How do you avoid a straight up and down body figure with skin removal surgery?

Thank you for your question.The contour after surgery depends on the patients frame. If you have more of an hour glass shape to begin with, then the skin removal should enhance that.

Thank you for your question regarding body shape after a body lift. This is a pervasive question. First of all, you must realize that your current body shape is probably due to excess skin and fat. These pockets of fat are around the lower lateral or outside portions of the breast. Another centralized local pocket is in the hip region. If these areas are significant, even after a hundred-pound weight loss, you can still have an hourglass figure. This means even though you've lost a lot of weight you still have curves. With a body lift, a significant amount of excess skin and fat is removed from the abdomen and hips. By eliminating these pockets of fat, this can change the shape of the lower body. There are ways to maximize the potential for an "hourglass shape" after a lower body lift. This includes the corset abdominoplasty or sewing up the rectus abdominis muscles. I almost always perform this step.  Also, by adding a second stage procedure, namely a vertical torsoplasty, an hourglass figure can be created. During a vertical torsoplasty, an incision is made from the armpit to the hips. The waist is tightened, and the hips are brought in. This can give you an excellent hourglass shape after a body lift. If the defect is not too large, aggressive liposuction may be able to achieve an hourglass shape. Therefore, go ahead and have the 360 circumferential lower body lift. Then later, if you still don't have that hourglass shape, consider either liposuction of the love handles or a vertical torsoplasty. Usually, these are not performed at the same time. The reason they are not performed at the same time is that of blood supply. If performed at the same time, blood supply can be compromised to the abdominal portion of the flap. When considering reconstructive surgery after massive weight loss, please seek an experienced, board-certified, plastic surgeon who specializes in reconstructive plastic surgery after massive weight loss. Travel out of state if you must to find such an expert. Thank you for your questions regarding hourglass-shaped after a 360 body lift.

Thanks,

Dr. Katzen

Congrats on the 100# weight loss! There are many procedures involved with your reconstruction. They have to be planned accordingly, step by step. I disagree about the 'straight up and down' figure.
The initial combination might include 'belt lipectomy', SAL back/braline 1st, then breast lift/augmentation submuscular; then abdominoplasty/ventral hernia-diastasis recti repair.
The second stage (months later) would include reconstruction of the thighs which might in the groin crease and the posterior buttock crease- not vertical incisions on the medial thigh down to the knees!
Arm lipectomy and SAL arms can be done alone or with one of the other procedures. I would recommend two board certified plastic surgeons to perform the procedures to save time and anesthesia. Also, make sure you be put on Lovenox postop to decrease chance of developing any blood clot. It is safe and does not cause bleeding problems.
Continue to lose the weight, use pre-op and post-op vitamins (Vitamedica...check it out), tone those muscles and choose the best plastic surgeon with the most experience.
Good luck! 

hello thank you for your question and provided information as well.. based in your question is difficult evaluate you if the case dont have a picture ; my recommendation is get a consultation in person with your plastic surgeon to discuss all about the theme.

The technique used to only remove skin after weight loss will ALWAYS leave a square shape. In order to create a shape the Skin removal must be turned into a Real Lower Body Lift with the goal of accentuate the curves. So I combine the Circumferential skin resection with pubic lift, muscle repair tight to create waist, lift or outer thigh, real buttocks lift and liposuction to lower back and waist to create curve in the area and use that fat to transfer to buttocks and hips. So the surgeon you chose MUST be knowledgeable not only in Tummy Tuck, but an expert on after weight loss surgery and have consistent results of curvaceous results among those patients. Be encouraged Dr. Cárdenas 

Dear Isalu82,it is hard to tell for sure without an examination. If you are considering a surgery, I would suggest you to 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

and develop the hanging skin, excisions will remove the hang but due to lack of fat, you do not have a curvy body.  Discuss your concerns with your surgeon and see if he/she can used buried flaps to help give you curves where you want them.  Know that doing this may result in other undesired contours that may require revisions in the future.

Hello and thank you for your question. Congratulations on your weight loss. You are absolutely correct. That is why I developed the hip flap just for that reason. In some patients however even with this flap it is difficult to obtain even a slight hourglass shape. It really depends on what you start with.Peter Fisher M.D