Is This Normal After Having Cosmetic Sx? (photo)

I lost a lot of weight (400 to 245). I had gynecomostia done in 2009&2011 had ext. abdominalplasty same dr. My only problem is that after the 2 sx I figured I will be good for a while. It still left me exc. skin love handle area & even after gynecomastia I still have loose skin on the side too, as if there were not removed & lipo'd. Isn't that part of these procedures? The gyne sx the dr had to redo over and pix will show u how it looks after doing twice total cost, out of all my savings 15k

Doctor Answers 8

Massive weight loss

You need a second opinion. The results are suboptimal and going to be very difficult to correct.

You need good evaluation and a sound surgical plan fot the upper body and the lower body.

Baltimore Plastic Surgeon
4.2 out of 5 stars 7 reviews

There will always be laxity.

Hello and thanks for your post. There is always a certain amount of laxity that returns after surgery. Perhaps you should seek a second opinion with a qualified plastic surgeon about your options. Best wishes.

Aldo Guerra, MD
Scottsdale Plastic Surgeon
4.9 out of 5 stars 202 reviews

Is This Normal After Having Cosmetic Sx?

By NOT posting a before series of photos very hard to tell if this is a great result with massive excision of skin and fat vs a very conservative excision. Only you can the photos befores and afters can help us. 

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.6 out of 5 stars 174 reviews

Massive Weight Loss Skin Laxity

Congratulations on your weight loss.  The results of body contouring after weight loss is dependent on several factors.  Patients who have such a dramatic change in weight require more procedures and stages.  Patients who are still not at an ideal body weight are also more challenging.   Your results have been compromised by these factors.  Mastopexy and an Inverted T abdominoplasty alone are incapable of addressing the skin laxity and subcutaneous fat issues that you are still suffering from.  If you still have a significant amount of subcutanous fat in an area it will result in incomplete correction and relapse of skin laxity.  Debulking liposuction followed by an excisional procedure can improve the results significantly.  This approach will be needed for your arms, upper back/side of chest wall, love handles and lower back.  You should consult with a surgeon with significant experience in body contouring after weight loss to more effectively manage your expectations about what can be accomplished with each procedure.  Hope this helps. All the best.

Robert F. Centeno, MD, FACS
Columbus Plastic Surgeon
4.9 out of 5 stars 77 reviews

Surgery revision question

The key is to figure out if your doctor trained to do these types of surgeries and did you see before and after pictures of his or her work before undergoing surgery. While board certification in plastic surgery is important there are many doctors who do not know how to perform this type of work. As you know it is very expensive to have this type of surgery done and there may be some greedy people out there doing surgery that they are not really trained or experienced to perform. Please seek the consultation of a board certified plastic surgeon who does post weight loss body contouring. I am sorry to tell you this but you will probably spend a lot more  then you have already spent on future revisional surgery.

Gregory T. Lynam, MD
Richmond Plastic Surgeon
4.9 out of 5 stars 60 reviews

Normal after Cosmetic Surgery

   Hard to say if this is an OK result or not.  Preoperative pictures would give a better idea.  To get a better looking chest with higher areolae, you will need a revision.     To tighten at the waist you can use the vertical scar and take out more tissue.  If you have already had two surgeries, you will need a plastic surgeon who performs hundreds of body contouring surgeries each year and is comfortable with any starting point.  Kenneth Hughes, MD Los Angeles, CA

Kenneth B. Hughes, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 496 reviews

Weight loss and surgery

It is not uncommon for patients to have rebound laxity after the procedure. I have seen it in all patients to some extent. Some worse than other.  It is multifactorial in nature.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

Body contouring after massive weight loss.

There are many factors that lead to a successful outcome in patients who undergo post-bariatric plastic surgery.If I had to pick one thing that would predict your outcome without examining you.....BMI or body mass index. See link below to check yours out.

In general, BMI >35 , in my opinion, should avoid body contouring surgery until they have reduce that number. BMI 30-35, can proceed with surgery, but will not have a fantastic result and may require additional procedures, at additional cost. Looking at your pictures, I'm guessing your BMI was > 30 before surgery?

Also, along the same lines, we should look at your before pictures. What has been the relative improvement?

Liposuction will not reduce the amount of excess skin and has to be used cautiously in the chest and abdomen. This is where a reduction in your BMI might be more beneficial. 

My advice to you ,  if you are still interested in getting a better result and you have the time and $ to do it, is to get a second opinion from someone who does a lot of these procedures. 

Hope this helps,

Dr B

Kenneth Bermudez, MD
San Francisco Plastic Surgeon
4.9 out of 5 stars 15 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.