Does expertise in mommy makeover translate to body lift after massive weight loss?

Question

When looking for a plastic surgeon to do a body life and other procedures specifically meant to address loose skin after massive weight loss, is a doctor experienced with/known for "mommy makeover" procedures likely to have skills that translate well into post weight loss procedures? It seems there are very few surgeons that specifically and overtly specialize in post-massive weight loss procedures. Thank you!

Gerald Minniti, MD, FACS · Answer

I think it's fair to say that the exclusive specialization in cosmetic plastic surgery for massive weight loss  (MWL) patients is rare, and that those who do a lot of it are more expert than those that don't. However, principles gleaned from 'regular' skin removing surgeries like abdominoplasties, arm lifts and thigh lifts are the same for surgeries performed on massive weight loss patients. As an aside, I can think of a half dozen of my colleagues in town who do a better job on MWL patients than the one colleague who does it almost exclusively. Who you choose needs to show proficiency at the specific procedure of interest, for instance a lower body lift, but doesn't need to be only doing that one procedure.

Christine Fisher, MD, FACS · Answer

Fantastic question!  Congratulations on your weight loss!  There are definitely some nuances to aesthetic skin removal surgery versus a traditional mommy makeover which only removes a small to moderate amount of excess skin.  It is ideal so seek out a board certified plastic surgery that has specific training in post weight loss skin removal.  I specifically trained with an expert in the field while in my plastic surgery residency, and have continued to progress in the procedure, performing skin removal regularly in my 11 years of professional practice.  It sounds like you’re doing your due diligence to be an informed consumer and I highly recommend having a few consultations before choosing your surgeon.  Best of luck in your aesthetic journey!

J. Timothy Katzen, MD, FACS · Answer

Hello.  Thank you for your question regarding "does expertise in mommy makeover translate to body lift after massive weight loss?" The short answer is "no".  Plastic surgery expertise in one type of patient does not translate into expertise in another type of patient.  Skills sets are different.  Additionally, weight loss patient are different.  Weight loss patient skin, muscle, and fat are different from women who have had a child.  Typically, massive weight loss skin and rectus have been stretched much more and for longer than post-pregnancy skin and muscle.  Therefore, compared to post-pregnancy patients, massive weight loss patients require more skin to be removed and the rectus muscle to be tightened more.  Both the skin and rectus muscle have to reduced and tightened more than pregnancy patients.  Also, compared to post-pregnancy patients, massive weight loss patients who have undergone stomach altering surgeries have different metabolic needs.  Most weight loss patient are anemic or have low hemoglobin levels.  They may  also have B12 deficiencies.  These conditions can lead to poor wound healing.  Plastic surgeons who specialize in massive weight loss recognize these conditions and are ready to treat.  Plastic surgeons who specialize in mommy makeover may not recognize these conditions or know how to deal with poor healing and wounds.  In regards to plastic surgeons who specialize in weigh loss, there are plastic surgeons who specialize in massive weight loss  Please just dig deeper in you Google search: )).  I hope that I have answered your questions about "does expertise in mommy makeover translate to body lift after massive weight loss?" Good luck.  Sincerely, Dr. J. Timothy Katzen, M.D.

Jeffrey M. Darrow, MD · Answer

A surgeon who has extensive experience with mommy makeovers, which can involve abdominoplasty and breast lifts, should be able to translate that knowledge of proper skin removal, skin tension and incision placement to the different weight loss procedures.  Some surgeons may have gained this knowledge during their residency and early practice focus and other surgeons can learn through the extensive continuing medical education courses at the numerous Plastic Surgery meetings throughout the year.  A well trained plastic surgeon, who takes interest in post weight loss surgery, can perform these procedures extremely well.

Daniel Barrett, MD · Answer

Dear Persistent123642,

finding the right Dr. is extremely challenging especially with the number of online platforms and resources available. There a lot of great Dr's available. Make sure he/she is a board-certified plastic surgeon. Definitely check to make sure your choice specializes in the procedure you want and spend the time to read through patient testimonials. There is a number of different sites where you can check for reviews (Realself, yelp, google, etc.).
You can always pick up the phone and call around also, find an office you feel comfortable with and set up a few consultations.

Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Chet Mays, MD · Answer

Thank you for your inquiry!   We would love to sit down with you in person and discuss your concerns and your options. Schedule a consultation with a Board-Certified Plastic Surgeon to assist you in reaching your goals.

Jose Telich, MD · Answer

Dear Persistent while mommy makeovers and post-weight-loss body lifts share some similarities, they address different challenges. Mommy makeovers often focus on restoring the abdomen and breasts after pregnancy, while post-weight-loss procedures handle more extensive loose skin across multiple areas like the thighs, arms, and back. Skin after massive weight loss is typically thinner and more delicate, so these surgeries require specialized techniques.

