Will body lift (flanks) help with loose lats skin? (Photo)

Question

Hey doctors, I had abdominoplasty done to remove excess skin in lower abdomen after 205lb weight loss. I'm still finding it very difficult to get rid of flank fat/skin and was told by my doctor that I would need a body lift. I'm not sure if this would also fix the excess skin I have in my lats that I'm shown pinching in the picture. I would love your help finding the best solution to get rid of my flanks along with helping the loose skin in my lats. Thank you!

Robert W. Kessler, MD, FACS · Answer

Congratulations on your weight loss.The image you shared demonstrates the difference between an abdominoplasty and a lower body lift. The flank fullness persists and in fact is exaggerated by the abrupt ending of the abdominoplasty incision. The completion operation is called a transverse thigh body lift and will continue the incision from the abdominoplasty and meet at the buttock crease. You will love the abdomen and waist contour. This operation will not completely address the excess skin of the chest and back. This will most likely require what is called a bra line back lift which begins just in front of where you are pinching and ends in the mid back depending on how much laxity there is. There are lesser variations of this procedure but a consultation would be necessary to determine that.Seek out a board certified plastic surgeon with experience in body contouring after significant weight loss.Good luck and I hope this was helpful.

J. Timothy Katzen, MD, FACS · Answer

Thank you for your question regarding what to do with loose skin around the lats. Congratulations on your weight loss. This is a common problem for patients who have undergone massive weight loss. The only way to remove the skin is to have the skin excised. Liposuction will not remove the skin. It only removes fat. In your situation, I would suggest a torsoplasty. A torsoplasty is a plastic surgery procedure that removes excess skin and fat from the torso. There are two types of torsoplasty horizontal torsoplasty and vertical torsoplasty. I would suggest, in your case, a vertical torsoplasty. In a vertical torsoplasty, an incision is made from the armpit down the side of your torso.
A large elliptical area of skin and fat is removed. The result is a scar that goes down your side that is usually hidden when your arms are at your side. The only disadvantage of this procedure is that the nipple is pulled to the side or laterally. During the procedure, the nipple must be relocated as a sliding or free graft. Your plastic surgeon will discuss this with you at length. Another option is a horizontal torsoplasty. In a horizontal torsoplasty, the incision starts underneath the breast and extends across your back. The disadvantage of this procedure is that there is a noticeable scar across your back. In women, this scar is easier to hide. In men, this scar is more challenging to hide. Either way, I do not think you need a horizontal torsoplasty. In my opinion, you need a vertical torsoplasty. Thank you for your question regarding what to do with loose skin around your Latissimus Doris after massive weight loss.
I specialize in reconstructive plastic surgery after weight loss.  If you have any more questions regarding the panniculectomy, extended lower body lift, lower body lift, 360 circumferential lower body lift, belt lipectomy, belt abdominoplasty, or belt dermolipectomy, please contact my office. Since the panniculectomy or lower body lift is a big procedure, please seek an experienced, board certified plastic surgeon with significant experience performing the panniculectomy or lower body lift. Do your research.  Make sure they have performed at least 100 panniculectomies or circumferential lower body lift surgeries and have the before and after pictures to prove it.  Carefully examine their before and after pictures and check their reviews on RealSelf.   If you cannot find an experienced, panniculectomy or lower body lift surgeon in your neighborhood, consider traveling out of state if you must. Sincerely, Dr. Katzen. (“Verified” Plastic Surgeon, President of the American Society of Bariatric Plastic Surgeons, certified by the American Board of Plastic Surgery, Fellow of the International Society of Aesthetic Plastic Surgery, American College of Surgery, and International College of Surgery and ​member of the American Society of Plastic Surgery, American Academy of Cosmetic Surgery and RealSelf Hall of Fame.)

Carmina Cardenas, MD · Answer

The flanks saggy skin will be improved greatly after a Lower Body Lift and the combination with liposuction. Unfortunately the lower body lift will NOT improve or tighten the upper body skin. The lateral torso flaccid skin will be removed performing the Lateral torsoplasty ("crecent"  how some call it) or a back lift, depending on the excess of your back.Be encouraged.Dr. Cardenas

Manuel Ventura Gonzalez, MD · Answer

Thank you for your question, many congratulations for your results obtained with the previous surgery, taking into account the photo sent by you I can be visualize that in fact you have excessive skin on your back so you are a candidate to perform a back surgery.
If you have struggled with weight gain, and exercise and diet have not given you the dramatic transformation you would like, vaser lipo can be of help.
Vaser lipo uses precise, minimally invasive liposuction technology that produces eye-catching results in a single procedure, this technology offers many advantages compared to traditional liposuction treatments.
The procedure is selective in tissue, directed at fat, but protects other tissues from damage. It is powerful enough to remove substantial areas of fat, but soft enough to treat delicate areas such as the neck and arms.
Vaserlipo is clinically proven to produce even results in the treated areas, leaving your skin soft and your body beautifully contoured.

Robert M. Kachenmeister, MD · Answer

Congrats on your weight loss, that is such a great accomplishment! I would visit a few experienced Board Certified surgeons for opinions and go from there. Obviously there a few suggestions already answered for you and I think an in person consultation would allow you to learn about all options and the end result with each. Thank you for reaching out and posting photos. Best of luck! Dr. Kachenmeister

Arian Mowlavi, MD, FACS (license on probation) · Answer

Hello makebeatsmark,
An extended tummy tuck will remove the redundancy over the flank region. This procedure wraps around the lower love handle and flank area.
An upper body lift will addresses the lat region and remove the excess skin seen in the photo. 
Best wishes,
Dr. Mowlavi

Edward J. Domanskis, MD (in memoriam) · Answer

Body contouring after weight loss is my specialty. I am the President of the American Society of Bariatric Plastic Surgeons. As you know, once someone has excess skin, the best way to remove it is to cut it out. Non surgical means can be used but unfortunately, will not help that much. Different cuts could be used to try and hide the scars which usually heal well in that area.

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