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Patient Details
This woman, 5’8″ and 148 pounds, had bariatric (weight loss) surgery performed and lost over 100 pounds. She was interested in body contouring options for her loose, saggy skin. We elected to focus initially on the “big picture” and opted to perform a bilateral breast enhancement as well as an extended abdominoplasty. She is seen here about four years after her procedures. The improvement is obvious, her excess skin has been removed and the fascia of her abdomen was tightened (sort of like taking in your pants after you lose weight). She had a thigh lift performed elsewhere (this is the scar on the upper part of her thighs).
There is a large spectrum of options available for weight loss patients. Personally, I perform procedures that can be done on an outpatient basis (procedure in my office and return home or to a recovery facility, if you choose). Larger more complex procedures are best performed in the hospital setting. I always try to see the good aspects of every woman who has experienced massive weight loss and who has loose, saggy skin. In my opinion, the results don’t have to be perfect (in fact, it can’t be perfect), and I like to focus on those areas that patients benefit most from. Ultimately, “correcting” every area of loose or saggy skin will result in a “ragdoll” distribution of scarring which some patients may object to. Having said that, many bariatric patients don’t have concerns about scarring (‘anything is better than what I have’). You can imagine that to some degree bariatric patients would naturally have some body image distortion because of the radical change that has occurred to them. This takes careful and thoughtful counseling to explore these issues and determine what is best for the individual patient. If you are planning complex procedures that require a long operation time and a lengthy recovery, you must accept a higher complication rate. This is one of the prime reasons I prefer to stage your rejuvenation-I believe it is safer and more manageable to take it in bites rather than swallow the whole enchilada. You will sometimes pleasantly be surprised that less is more.
