Body contouring following massive weight loss resulting from bariatric surgery

A sharp increase in bariatric surgery has resulted in spike in the population of patients seeking body-contouring procedures. Skin and soft tissue redundancy of the trunk, buttocks, breasts, upper arms, and thighs following massive weight loss is unsightly and results in medical problems such as musculoskeletal strain from increased tissue weight, intertrigo or functional limitation with walking, maintaining adequate hygiene, bowel and bladder habits and sexual activity. These elements compound the inherent psychosocial issues related to massive weight loss. Using time-tested plastic surgical techniques, several operations have been designed and perfected to address the needs of these patients. These include breast, thigh and lower body lift, abdominoplasty, face and neck lifts as well as brachioplasty or arm lift. Recognizing that there is a qualitative as well as a quantitative difference in the type and amount of tissues in postbariatric patients these techniques have been suitably refined to optimize outcomes and provide safe and durable re-contouring. Consequently, bariatric surgery and the subsequent weight loss require an additional 2-3 years commitment towards body contouring procedures. Restoring their body image through reshaping procedures is an integral part of completing the treatment of post-weight-loss patients. Strategic skills in terms of assessment of each patient, careful planning, timing, especially for patient safety and technique are fundamental for the success of these often complex and extensive procedures.