Question: I had bariatric surgery for obesity 18 months ago. I have lost 125 pounds and now weigh 150 pounds. My weight has remained the same for the last 8 months. Everyone tells me how wonderful I look but I have a tremendous amount of sagging skin that I have to cover with my clothes. My face looks fine, but the skin on my arms, breasts, stomach and thighs look like deflated balloons. What can I do?
Answer: This is a common problem after any kind of extreme weight loss. Once your weight has stabilized for a year, you are eligible for cosmetic surgery. All of these target areas should not be treated at one time because it is too much surgery for the body to handle. An evaluation of your physical health and nutritional status must be completed prior to any surgical procedures.
I ask patients to prioritize their problem areas and then consider operating on a few at a time. I request that patients heal from each surgery for at least 6 months prior to undergoing the next stage. Surgical combinations often performed are: breast lift and tummy tuck, tummy tuck and arm lift, tummy tuck and liposuction of the legs, or a combination of whatever surgery is needed. Liposuction is often required prior to lifting the thighs or tightening the tummy because the remaining fat can weigh down the skin, which will result in sagging.
A discussion with your plastic surgeon will help you decide which areas you can couple, and how much surgery is safe for you personally, as this varies with each patient. It may be recommended that only one area be treated at a time. You will need to have realistic expectations about your procedure.
I recommend that you consult with an experienced and board certified plastic surgeon to discuss your options, and review the risks, complications, and benefits associated with each of the procedures.
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Questions are answered by Dr. Mark A. Foglietti, a nationally recognized board-certified plastic surgeon and author.
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