Bariatric surgery, along with diet and exercise, can help you lose a significant amount of weight, if it’s needed for health reasons. But once the weight is lost (if you lose around 100 pounds or more) it can leave behind loose skin, or skin that has lost elasticity. And this can interfere with your daily life.
“Loose skin can collect moisture under the folds, causing irritation and rashes, particularly during the summer,” says Shoshana Ambani, M.D., a plastic surgeon at Henry Ford Health. “It can also lead to skin tears caused by friction or pinching when wearing certain types of clothing. This can lead to bleeding and discomfort.”
While additional diet and exercise can’t get rid of loose skin, body contouring surgery—a type of skin removal surgery—can. There are multiple types of body contouring procedures, but for those who have undergone massive weight loss, body contouring usually involves cutting out loose skin and tailoring the skin around it.
“Body contouring isn’t a cookie cutter procedure,” says Dr. Ambani. “Every surgery is unique to each individual. We take into account someone’s body shape, where they carry their weight, their stature, what look they’re going for.”
Where Can You Have Body Contouring Surgery?
Body contouring can be done basically anywhere on the body, including:
- Upper arms. A brachioplasty removes excess skin on the upper arms.
- Breasts. “We can remove excess skin and lift the breasts, which is called a mastopexy,” explains Dr. Ambani. “It reduces the likelihood of rashes under the folds of the breasts.”
- Abdomen. A procedure called a panniculectomy removes excess skin on the abdomen. Alternatively, a cosmetic abdominoplasty (commonly referred to as a tummy tuck) removes even more skin, tightens the abdominal muscles, and usually involves moving the belly button. “When you gain a lot of weight, your ab muscles spread apart and this creates a widened space between your ab muscles. It causes your abdomen to protrude, even after you lose the weight,” says Dr. Ambani. “Pregnancy can cause this to happen, too. An abdominoplasty repairs it.”
- Thighs. A thighplasty removes excess skin on the thighs.
- Buttocks. A lower body lift can elevate the buttocks and decrease sagging.
- Back. Excess skin can be removed from both the upper and lower back.
What To Know Before Getting Body Contouring Surgery
If you want body contouring in more than one area, do it in stages—not all at once. “Most surgeons recommend at least three to six months between surgeries,” says Dr. Ambani. This spaces out your wound healing and the amount of anesthesia you get. Oftentimes, however, patients will wait a year between surgeries so they can live their life in between procedures.”
Dr. Ambani recommends doing a maximum of two areas at once—for example, the arms and breasts or breasts and abdomen. She advises having a thighplasty last, since it involves more downtime and wound-healing delays. (This is because the incisions are located in a spot that makes them difficult to properly care for.)
Scarring is an inevitable part of body contouring surgery—there’s no such thing as a scarless skin removal surgery—but Dr. Ambani says advanced surgical techniques make scars as minimal as possible. “It takes one to two years for scars to fully mature, so after that time, you can do a scar revision if you’d like,” she says.
Recovering After Body Contouring Surgery
You can expect to feel better three to four weeks after surgery, says Dr. Ambani. By six to eight weeks, you’ll likely feel more like yourself. And in 12 weeks, your wounds will have mostly sealed and healed. While recovering, Dr. Ambani recommends:
- Walking at least every two hours for 10 to 15 minutes at a time for 90 days afterward. In rare circumstances, body contouring can be associated with blood clots in the legs, so it’s important to keep your legs moving.
- Eating a healthy, high-protein diet. “High-protein diets improve wound-healing capacity and help speed up recovery,” says Dr. Ambani. (Even better if you start this diet before surgery.)
- Refraining from housework for three to four weeks.
- Refraining from aggressive exercise for eight to 12 weeks.
Not sure if body contouring is right for you? Talk to your doctor or make an appointment with a plastic surgeon, who can give you a unique assessment of what would be best for you.
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Dr. Shoshana Ambani is a board-certified plastic and reconstructive surgeon. She is the medical director of plastic surgery at Henry Ford Medical Center — Cascade Ridge. Her areas of particular interest include breast reconstruction and other breast surgeries, abdominoplasty with liposuction and other body contouring surgeries, rhinoplasty (nose reshaping to improve appearance or breathing), and facial rejuvenation (eye lift, brow lift).