Second Helping Toolbox
Types of Loose Skin Surgery Procedures
With the popularity of weight loss surgeries and the surplus of excess skin in its wake, plastic surgery responded by creating an entire sub field called body contouring. The name’s significant, because loose skin isn’t limited to your stomach alone. It also isn’t limited to various bariatric procedures – diet and exercise-focused weight loss, or even pregnancy-related weight loss, benefit from body contouring also.
Depending on the amount of loose skin, weight lifting and developing your muscle tone can somewhat compensate, and for women shapewear can provide a temporary stand-in for plastic surgery. Unless loose skin is at risk for infection, or its hampering your movement, these procedures aren’t a necessity in a medical sense.
So it helps to keep realistic expectations and think of body contouring in a specific context. The motivations of body contouring procedures are more reconstructive or corrective than aesthetic. If you have the money, desire and sufficient time to adjust to all the other adjustments to life post-weight, finding a the good plastic surgeons who understands these differences should be the next item on the list. Also, these surgeries can offer improvement — literally. “Improvement” doesn’t equal “perfection.”
Nonetheless, it can make a difference in your aesthetics, how well clothes fit in various sizes, etc. Psychologically, it can provide a very physical closure to the whole weight loss process. At more extreme levels, it can help you move around and function more. So don’t confused body contouring with a botox treatment or facelift. There’s more to it.
Here’s an overview of different procedures available when dealing with loose skin – including areas where it’s likely to occur. There are risks and considerations for healing you need to consider, but we’ll address that in a separate article in the Second Helping Toolbox. Like with all things Second Helping, that’s a decision you make on your terms, not what anyone else thinks you should or shouldn’t do.
Midsection
Abdominoplasty | This procedure creates an incision (and thus scar) from one hip bone to the other and another around your belly button so it can be repositioned after loose skin is pulled down, removed and trimmed. Other techniques can extend the incision to include love handles, or extend up your torso to address loose skin in your upper abdomen.
Panniculectomy | These are usually reserved for patients who have lost 100-200 pounds but are still too obese to contour your body. Rather and reconstruct the abdomen, this procedure just removes the flap of skin from your abdomen called the pannus. The Pannus is graded on five levels – grade 1 is minor sagging, just above your pubic area, grades 4-5 completely cover your pubic area and can extend far below to your knees, increasing risk of infection and hampering movement.
Take note | In either case, procedural techniques can workaround any scarring created by bariatric surgery. Also note neither abdominoplasty or panniculectomy have nothing in common with liposuction; these procedures are concerned with excess skin, not fat. However, for aesthetic reasons minor liposuction can be used to remove excess subcutaneous fat (fat you can’t do much about) to provide smoother lines. But by definition these procedures don’t correspond with fat removal.
Hips, Thighs, Gluts
Buttock/Outer Thigh | These procedures function as the opposite of an abdominoplasty, forming incisions along your bikini line but extending across your back. Excess skin from outer thighs and buttocks are removed. Augmentation of buttocks that look deflated can happen semi-automatically, with surgeons rearranging existing body tissue to reconstruct buttocks. Implants can also be applied, but any kind of aesthetic construction often occur separately.
Inner thighs | Because the skin in your inner thighs is naturally thin and tender, this is a complicated area to contour. Incisions can be made horizontally (between your legs and hips) or vertically to remove excess skin. This can be one of the procedures where it’s most important to keep realistic expectations – improvement means just that, not necessarily perfection.
Upper Body
Breast/Chest reconstruction | For women, breast reconstruction is regularly discussed; in a weight loss context, breasts can appear deflated similarly to buttocks, excess skin is lifted and (if so chosen/necessary) paired with implants. For men with sagging chest skin, incisions and scarring are more visible but result in more traditionally masculine-looking chests.
Upper arms | For both upper back and the “batwings” – sagging skin under the arms, incisions vary with the amount of loose skin along the arms.
Upper Back | Loose skin can appears more like deposits of fat than a melting effect. An incision across the upper torso can remove these deposits and create a smoother (and more comfortable) appearance.
Face/neck Lifts, aka rhytidectomy | For women, a standard face lift makes incisions near the ears and adjusts the loose skin . For men with sagging skin along the neck, the incision’s made under the chin, which can easily be masked with a goatee or beard.
Body Lifts
Take note | Body Lifts are any of the above procedures in combination. Usually these procedures are grouped by incision types, but depending on the extent of skin and other factors, surgeons may elect to split procedures into phases. These offer different advantages/disadvantages – one recovery time versus multiple, but also more extensive healing.
Upper Body lift | Chest/breast, back and arms can possibly be addressed at once, with incisions from across your back to the sides of your chest/breast, and another incision along the upper arms.
Lower Body Lift | A circular incision running the length of your torso. Most underwear and swimwear will hide these scars, and this incision allows doctors to address the abdomen, buttocks and outer thighs simultaneously. Inner thighs may or may not be included in a lower body lift.
Sources
Body Contouring Surgery After Weight Loss
Improvement is pretty damn close to perfection for me. It’s all about expectations.