Hi pshn, Thank you for your question regarding 100 pound weight loss and plan on loosing another 100 pounds and will you need multiple skin removal procedures over time. You should wait until you reach your lowest body weight before you undergo reconstructive plastic surgery after massive weight loss. If you have not completely lost all your weight (even though you have loose skin along the way), it does not make sense to have surgery prematurely. If you undergo surgery now, your surgery will have to be redone after another hundred-pound weight loss. Therefore, most plastic surgeons who specialize in reconstructive plastic surgery after massive weight loss would advise you wait till you’ve lost all your weight and are close to your goal weight. Once your weight has been stable for approximately 3 to 4 months, you should then consider plastic surgery procedures for loose skin. Based on your current photos, you still have a distended peritoneal cavity. The peritoneal cavity is a reflection of the amount of visceral fat you still possess. An enlarged peritoneal cavity is why your abdomen is still distended, without significant rolls of excess skin. I anticipate that, with further weight loss, your peritoneal cavity will shrink. If you find it more difficult to lose weight, consider GLP-1s such as Ozempic, Wegovy, or Mounjaro. Once you have lost all the weight, you will likely need a 360-degree circumferential lower-body lift. The 360 circumferential body lift includes an extended abdominoplasty, pubic lift and reduction, rectus abdominis plication, relocation of the belly button, hip lift and reduction, and buttock lift and reduction. If your chest bothers you, you will need an upper-body lift, which may include a chest reduction. You will probably need an incision in the inframammary fold where the breast meets the chest. You’ll then need to reposition the nipple-areolar complex. You may also need a thighplasty, or thigh lift and reduction. Your thighplasty may require an incision from the groin to the inner knee. After more weight loss, your buttocks will need to be re-evaluated; you may or may not need buttock fat transfer. The staging and areas of surgery will be determined after your final weight loss. Most plastic surgeons who specialize in plastic surgery after massive weight loss recommend that patients undergo a 360-degree circumferential lower-body lift first. The thighplasty may be performed with the 360 circumferential lower body lift or at a later date. After you recover from the lower-body lift (approximately 1-2 months), consider gynecomastia reduction. Gynecomastia reduction after weight loss is also referred to as an upper-body lift. However, everything should be on hold until you have lost at least another 100 pounds. In conclusion, lose another 100 pounds and then consider plastic surgery for the loose skin after massive weight loss. Don’t waste your time, energy, and money on plastic surgery procedures at this time. I hope I have answered your question regarding 100-pound weight loss, my plan to lose another 100 pounds, and whether you will need multiple skin removal procedures over time. To get an accurate assessment of what exactly you need, schedule a free virtual consultation. Most plastic surgeons offer free virtual consultations. If you have any further questions regarding the lower body lift, 360 circumferential lower body lift, belt lipectomy, belt abdominoplasty, or belt dermolipectomy, please consult an experienced plastic surgeon. Because the body lift is a complex procedure, please consult an experienced, board-certified plastic surgeon with significant experience performing the lower body lift. Do your research. Ensure they have performed at least 150 circumferential lower-body lift surgeries and have before-and-after photographs to document this. Carefully examine their before-and-after images and review their RealSelf reviews. If you cannot find an experienced lower-body lift surgeon in your area, consider traveling out of state if necessary. Sincerely, Dr. Katzen, MD, MBA, FACS, FICS, FASMBS (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.)
