Body Contouring Following Weight Loss

Many of our patients who experience weight loss are rightfully concerned with the large amounts of excess skin they see on their bodies. The following outline is an overview of issues to take into consideration if you are exploring the possibility of plastic or cosmetic surgery, and the post-weight loss procedures that are available at Eviva.

Effects of Massive Weight Loss:

Stretched, loose, difficult to manage skin
Rashes
Ill-fitting clothes
Relapse in weight gain

Goals:

Restore functional & aesthetic body contour
Remove difficult to manage tissue
Help restore positive self-image
Help maintain long-term weight loss
Cosmetic surgery can be that final step in your journey

When Can You Consider Cosmetic Surgery?

More than 1 year following weight loss surgery
Weight should be stable
Nutritionally-optimized
Best timing will depend on whether multiple surgeries are desired, and whether these will be combined, staged (multiple parts), or individual surgeries

Insurance Coverage:

Abdominoplasty and breast reduction might be covered by insurance under certain conditions. Most other procedures are not covered.

Criteria for insurance coverage:

Abdominoplasty

Documentation of rashes or sores by your primary care doctor
Skin that hangs below the pubic bones
Insurance may only cover a portion of the operation

Breast reduction or augmentation

Medical necessity: rashes; neck, back, or shoulder pain and bra-strap grooving
Documentation ruling out another cause of the pain is required
Removal of a certain amount of tissue is necessary to qualify
Breast lifts are not covered

Liposuction

Effective in contouring problem areas that have not gone away despite your best efforts of weight loss.
Liposuction is performed independently or combined with a skin removal surgery such as an abdominoplasty, thigh or arm lift. In our experience, when combined with these procedures, we can deliver a more profound result.

Abdominoplasty (Tummy Tuck):

Removal of loose skin
Tightening of muscles
Repositioning of belly button (you keep your own belly button!)
Wide variety in degree
Can be combined with liposuction

Breasts:

Common concerns: deflated appearance when you lose a significant amount of weight. Alternatively, large breasts can cause neck, back pain.
Options include breast reduction, lift, or augmentation
Breast lift and breast reduction are similar – differ in how much removed
Breast lifts result in improved shape. If you also desire improved fullness and volume, a breast augmentation can be combined with the lift procedure as a single operation or staged.

Back:

Options: Liposuction, Lower Body Lift, or Gluteal Augmentation
Procedure chosen by primary complaint. Usually combined with an abdominoplasty, either as one stage or two

Thighs:

Options: Liposuction, Horizontal Lift, or Vertical Lift
Liposuction may be considered if there isn’t loose skin
A thigh lift is recommended if there is excess skin
- Limited lift with an incision in the groin crease only
- Extended lift with the addition of a scar along the inside of the thigh

Arms:

Options: Liposuction, Limited Lift, Extended Lift
Upper arm fullness can be improved with liposuction contouring.
If the problem is loose skin, we generally recommend surgical excision of the excess skin.
- This can involve an incision in the armpit, in mild cases, or an incision down the inside of the upper arm.
- The main drawback of this operation is the visible scar and a tendency for skin to stretch over time.

Face & Neck

Common complaints include hollow cheeks, jowls, deep skin folds, or “looking old” following weight loss.
Options: Restore fullness with synthetic injectables or fat grafting, facelift/neck lift, or neck liposuction