I need help & advice sorting my body after losing 8 stone post gastric sleeve (Photos)

Question

I had a gastric sleeve oct 2021 lost 8 stone so far and still loosing but my body is disgusting i need a professional opinion pn what work i need done and how much this is going to cost me. i need the bottom of my back cut off along with my tummy and i need my breasts sorting out as they have dropped so much. they actually hurt my back coz there heavy!! Any help and advice would be amazing

Carmina Cardenas, MD · Answer

It is wonderful what you have achieved!! Congratulations. 
You have developed flaccid  skin on your abdomen, not only length (apron hanging) but also a lot of excess of width, you still have some visceral fat so it will be very helpful if you trim  more weight to reduce visceral fat and after the Loer Body Lift Fleur de Lis, achieve a beautiful and attractive flat abdomen performing.  You will need as part of the procedure most likely mons pubic lift, outer thigh lifting, reduction and tightening of lower back and definitely a real buttocks lift and auto augmentation creating a beautiful buttocks flap, using your own tissues above buttocks. 
In my opinion the Royal LBL and Fleur de Lis willl be large enough surgery, so I would recommend to do the upper body separated: Major breast lift also using your pie tissues to create a bit of fullness on top, arms and lateral torso. 
Be encouraged!! You have achieved already a wonderful goal, so what is next will be very rewarding. 
Dr. Cárdenas

J. Timothy Katzen, MD, FACS · Answer

Hello NadineMCX, 
Thank you for your question regarding advice sorting out your body after losing eight stone postop gastric sleeve surgery. Congratulations on your weight loss!  Great job.  The most important thing for you now is to continue losing weight. It makes no sense embarking upon reconstructive plastic surgery after massive weight loss at this point. If one or to do reconstructive plastic surgery after mass of weight loss at this time, post-operatively you may continue to lose more weight and thus, damage and destroy your plastic surgery results. This post plastic surgery weight loss may require either partial or total revision of plastic surgery already performed. 
In terms of the procedures you will need, you will probably need a 360 circumferential lower body lift. The 360 circumferential lower body lift is also called an extended tummy tuck and butt lift, belt lipectomy, or belt abdominoplasty  The 360 circumferential lower body lift procedure includes abdominoplasty (tummy tuck), pubic (mons) lift or reduction, hip lift/reduction, and butt lift/reduction.  
You did not provide pictures of your breast. However, I would anticipate you would need a breast reduction, based on your complaints. I would anticipate you would need a full anchor mastopexy and breast reduction. That means the incision goes around the areola, down the front of the breast, and underneath each breast. 
On average, the 360 circumferential lower body lift takes approximately six to eight hours to complete under general anesthesia. Typically, your breast reduction would take 4 to 5 hours.  
In regards to price, this varies widely by geographic location. I would suggest you consult with several board Certified plastic surgeons to get the price range. You may also consider traveling internationally to find a body lift expert. I specialize in reconstructive plastic surgery after weight loss.  If you have any more questions regarding the lower body lift, 360 circumferential lower body lift, belt lipectomy, belt abdominoplasty, or belt dermolipectomy please contact my office. Since the body lift is a big procedure, please seek an experienced, board certified plastic surgeon with significant experience performing the lower body lift. Do your research.  Make sure they have performed at least 100 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, 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 RealSelf Hall of Fame, and RealSelf Doctor Advisory Board for Medical Review and Consumer Panel.)

Daniel Barrett, MD · Answer

Dear nadinemcx,
congrats on the weight loss! Generally speaking, you want to reach your goal weight before you consider surgery, otherwise your results will be suboptimal if you continue to lose weight after the surgery. If you are considering surgery, I would suggest you consult a board-certified plastic surgeon. Only after a thorough examination, you will get more information and recommendations.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Camille Cash, MD · Answer

Congratulations on your impressive weight loss!  Once you have reached your goal weight and are able to maintain it you are ready for skin removal surgery.  From the submitted photos it appears you are a good candidate for a circumferential tummy tuck with liposuction for contouring.  The breasts can be addressed based on your concerns, whether it be a lift, implants, or both.  I've included a video that I hope you find helpful.

Ahmad H. Ahmadi, MD · Answer

You need a lower body lift to start with.  Typically gastric sleeve patients require addiiontal procdures such as arm lift, thigh lift and breast lift.  You will need to see a board-certified plasti srugeon to examine you and quote you price.  LPricing varies from region to region.  Good luck.

Derek Fletcher, MD · Answer

Congratulations on your weight loss! Based on your photos you will eventually need a circumferential lower body lift. This operation is designed to remove extra skin and soft tissue from the entire circumference of your body. It is a powerful operation that can dramatically improve body contour, both functionally and aesthetically. This operation is often combined with liposuction and rectus plication. When well planned and executed, it can lift the lateral thigh and buttocks. It is possible to combine this operation with a breast lift. An in person exam is necessary to determine how many procedures can be safely combined under one general anesthetic.
Timing of surgery and safety are critically important. I advise weight loss patients to maintain their goal weight for 9-12 months prior to having a lower body lift. I routinely communicate with our weight loss surgeons to ensure that all aspects of my patient's health (especially nutrition) are optimized prior to surgery. Sometimes that means additional consultations with sub specialists to obtain preoperative medical clearance. Surgery takes between 4 and 7 hours depending on the individual and what is being done. My patient's stay overnight at our accredited surgery center with two-on-one nursing to ensure maximum safety and comfort. I see my patients on day 1, 8, 14, week 6, week 12, and at 1 year. 
Hope this helps and best of luck on your journey!

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