Post Bariatric Surgery
This constitutes a group of procedures that are utilized to tighten excessively loose skin, frequently after massive weight loss.
Post Bariatric Surgery Procedure Options
A smaller group of patients, who are normal weight and have never been overweight, will present with loose enough skin to warrant surgical tightening in the inner arm, posterior trunk, buttocks or thigh regions. Your doctor considers age, obesity and smoking habits when evaluating a candidate for this procedure.
Tummy Tuck
Abdominoplasty or a “tummy tuck,” is designed to correct a protruding abdomen resulting from weak abdominal muscles, weight gain or pregnancy. Obesity and aging cause the skin to lose its elasticity. These conditions may not respond well to diet or exercise if the skin and underlying muscles have been stretched.
With abdominoplasty, the abdominal wall muscles are tightened and excess fatty tissue and skin are removed to improve the body contour. The goal is a narrower, flatter abdomen. Realistic expectations are important. Abdominoplasty is not a substitute for weight loss. Your doctor considers age, obesity and smoking habits when evaluating a candidate for this procedure.
Body lift, or belt lipectomy, is performed to remove the excess skin and fat that exists on the body as a result of age or extreme weight loss. The body lift is performed on the lower torso and upper legs and involves the belly, hips, back, buttocks and outer thighs. People who have excess skin or fat in all of these areas may benefit from the body lift procedure.
This procedure involves a tummy-tuck combined with a circumferential excision of excess tissue from around the entire trunk while elevating the buttock and outer thighs. Obviously, this is a very extensive procedure requiring longer operative times and recovery than just a tummy-tuck. A lifting effect is obtained at the level of the buttocks, the outer thighs as well the abdomen and flanks.
Body Lift
Arm Lift
An arm lift, or brachioplasty, is a procedure to remove excess fat and skin of the upper arm. Aging or weight loss can cause the upper arm skin to become loose and sagging. An arm lift serves to remove excess skin and fat which reduces the circumference of the upper arm. The extra skin and fat are removed through an incision along the inner aspect of the upper arm. This incision is placed in order to best tightened the tissue but the incision must also be well hidden.
Liposuction is a very common, popular procedure. It is designed for the long-term removal of fatty tissue, commonly referred to as “cellulite.” It is an elective procedure that allows the plastic surgeon to remove undesirable, subcutaneous fat in isolated areas that do not respond to diet and exercise. These areas include the hips, thighs, abdomen, knees, ankles, face, neck, and arms.
Liposuction is most successful in people with good skin tone who have fatty deposits. It is not a treatment for obesity. If weight gain occurs following liposuction, the fat will be deposited in areas that have not been treated. The procedure can be repeated, if necessary. To maintain the safety of the procedure, there is a limit on how much can be done at one time. A variety of factors can affect the results: Physical condition, genetic makeup, diet, exercise, smoking, alcohol intake, and skin elasticity.
Body contours made irregular by fat can be improved by this procedure; it cannot correct contours that are irregular for other reasons, such as muscle weakness or hernia. However, combined with other procedures, liposuction can correct these other deformities with good results.
Liposuction
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We will review your medical history to better understand your overall health. Our doctor will discuss your goals and help you understand what options may be available and what to expect from treatment.
FAQ’S
It’s important to maintain a stable weight for between 12-18 months after bariatric surgery to ensure the skin and tissue have adapted after the procedure. Other lifestyle habits, such as smoking or drinking alcohol excessively, can impede healing. Dr. Pu can take a look at these factors, along with diet and any supplements taken, to provide a timeline for when to pursue post-bariatric surgery.
Weigh is rarely distributed evenly on the body and varies from person to person. Massive weight loss often leads to loose skin around the abdomen and thighs, which a tummy tuck or body lift can address. Sometimes, individuals who have never been overweight will notice areas on their body where skin tightening may be right for them. A consultation with Dr. Pu can help determine which particular procedures are appropriate to individual goals to achieve a toned and tight look.
