How to Decide on Procedures & Choose a Surgeon when They Present Such Different Treatment Plans & Staging? (photo)

Lost 115 lbs, left w/ saggy skin...met with 5 board certified plastic surgeons, and instead of being closer to a decision, I'm more confused. I've been told different opinions and all these surgeons seem knowledgeable & convincing...Do I need a LBL or would an extended TT be sufficient? Can I put implants in at the time of BL or should it be staged separately? I'm unhappy with my breasts and stomach, prefer only one surgery & scars that are hidden. Yet I don't want dog ears or unbalanced body.

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14 Doctor Answers | Asked by ps2012 in upstate NY

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Surgeons will have different opinions; be sure your surgeon is experienced in the area of weight loss

Congratulations on your significant weight loss. I can understand your frustration with so many different opinions regarding your procedures. Truth is that there is no right answer and as I say, plastic surgery is like baking an apple pie. There are a thousand and one ways to make a really good apple pie! If you were my patient, I would suggest a single surgery to include a circumferential body lift, breast lift, and implants. The reason I would... more

Different Treatment Plans & Staging

When there are choices and options, it is not surprising that you will get differing advice. I'll add mine, but I would yield to an surgeon who had the opportunity to do an exam. Given your stated preferences and what I can see in the photos, I would favor an extended TT, and a breast lift. I don't see enough soft tissue excess along the back to justify extending the incision all the way around. At the same setting I would do a full anchor pattern breast lift.I... more

Choosing a Surgeon

I think that an experienced plastic surgeon could perform both procedures, tummy tuck and breast lift with or without implants in under four hours. From your pictures, I do not think you really need and extended tummy tuck, but liposuction alone would not work. An anchor type breast lift with or without implants is the only lift that would probably work as you have quite a bit of sagging. the larger the implant usually translates into a shorter scar in the breast crease, though going... more

Confused, what procedure is best for me.

Congratulations on losing the weight. I commonly perform multiple procedures in one setting safely. You can 2 team the procedure safely and get multiple procedures done in one setting. For example, lower body lift, medial thigh lift, and breast procedure in one setting safely. Breast lift with or without implants can be performed. The decision on whether you want implants is whether you want to be bigger than you are in a bra. If you do then add an implant at the time of the procedure... more

Rick Rosen, MD

3 reviews

Norwalk Plastic Surgeon

What Type of Surgery Should I Have After Massive Weight Loss?

Dear ps2012, Different plastic surgeons will often choose different combinations of procedures to obtain the desired results. The plastic surgeon uses the stated goals of the patient in combination with the examination to help in this process. This is why you are facing such a variety of recommendations from all of your doctors. You can help narrow which surgeon's recommendations are right for you by focusing down on your priorities. The final shaping... more

Treatment options

Congratulations on your weight loss. I'm glad to hear you only visited with board certified plastic surgeons. Given your anatomy, there are definitely different treatment options. Which is the "best" for you will depend on your goals, your anatomy, and of course, your budget. There are different ways to treat excess skin. My suggestion: review your surgeon's before/after photos and go with your gut feeling - pick the surgeon and the office staff with whom you... more

Body lift vs extended tummy tuck after weight loss

Firstly, congratulations on the weight loss - 115 lbs is quite the accomplishment. Based on both your photos and details shared within your question, I think the best path forward for you would be to combine an augmentation mastopexy (that uses a small implant to maintain superior fullness) with a full tummy tuck that can be extended laterally if the laxity in the flank area is excessive. A little bit of liposuctioning to the hips and lower back can also be performed if needed. The... more

Massive weight loss and surgery

Unfortunately, it is like going to different restaurants, each chef makes his chicken soup a bit differently. AS for you, a body lift may be good if you feel that buttock area is a bit saggy and loose. If not, just an extended tummy tuck may be reasonable. I prefer to not combine the breasts with a lower body lift in most cases. Good luck.

Steven Wallach, MD

12 reviews

Manhattan Plastic Surgeon

Procedure choice after weight loss

I'm sorry that your consultations generated more questions than answers. After losing lots of weight, plastic surgery involves a tradeoff - scars for better contour. Although an accurate treatment plan depends on an actual consultation and examination of your skin quality and a number of other factors, based on your pictures I'd recommend an "extended" abdominoplasty in conjunction with a breast lift (and an implant, if you're not happy with the volume in your breasts)... more

What kind of body lift do I need?

You have done a wonderful job losing weight. Now the fun begins, getting ready to get all the new outfits. Looking at your pictures, if you are in reasonable health I would recommend the following: A Dr "O" Total Body Lift. That comprises of an abdominoplasty, Corsetplasty, Beltectomy, Bra roll excision, +/-a reverse abdominoplasty. This procedure will tighten up your trunk in one procedure. During that surgery I would recommend you do a breastlift with/without... more