Lost 80 pounds, hanging skin around torso and legs - what procedure would be best? (Photos)

Question

I’ve lost a lot weight. And have large amounts of hanging skin. What’s the best procedure?

Daniel Barrett, MD · Answer

Dear Cheerful944573,

it is hard to tell for sure without an examination. 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

J. Timothy Katzen, MD, FACS · Answer

Hi Cheerful944573, Thank you for your question regarding having lost 80 pounds and now having hanging skin around your torso and legs and what procedure would be best. Thank you for your history and photos. Congratulations on your weight loss. It is very difficult to determine which torso and thigh procedures you need from the pictures you provided. Perhaps you can upload different pictures depicting these areas better? Did you previously have an inverted T abdominoplasty (tummy tuck)? In regard to the thigh lift/reduction, there are 6 different types of thigh lifts: crescent, modified vertical medial, longitudinal vertical medial, complete medial, horizontal hip lift, and outer thigh lift. Basically, if your inner thighs bother you in the inner 1/3 of your thigh, you need a crescent thigh lift. If your inner thighs bother you to the knees, you need a longitudinal vertical medial thigh lift. If your inner thighs bother you to the ankles, you need a complete medial thigh lift. If your outer thighs bother you, as well as your abdomen, you need a horizontal hip lift as an extension of your tummy tuck. If your outer thighs bother you to the knees, you need a vertical lateral thigh lift. All thigh lifts are performed under general anesthesia and require about a 2-3 week recovery.
There are two methods for removing fat from the back: vertical torsoplasty and horizontal torsoplasty. A horizontal torsoplasty is also referred to as a braplasty, bra straplasty, upper back lift, bra lift, or upper body lift. An hourglassing procedure is also referred to as a vertical torsoplasty.
A vertical torsoplasty involves the creation of an incision that extends from the armpit to the mid-axillary line on the side of the chest. The posterior direction of tissue dissection is toward the rear. The lateral breast skin and adipose tissue are drawn forward. A substantial portion of excess lateral chest skin and fat, resembling a football, is excised. The vertical torsoplasty incision is located in the midaxillary line and can be concealed by holding your arms at your sides. The vertical torsoplasty is completed in approximately two hours and is performed under general anesthesia. Typically, a drain is maintained for a period of 7 to 10 days. It is imperative that you allocate yourself a two-week recuperation period. Prolonged use of a medical-grade compression garment for a minimum of six weeks is advised to lessen edema, pain, and scarring. During a horizontal torsoplasty, an incision is made horizontally across the back during a horizontal torsoplasty. A butterfly-shaped area of skin and fat is removed. Two drains are inserted and are typically removed within two to three weeks of the procedure. General anesthesia is administered during the horizontal torsoplasty procedure. Allow for a recovery period of 2 to 3 weeks following a horizontal torsoplasty. Most plastic surgeons offer free virtual or in-office physical consultations. Therefore, explore what other plastic surgeons have to say. I hope that I have answered your questions regarding the torso and thigh reduction. If you have any more questions regarding the thigh lift, thigh reduction, crescent, modified vertical medial, longitudinal vertical medial, complete medial, horizontal hip lift, outer thigh lift, horizontal torsoplasty, or vertical torsoplasty, contact an experienced plastic surgeon. Please seek an experienced, board-certified plastic surgeon with significant experience performing thigh lifts. Do your research. Make sure your chosen plastic surgeon has performed at least 100 thigh lifts and 50 torsoplasties. Make sure they have the before-and-after pictures to prove it. Carefully examine their before-and-after pictures and check their reviews on RealSelf. Sincerely, Dr. Katzen, MD, MBA (President of  the American Society of Bariatric Surgeons; Certified by the American Board of Plastic Surgery; Fellow of the International Society of Aesthetic Plastic Surgery, American College of Surgery, International College of Surgery, and American Board of Metabolic and Bariatric 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.)

Jeffrey M. Darrow, MD · Answer

Congratulations on your weight loss! You have obviously put a great deal of effort into your weight loss and toning your physique.  The excess skin around your trunk will best be handled with a lower body lift.    This very powerful operation, which removes this excess skin, will tighten and smooth your abdomen, sides and flanks, improve some of your upper inner thighs and outer thighs and lift your buttocks.  As you are at an excellent weight, your results will compliment your muscular frame.  The procedure takes approximately 4 to 5 hours and is performed under general anesthesia. Recovery is on the order of approximately three weeks. Consult with your Plastic surgeon regarding this.

Michelle Zweifler, MD · Answer

A lower body lift addresses excess hanging skin around the torso.  With a circumferential abdominoplasty the outer thighs and buttocks get lifted in addition to flattening the stomach.  The trade-off is the scar; in general, it takes a year for scars to fade.

Don W. Griffin, MD · Answer

Thank. you for your question. There are specific procedures that address skin laxity in different areas of the body. For the truncal area, a mid-body lift (also goes by other names like circumferential abdominoplasty, trunk lipectomy and other names) addresses laxity on the abdomen, flanks, upper thighs and buttocks. A thigh lift addresses laxity on the anterior and medial thighs. Brachioplasty surgery addresses excess skin on the upper arms. There are also procedures to address laxity on the chest and upper back. I would recommend that you consult with a board certified plastic surgeon in your area that has expertise in these procedures to come up with the best options to treat the areas that bother you.

Mehmet Ozdemir, MD · Answer

Thank you for your question.
After significant weight loss, excess skin around the torso and legs is common. Procedures such as a body lift or lower body lift, sometimes combined with a thigh lift, can help remove excess skin and improve overall body contour.
A detailed evaluation would help determine the most suitable surgical plan based on your anatomy and goals.

Camille Cash, MD · Answer

Congratulations on your weight loss and commitment to your health!  For skin around the trunk a circumferential tummy tuck, also known as a lower body lift would be most helpful.  This would remove the excess skin and create a smoother contour.  The incision as it implies goes around the circumference of the trunk.  I've included a video that I hope you find helpful.

Lost 80 pounds, hanging skin around torso and legs - what procedure would be best? (Photos)

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