled with lower body lift (belt lipectomy), liposuction, and fat grafting of buttocks (Brazilian Butt Lift). Alternatively, breast augmentation with lift, breast lift or reduction, fat grafting of breasts may be performed at the first stage and corrective arm surgery may be deferred to a second stage with a total thigh lift. Stages are staggered by a minimum of 3 months and more typically 6 months.
Additional procedures such as upper body lift, or brassiere roll reduction may be added depending on the unique needs of each patient. Revisions may be necessary following corrective surgery for massive weight loss because the elasticity of the skin has been affected by the wide swings in weight. This is particularly true following breast lift with augmentation and it is for this reason that a staged approach for this procedure may be necessary to ensure a good result.