Common Plastic Surgery Options After Weight Loss

Losing weight is a major life change and a big step toward a healthier future. Did you know that it’s common for people who have lost a large amount of weight to have plastic surgery to remove excess skin? We’re here with our expert, board-certified plastic surgeon Omar Beidas, MD, to walk you through some of the most common plastic surgery procedures to remove excess skin following weight loss, along with answers to some frequently asked questions.

Plastic Surgery Procedures to Consider After Weight Loss

First, Dr. Beidas provides information about many of the plastic surgeries people might consider after losing a significant amount of weight.

In his own words, Dr. Beidas explains each procedure:

• Panniculectomy: This is a procedure that we typically perform through insurance. It involves the removal of skin from the lower abdomen, similar to an abdominoplasty, which is commonly referred to as a “tummy tuck.” Insurance will not cover muscle tightening (which makes the operation a full tummy tuck) or liposuction, but that can be added at the same time for appropriate candidates.
• Tummy tuck (abdominoplasty): This involves the removal of skin from the lower abdomen, repositioning the belly button and tightening the muscles. It’s almost always combined with liposuction to give a nicely contoured abdomen.
• Fleur-de-lys: In addition to a horizontal scar with a panniculectomy/abdominoplasty, a fleur-de-lys is a vertical scar to remove excess skin of the central abdomen that would not be treated with the traditional low horizontal scar alone.
• Body lift or 360: As the name suggests, this procedure includes a horizontal scar across the lower trunk that is circumferential, meaning it goes around the entire body. This is used to lift the outer thighs and shape the buttocks in addition to the abdomen. If a patient desires more fullness of the buttocks after weight loss, we can perform an auto-augmentation where we use the tissue that other surgeons might discard and reposition it into the buttocks for volume.
• Upper back lift/bra line lift: This is a very powerful procedure and a really underappreciated one in weight loss patients. This operation continues a breast lift/reduction scar and continues around the upper back. In women, the goal is to hide the scar underneath the bra strap.
• Arm lift/brachioplasty: This is removal of excess skin from the arms. In weight loss patients, the scar is on the inside of the arm — where a jacket seam would be — and typically extends onto the outer chest the closer to the body it gets and typically ends at the elbow. In some patients, it may need to be extended past the elbow as it moves farther away from the body if there is significant loose skin in the forearm.
• Thigh lift: This procedure removes excess skin from the thighs. There are two general ways this is done in weight loss patients. The most skin reduction is done with a long incision along the inside of the thigh, like a seam on a pair of pants, as it will hide best. Another technique that is used less often, as it will not tighten as much, is a scar along the crease of the groin and in the lower buttocks/upper thigh.

Breast Procedures

• Breast reduction/lift: A breast reduction involves removal of skin/gland/fat and repositions the tissue higher on the chest (also lifts the breast), whereas a lift only involves removal of skin and minimal or no gland/fat. Various scars exist to perform this operation, from something as minimal as liposuction only to a large anchor-type scar. Breast reduction is the procedure with the highest plastic surgery patient satisfaction rate.
• Breast augmentation: Augmentation can be performed using implants (saline or silicone), or using your own fat (yes, you read that right). Both options are same-day surgeries, meaning you go home the same day and have a minimal recovery time. The main difference is that implants are not lifelong devices and will require some maintenance such as monitoring and will likely require future surgery. With fat transfer, we borrow fat from an unwanted area of the body and transfer it to the breast (or other area). This generally requires 2-3 small operations depending on the volume desired, but has no long-term maintenance since the tissue is yours. Typically, weight loss patients require a lift. I (Dr. Beidas) can perform an auto-augmentation using your own tissue to avoid the use of implants. This is a special technique I learned due to unique training with the masters of plastic surgery after weight loss.
• Gynecomastia: This is the removal of loose skin and/or fat/gland from the chest of a male. This procedure can be performed using a larger scar along the lower fold of the chest or through a small scar around the areola.

Frequently Asked Questions

Dr. Beidas provided answers to some frequently asked questions surrounding plastic surgery after weight loss.

How long after weight loss should a patient wait to get plastic surgery?

Dr. Beidas says, “The best results are obtained by patients who have worked hard to lose weight and maintain a healthy lifestyle. This means eating well and working out to maintain their weight. Patients should have a stable weight for at least three months prior to undergoing plastic surgery. I hate to generalize by BMI, but unfortunately it’s the only measure we have. Patients with a BMI under 28 get the best results, whereas patients with a BMI 28-32 get good results. Patients with a BMI greater than 32 may be candidates for select operations, but in general they won’t get the most aesthetic outcome.”

How long is recovery time?

“Recovery time varies based on the operation(s) performed. Most procedures require 1-2 weeks of downtime, whereas combination procedures can require up to 3 weeks of recovery. Regardless of the operation, patients are not allowed to perform heavy lifting or strenuous activity for six weeks after surgery,” Dr. Beidas explains.

How does the procedure support a patient’s recovery and healthy lifestyle following weight loss?

According to Dr. Beidas, “Depending on a patient’s lifestyle, the loose skin can be an interference to exercise, daily activities, hygiene and obtaining a proper clothing fit. The presence of excess skin is also a constant reminder for many patients of their former selves, so there is a psychological component to ‘not seeing your hard work.’ Studies have proven that these operations can boost a patient’s self-esteem, quality of life and overall well-being.”

How can you and your team support weight loss patients?

Dr. Beidas says, “We are dedicated to helping patients get through the final stage of their weight loss journeys! We can help navigate the insurance process for panniculectomies and have self-pay package pricing for all the other operations that a patient can desire. I (Dr. Beidas) performed a unique fellowship where I trained with world pioneers in plastic surgery after weight loss, and now I’m invited to lecture/teach other surgeons. I understand that weight loss patients often feel embarrassment around the loose skin, and I want to help them live their best lives!”

Your Weight Loss Journey Begins Now

We thank Dr. Beidas for his time and thorough, thoughtful responses. Learn how he and our team can support you on your weight loss journey and request a consultation today.