Yes, many patients who have experienced significant weight loss opt to combine multiple post-bariatric procedures in one session. For instance, loose skin may affect the abdomen, thighs, arms, and breasts after major weight loss, and performing a tummy tuck, thigh lift, and arm lift together can deliver comprehensive body contouring. Combining surgeries may reduce total recovery time and anesthesia exposure, but it also increases surgical complexity and requires a stable health profile. During your consultation with Dr. Pu, you can work together on your personalized plan for the areas you’d like to address.
You’ll generally be considered a good candidate when you have lost a substantial amount of weight (often via bariatric surgery or lifestyle change), your weight has stabilized, and you’re in good overall health. You should have realistic expectations, maintain a healthy lifestyle, and be free from medical issues that would delay healing. Because body contouring after weight loss addresses excess skin and structural changes, it’s important that weight loss is complete or has been maintained for several months so that Dr. Pu has a stable canvas to work with.
After significant weight loss, common areas of concern include the abdomen (often with a “pannus” or skin overhang), flanks and lower back, upper arms, thighs (inner and outer), buttocks and hips, and breasts (which may have lost volume and sagged). Alongside these areas, body contouring is often performed via arm lifts, thigh lifts, tummy tucks, body lifts, and breast lifts or augmentations to restore contour and tone in these areas.
A tummy tuck (abdominoplasty) focuses primarily on the abdomen, removing excess skin and fat and tightening underlying muscles. By contrast, a body lift treats the abdomen, flanks, lower back, and buttocks circumferentially — addressing all-around skin laxity rather than just the front. After massive weight loss, a body lift may better address the loose skin and tissue that extends around the torso and beneath the buttocks and thighs.
Recovery varies depending on how many areas were treated and the extent of surgery, but you should plan for several weeks of limited activity. You’ll likely wear compression garments, avoid heavy lifting and strenuous exercise for several weeks, and require assistance with daily tasks initially. Swelling, bruising, and discomfort are typical. You’ll gradually increase mobility, though full contour settling and scar maturation can take months. Support from caregivers and following post-operative instructions are essential for healing and optimal results.
Yes, general anesthesia is typically used for post-bariatric surgeries and allows for a comfortable and pain-free experience. This also ensures Dr. Pu can perform precision work, leaving you with that tight, contoured, look.
Recovery times vary depending on the procedure. A procedure done on a smaller area, like an arm lift, usually takes only a couple of weeks, while a tummy tuck or full body lift may take up to 8 weeks for a full recovery. Normal activities can usually be resumed two weeks after a more extensive procedure. Dr. Pu can factor in age, general health, and post-procedure care to give a more personalized recovery estimate.
Compression garments help control the initial bruising and swelling, which occur after any surgery and play an important role in the early recovery stage. Avoiding intense exercise and work after surgery for the entire recovery process can go a long way in letting your body get the rest it needs. Immediately following the procedure, stay hydrated and eat a healthy, balanced diet to give your body the best conditions to heal.
After large volumes of weight loss, skin may have lost elasticity and may not bounce back on its own. Stretch marks indicate skin damage at a deeper level and may persist even after surgery. Dr. Pu considers skin laxity, texture, and residual fat when planning contouring. Depending on your condition, you may need tailored procedures or additional treatments to improve skin appearance.
With proper weight maintenance, healthy lifestyle habits, and reduction of significant weight fluctuations, results can be long lasting. Because sagging skin and excess tissue are removed, the contour improvements are durable. However, aging, gravity, and changes in weight can affect tissues over time. Being at stable weight, staying active, and following follow-up care helps preserve your new shape.
Scarring is an inherent part of these surgical procedures. However, Dr. Pu aims to place incisions in natural skin folds or discreet locations when possible. The severity and length of scars depend on how much tissue was removed and the areas treated. Over time, scars typically fade and can become less noticeable.
Nutrition and stable weight are critical. You should be at or near your goal weight and maintain it for several months before undergoing contouring to ensure the body has stabilized. After surgery, following a balanced diet, staying hydrated, managing protein intake, and avoiding smoking are important for healing and maintaining results.