A surgeon skilled in mommy makeovers might have some of the expertise you’re looking for, but it’s a good idea to find someone who regularly performs post-weight-loss procedures. Look for a surgeon who can show you before-and-after photos of patients with similar concerns—that’s a great way to see their experience and results. You deserve someone who truly understands your unique journey and can help you achieve the best outcome.

Salvador Medina, MD · Answer

Hello Persistent123642.

As you mentioned, there are some surgeons that  specialize in massive weight loss surgery. It entails different techniques to address more extensive procedures and have the best outcome.

Let me know if you would like more information.

Dr. Medina

Camille Cash, MD · Answer

When researching surgeons you can look for those who have experience in patients after major weight loss.  Look for before/after photos and ask lots of questions.  I was proud to be featured on Skin Tight, a TLC program which featured helping patients to feel more confident in their new bodies after major weight loss. Visit my website to learn more.

Mats Hagstrom, MD (license on probation) · Answer

Plastic surgeons who specialize in doing weight loss related plastic surgical procedures are the ones who have the most experience with this kind of surgery.
Generally speaking having more experience tends to make people better, but some plastic surgeons weren’t good to start with and are never going to be great.
Others can do an exceptional job at many different procedures, even if they haven’t done it for quite a while, tired
 For weight loss patient there are a few things to consider when contemplating this type of work.
First is the extent of the procedure.
Generally speaking the more skin laxity somebody has the more extensive the procedure should be, and when in doubt the surgery should be taken further around the back, sometimes a wraparound a.k.a. body lift.
 Some providers to do a flirt pattern, adding a vertical scar on the front.
In my opinion, adding the vertical scar should be the last resort after a wrap around. Tummy tuck has been done first.
Start quality
Quality quality work is generally based on the design of the incision and how good the belly button and up looking on a regular basis.
 The biggest mistake I see is not having an extended or wraparound tummy tuck on individuals who have skin laxity and more than just the front of their abdomen.
This leaves them with big dog ears that should’ve been addressed during the primary procedure.
There are also other procedures to consider like thigh lift, arm lift, breast lift, facelift, etc. 
In the end, I suggest you screw a bunch of local plastic surgeons before, and after pictures on their websites and pick out the ones who seem to do good work and have high numbers of before, and after pictures.
You may want to look through reviews to make sure they’re also getting positive reviews from people who had these type of procedures.
 Next plan on scheduling multiple in person consultations with those providers.
There’s no correct number of consultations needed to find the right plastic surgeon.
The more consultations you scheduled the more likely are to find the better provider for your needs.
The more consultations you scheduled the better you’ll be at doing plastic surgery consultations as well.
There are substantial differences in skill and experience for this kind of work.
During each consultation, bring pictures of your body, the same way plastic surgeons take before and after pictures.
Have someone else take the pictures or use the timer on your camera.
Take the picture from about 8 feet away at the level of your upper abdomen.
Crop the picture to include your entire torso, cropping it at your neck and just below the knees.
You need pictures of your front side and backside.
Bring those pictures with you to each consultation to use as a reference whenever you are reviewing before and after pictures.
During each consultation, ask each provider to open up their portfolio and show you their entire collection of before, and after pictures of previous patients who had similar body characteristics to your own. Period
Don’t let them show you pictures of regular tucks or people who don’t look like you.
 Being shown a handful of pre-selected images representing only the best results of a providers career may be insufficient to get a clear understanding of what average results look like in the hands of each provider. Procedures a highly experienced surgeon should have access to 100 or preferably thousands of before and after pictures to choose from.
Body lift surgery is not common, but it’s also not uncommon.
I would say one out of eight tummy tuck surgeries ends up being an extended or wraparound in my experience.
Assessing extremity skin surgery is more complex than the torso.
Breast surgery is pretty straightforward.
Finding the right provider is the most important variable to do that. I suggest patients have in person consultations exclusively, avoiding virtual consultations whenever possible.
I also recommend patients have more consultations with more providers than they may think is necessary.
The biggest mistake I see patients make is having only one consultation and then scheduling surgery.
Having only one consultation, more or less eliminates the ability to choose a better provider.
 The process of signing the right provider takes time.
I suggest patient spend a little less time on the Internet and a little more time actually making appointments and meeting with providers. 
Generally speaking people tend to not do a very good job at selecting plastic surgeons.
Most of the information available on the Internet is highly biased, filtered and misinterpreted.
Some of the absolute best plastic surgeons have virtually no Internet presence at all.
I would stay away from providers who seem to have strong social media campaigns, excessive number of reviews, or those who seem to have paid consultants promoting their practice.
Some of the best plastic surgeons I’ve known did not focus on self promotion.
They have plenty of work and they are busy taking care of their patients not promoting their practice.
When in doubt, slow down and schedule a few more consultations.
Best,
Mats Hagstrom MD

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