When a Tummy Tuck Is Not Enough
While the tummy tuck – or abdominoplasty – is our most frequent abdominal procedure, there are times when it's not appropriate. After extreme weight loss, some patients have excess skin that extends to the back, so we usually recommend a lower body lift in this case. This procedure will not only tighten the abdomen but will also lift the lateral thigh and buttocks.
Patients who benefit from this have usually lost more than 100 pounds and have often had bariatric surgery for weight loss. These patients often initially say that they only want to fix their tummy. However, if the excess skin in the back and sides is not addressed, a nice flat tummy will actually make the flanks and back appear even larger. In my practice the massive weight loss patient will start with the lower body lift. The next step is usually a breast lift and arm lift, followed by thigh lift. Staging the procedures allows an opportunity to do any revisions that might be needed during the subsequent stage.
The remaining extra skin following massive weight loss is a complex problem and should be addressed with a plan tailored for each individual patient’s needs. Losing weight from surgery or diet and exercise is a huge benefit to the health of these patients.
Unfortunately, the aesthetic outcome may not be as great. Removal of excess skin and restoration of a more normal contour can complete the transformation, restore self-esteem and improve their quality of life.