Alfred R. Antonetti, MD

Congratulations on your weight loss. You posted no pictures of your back so we can not tell what do to here. Patients with massive weight loss have very large amounts of overhanging tissue and would benefit from a circumferential or extended al least abdominoplasty. This removes the horizontal excess tissue . There is also some excess vertical tissue that could be removed with the Fleur de lis but this leaves you with a vertical midline scar and some patients and surgeons do not like this. You will made the decision on this after consultation with your plastic surgeon. The best results you are going to get is with weigh loss first or you will have lesser results. At 290 you are still on the heavy side and should loose to below 200 for the better result. Massive weight loss patients will have a lot of benefit from the surgery but many will require other secondary procedures each for a little improvement later.

FACS means you are a Fellow in the America College of Surgeons. To be a member you have to be in practice and be certified by one of the surgery boards. As a diplomat of the American Board of Plastic Surgery, you are eligible to belong to FACS. You pay a big fee and continue to pay every year to belong. Only surgeons with good credentials can become members. I am a member and use the FACS after my name. It made me feel good but I don't know if it has ever done anything for me. Most of the members are general surgeons and it is a lot more important for them. For a plastic surgeon I believe it has lost a lot of its relevance. To a plastic surgeon it is a lot more important and prestigious to belong the American Society of Plastic Surgeons and the American Society for Aesthetic Plastic Surgery and a lot of us belong to this as well. Hope this answers your question.

It is possible to do liposuction with fat transfers on you. You appear to have good skin without any looseness and would be a good candidate. No transfers of neck skin.

It will probably not go away by itself. It looks like a small fat collection or lipoma. It may be possible to treat this with a small touch up lipo under local anesthesia.

It is possible that have some weakness of the abdominal wall or even a hernia development. You need to see your surgeon for examination.