Anyone who had lost a tremendous amount of weight either through diet and exercise, bariatric surgery or both is typically left with folds of loose skin on various areas of the body. As bariatric surgery has become safer and much more common, the procedures to rid the body of the excessive skin have been improved and more refined.
Surgery or Bust
Unfortunately, there is no way to get rid of excess skin except to cut it out. As there is no muscle in the skin, there is no way to exercise it away. Continuing to diet and get rid of fat until an optimal BMI is achieved is great but you cannot diet away the skin either.
Timing of Surgery is Important
In order to get the best result from surgery and to have the lowest risk of complications, it is best to time post-bariatric surgery when you have lost the majority of the weight and your weight has stabilized for at least several months. It can be a waste to start having skin removal surgery during the weight loss period as the fold of skin will only come back when the fat disappears.
It also is important to be in a positive nitrogen balance with respect to your diet and that you have not developed any nutritional deficiencies as a result of your weight loss surgery that could affect healing.
Bar far, the most common plastic surgery performed on anyone who has lost a lot of weight is a tummy tuck or abdominoplasty during which excessive amounts of skin and fat are removed and the muscles are tightened with sutures. There are many tummy tuck options including circumferential procedures (lower body lift) or extended vertical procedures (fleur-do-lis) that are specifically designed for massive weight loss patients.
The second most common procedure in women after substantial weight loss is a breast lift. In this, excess skin is excised, the breast is lifted and usually the areola is reduced in size with the nipples being repositioned higher on the breasts. Breast implants can be placed at the same time if enlargement is also desired.
Arm and Thigh Lifts
Less common but no less important procedures are arm and thigh lifts, which can be done together or in combination with other procedures. With these, excess skin and fat is removed, sometimes combined with liposuction to get rid of stubborn fat that persists after weight loss. These procedures result in tighter skin on the upper arms and thighs as well as an overall decrease in size and smoother contour.
The majority of buttock lifts are done in combination with a tummy tuck as a circumferential tummy tuck or lower body lift. Fat can also be injected into the buttocks at the same time to enhance that area; this is known as a Braziallian Butt Lift or BBL. In order to perform a BBL, fat must be taken from other areas to be injected. Some patients lose the vast majority of their excess fat from the bariatic surgery to not have enough left to perform a BBL.