Body Contouring After Extreme Weight Loss: How Common Is It?

September 23, 2016

By Dr. Jamil Ahmad, MD., FRCSC., Director of Research and Education, The Plastic Surgery Clinic

Losing a significant amount of weight is a major achievement, but for many, it’s only half the battle. If you’ve managed to lose a large amount of weight, you deserve to be thrilled with this accomplishment. The hard work you put into living a healthier lifestyle, whether it be through diet and exercise, or a surgical weight loss procedure, is worthy of congratulations.

I see many patients who’ve made it to their target weight, but still feel unfulfilled due to excess skin, loose tissue, or issues with their physical proportions, which is a result of their extreme weight loss. For these patients, restorative surgery for significant weight loss may be the answer.

At The Plastic Surgery Clinic, many of my prospective patients will ask: Am I a good candidate for body contouring?

What is Body Contouring?

Body contouring encompasses an array of surgical procedures where excess skin, as a result of significant weight loss, is trimmed away. The various types of body contouring procedures I frequently perform include:

Arm Lift:

A surgical procedure that gives you leaner, more toned-looking arms by removing excess skin and tightening tissue.

Thigh Lift:

An operation designed to improve the contour of the upper legs through the removal of unwanted skin as well as tightening the underlying tissue.

Tummy Tuck:

Also known as abdominoplasty, this surgical procedure creates a smooth, flat tummy by eliminating sagging skin and tightening slack abdominal muscles, as well as removing any stubborn fat deposits.

Buttock Lift:

A buttock lift is designed to lift a sagging, shapeless rear end and improve firmness by removing loose skin and possibly remodeling the fatty tissue through injections harvested from other parts of your body.

Breast Lift:

Breast lift surgery is performed in order to reform sagging breasts into a more youthful, perky shape; sometimes breast implants are used to improve size and shape at the same time.

Body Contouring: It`s More Common than You Think

Skin elasticity weakens with age, and additionally, in patients who have undergone extreme weight loss. In weight loss patients, for example, the skin has stretched to an extent where the elasticity is permanently diminished, leaving them with extra skin and unnatural skin folds where there are normally none. The excessive skin makes patients very self-conscious. It may also interfere in physical activities and can be difficult to care for, leading to skin infections and skin breakdown. As a result of these physical complications, restorative body contouring is the only form of correction.

A Life-Changing Procedure

Body contouring procedures are extremely common in patients who have lost over 100 lbs, as their excess skin is circumferential, meaning it extends from the abdomen around to the patient’s back. A recent patient of mine had undergone extreme weight loss – she lost over 130 pounds – which resulted in weakened skin that became excessive and uncomfortable. As is commonly the case with those who achieve significant weight loss, instead of being able to embrace their improved lifestyle, she found that her leftover skin interfered with the ability to embrace this new milestone in her life.

Unfortunately, excess skin will not respond to changes in diet and exercise. The only way that it can be adequately eliminated is through surgical restoration. The following images show my patient at the different stages of her post weight loss journey: before her extended abdominoplasty procedure, and 3 months post op.

No-Drain Tummy Tuck

The highlight of this patient`s procedure was that it was done without the use of drains. This new technique, called Progressive Tension Abdominoplasty, is a form of drainless tummy tuck that seals the space between the skin and muscle where fluid tends to accumulate. Using a special kind of internal stitch called the Quill suture, the skin and muscle are locked in place with the barbs of the suture.

In past surgical techniques, the space between the skin and muscle was left open and unattached, allowing a space where fluid could collect. As fluid collected, causing a seroma, the healing process would slow down, so surgeons would prevent this by inserting small drains to remove excess fluid.

The other point of note for this particular case is the use of an extended abdominoplasty technique. Because this patient was concerned about excess circumferential skin, a typical abdominoplasty would have presented limitations in achieving a desired end result. A typical abdominoplasty uses an incision that extends from hip to hip as this is typically where excess unwanted skin is located in a tummy tuck patient. However, in this case, where body contouring is necessary after significant weight loss, an extended abdominoplasty was used to extend the incision beyond the patient’s hips in order to address the excess circumferential tissue.

This patient, who lost over 130 lbs. through diet and exercise, is much happier with the overall appearance of her body. Because her skin now fits the curvature and contour of her figure, her hard work and dedication in achieving her goal weight can be more easily recognized. This is just one of the incredible stories I witness every day, and just the beginning of this patient`s life-changing journey. In January 2017, she will under a thigh lift to improve the contour of her upper legs.

Body Contouring at The Plastic Surgery Clinic

Your body contouring procedure can be performed on site in the state-of-the-art facilities of The Plastic Surgery Clinic. The Clinic exceeds national, provincial and municipal health care facility standards.

If you prefer, you can also have your surgery at one of the hospitals where Dr. Frank Lista, Dr. Ryan Austin and I enjoy privileges. These include the Mississauga site of the Trillium Health Centre and the University Health Network in Toronto.

Should you decide to undergo a body contouring procedure, whatever your motivation, be sure to consult with a highly qualified, board certified plastic surgeon that specializes in all areas of body contouring. Together, both of you will be able to determine an end result that not only benefits your lifestyle, but also meets your aesthetic goals.

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