How safe are body contouring surgeries for removal of excess skin after weight loss?

Question

Hi, I hope you are doing well! I am wondering how safe are body contouring/body lift surgeries for removing excess skin from weight loss? I am 24 years old and was obese for most of my childhood. I have lost over 140 lbs and am in great health now. I think some areas could be tighter because of the weight loss but the excess skin is not severe. How safe are these procedures? And if there are multiple areas of concern, what is the best way to split up the areas in a few surgeries? Thank you!

J. Timothy Katzen, MD, FACS · Answer

Thank you for your inquiry regarding the safety of reconstruction surgeries after significant weight loss. Allow me to extend my heartfelt congratulations on your remarkable accomplishment of losing 140 pounds, which undoubtedly reflects positively on your overall health.

Without visualizing the areas that require attention, it is difficult to provide a definitive treatment plan. However, based on my experience with weight loss patients, we typically stage the procedures in two to three surgeries, depending on the extent of correction required in each area of concern. The majority of patients seek correction of their abdominal region, which we address in the first stage with a tummy tuck or 360 lower body lift combined with a thigh lift and reduction. The second stage usually entails addressing the upper body, including the breasts, arms, and torso, depending on the area of concern, such as side boob or back fat. While some patients opt to break these procedures into three separate surgeries, most cases can be completed in one session.

It is important to note that every surgery carries inherent risks of complications. Therefore, I strongly advise you to seek a board-certified plastic surgeon who has extensive experience in performing these procedures to ensure optimal outcomes and minimize the likelihood of adverse events.

As a board-certified plastic surgeon with a focus on reconstructive surgery after weight loss, I am pleased to offer my expertise regarding procedures such as the lower body lift, 360 circumferential lower body lift, belt lipectomy, belt abdominoplasty, and belt dermolipectomy. Should you require additional information on any of these procedures, please do not hesitate to contact my office.

It is important to note that the lower body lift is a significant procedure, and as such, I strongly advise seeking an experienced, board-certified plastic surgeon with extensive expertise in performing this surgery. When researching potential surgeons, I recommend reviewing their before and after photos to ensure they have a proven track record of success with at least 100 circumferential lower body lift surgeries. Additionally, be sure to carefully examine their reviews on RealSelf, as well as their professional affiliations and certifications.

If you are unable to locate a qualified lower body lift surgeon in your area, I suggest considering travel to a surgeon with the necessary expertise. As a verified plastic surgeon and President of the American Society of Bariatric Plastic Surgeons, certified by the American Board of Plastic Surgery and Fellow of the International Society of Aesthetic Plastic Surgery, American College of Surgery, and International College of Surgery, I am dedicated to providing my patients with the highest standard of care. As a member of the American Society of Plastic Surgery, American Academy of Cosmetic Surgery, and RealSelf Hall of Fame, I remain committed to advancing the field of plastic surgery and delivering optimal outcomes for my patients. Sincerely, Dr. Katzen.

Jose Telich, MD · Answer

Dear realselfmember000, thank you for your question, and congratulations on your incredible weight loss journey!

Body contouring surgeries, including body lifts, are generally safe procedures when performed by a board-certified plastic surgeon in an accredited surgical facility. These surgeries can significantly improve comfort and confidence by addressing excess skin and restoring contour. However, like any surgical procedure, there are risks involved, including infection, bleeding, delayed wound healing, or complications related to anesthesia.

For patients like you with multiple areas of concern, it’s often safest to approach the procedures in stages. A comprehensive consultation with your surgeon will determine the priority areas and help create a personalized surgical plan. For instance, some patients may start with a lower body lift and address arms or thighs in subsequent sessions. This phased approach ensures optimal recovery and minimizes the risks associated with longer, more extensive procedures.

Take the time to discuss your health history and goals with your surgeon. With careful planning and proper postoperative care, body contouring can be a safe and transformative step in your journey. Best wishes as you take the next steps!

Derek Fletcher, MD · Answer

Congratulations on your weight loss! That is in inspirational accomplishment.
Safety is critical in body contouring surgery. The most common complications following abdominoplasty and lower body lift procedures include: delayed healing, incision separation, and seroma (wound fluid collections under the skin). For patients who achieved their weight loss through diet and exercise, these complications tend to be milder in severity. For patients who achieved weight loss through weight loss surgery (especially gastric bypass) these complications can be more significant. Especially if their nutritional status is not optimized before surgery.
The number of procedures performed in one operation depends on how extensive each individual component of the operation is, the time necessary to safely complete each technique and the health of the patient. I need more details to give you a precise answer.
Hope this helps and good luck on your journey!

Christopher Pannucci, MD, MS · Answer

Hi sim012345,
You bring up a great point. There are competing factors in the massive weight loss population, who typically have many distinct body areas which would benefit from surgery.
The 2 competing factors are patient convenience and patient safety.
Especially in weight loss patients, who would benefit from many different areas being treated, patients often come in with a goal of having everything treated simultaneously. This is certainly ideal to have a single operation with one period of recovery, in order to achieve your desired results.
From the surgeon's perspective, there are potential downsides to combining multiple operations. Specifically, there is a known straight line relationship between time spent in the operating room and risk for complications. This does not mean that you cannot combine procedures (surgeons combine procedures all the time), but it does mean that you and your surgeon should have a specific conversation about how much is too much.
Ultimately, you and your surgeon should be on the same page about goals, as well as risk tolerance, and should make a educated, thoughtful decision together about the trade-offs of number of surgical procedures performed at any one sitting.
Hope this helps.
Hope this helps.
Sincerely,Christopher Pannucci MDBoard Certified Plastic SurgeonPlastic Surgery NorthwestSpokane, Washington

Salvador Medina, MD · Answer

Hello!For post bariatric surgery we have to divide the procedures in stages.I recommend dividing in upper body lift (breast and arms), lower body lift (abdomen, back, butt), and thigh lift.There can be other combinations that depend on individual body types.In general the procedures are safe, with complications as any procedure, but they do imply long scars and more operating time. 
Dr. Medina

Carmina Cardenas, MD · Answer

You must understand that after massive weight loss (AMWL) any surgery will be very extensive and invasive and never just a cosmetic procedure, actually all of AMWL surgeries are considered reconstructive. So they automatically have a higher risk of complications but the big difference is the safety measures taken by the surgeon and team since before surgery, throughout surgery and very importantly after surgery. 
First the surgeon must be Board Certified, expert in AMWLsurgery and working with a team of people dedicated to fulfill the needs of this type of patients. 
Be encouraged. 
Dr. Cárdenas

Joshua Cooper, MD, FACS · Answer

- Congrats on the major weight loss you have achieved!
- We perform many lower body lifts, all on an outpatient basis, and our patients experience very few if any complications. The most common complication would be a minor one involving a spitting suture. 
- For the past decade we have also placed all of our lower body lift patients on a one week course of Lovenox (an injectable blood thinner) post-operatively to prevent blood clots as well. 
- We have never had to admit any of our body contouring patients to the hospital, so that definitely speaks to the safety of these procedures. 
- I would recommend setting up a consultation with a board certified (ASPS Member) surgeon who commonly performs body contouring procedures for patients after massive weight loss. 
- We often add on breast surgery as the same time as a lower body lift. Additionally, some patients choose to have an arm lift (brachioplasty) performed at the same time as their breast surgery. 
- Thanks for your question and wishing you the best as you complete your weight loss journey with body contouring!

Daniel Barrett, MD · Answer

Dear sim012345,
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

Camille Cash, MD · Answer

Congratulations on your impressive weight loss!  There is risk with any surgery but many ways to keep risks to a minimum.  Many patients don't realize that many of these are in your control.  It begins by selecting the right surgeon.  You want a board certified plastic surgeon with experience in performing the procedures that interest you.  When meeting for a consultation your surgeon will discuss your concerns, review your medical history, and determine if you are a good candidate for the procedure.  You then want to have your procedure performed in an accredited facility.  Before and after surgery you want to closely follow all of your surgeons instructions for optimal results.

Ahmad H. Ahmadi, MD · Answer

Body contouring procedures are considered safe if you do not have a significant medical history and you choose a board-certified plastic surgeon who operates at certified/licensed facilities.  No matter what, any surgery carries risks, and your surgeon will be able to explain them to you and recommend which areas can use improvement and which order.  Good luck to you.

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