Now that you have lost the weight… what happens next?
For those of us who have worked hard to lose the unwanted kilos and stones – be it through exercise, diet or lap band or gastric sleeve surgery – congratulations on achieving an incredible milestone. Not only is massive weight loss great for health in that it results in better blood pressure, lower cholesterol and blood sugar levels, but it restores energy and gives those who have reached their target weight, a new level of self-confidence.
For the lucky ones who have great genetics, our skin will retract beautifully that we will not have any excess skin or stretch marks to remind us of once being heavier. However, for the majority of us, massive weight loss can leave loose skin as a reminder of our former heavier self that no amount of exercise, dieting and skin creams can address. Most of us will still have extra folds of skin on our tummy, our chest wall, sagging skin hanging from our arms, lax skin on our thighs and maybe even deflated saggy breasts?
So what can we do to look good after dropping the kilos? Many of us resort to Shapewear, tight form-fitting slimming undergarments, or what I call “sucker innerers” that squash everything into a compact slimmer version of ourselves! However, after a while of this, it can get annoying for some, especially in the warmer months, when there has to be an easier way of looking great after massive weight loss that does not involve wearing binders and restrictive garments.
For some people who have lost large amounts of weight after bariatric surgery or through lifestyle changes, surgery can help remove excess skin and reshape the waistline, arms, thighs and breasts. This body contouring surgery can take many forms depending on the areas that need to be addressed.
Post-bariatric body contouring can include a body lift which is the circumferential removal of excess skin and fat from the abdominal wall, flanks and the back. A body lift not only removes excess tissue that may overhang and bulge, but can tighten the underlying muscle wall and lift a sagging mons pubis, lift the thighs and lift the buttock. A body lift is a major operation that must be performed under general anaesthesia and can take 2-5 hours and involves position changes whilst asleep. Patients stay in a hospital for 5-7 days on average and can return to exercise and vigorous activities after 4-6 weeks.
An arm reduction or arm lift, also known as brachioplasty, can reduce the circumference of the arms or improve the appearance of “bat wings” or “tuckshop lady arms”. The procedure involves removing an ellipse of hanging skin on the undersurface of the arms, leaving a long scar on the undersurface of the arm. The surgery is performed under general anaesthesia and takes 2-3 hours and often requires an overnight stay in the hospital and a pressure garment to be worn on the arm for 4-6 weeks after surgery.
The thighs can be reduced via a medial thigh lift or medial thigh reduction, which can involve a wedge of loose skin from the inner thighs removed and reduced and lifted leaving a scar in the groin crease. Alternatively, it can involve a longitudinal scar along the length of the inner thigh where a vertical ellipse of excess skin is removed. The surgery takes 2-3 hours and is performed under general anaesthesia.
All body contouring surgery is major surgery that like all invasive procedures has potential risks. Potential complications include infection, wound breakdown, thick or unsightly scars, a haematoma requiring a return to surgery and general risks such as a Deep Vein Thrombosis (blood clot in the legs) and a Pulmonary Embolus (blood clot in the lungs). These risks are minimized by careful surgical planning and optimizing medical conditions before surgery as well as using antibiotics, calf compression devices and TEDS stockings during surgery and attention to pressure care and chest physiotherapy after surgery. Your surgeon, anaesthetist and nursing team will take special care of you throughout the entire surgical journey.
Your surgeon will assess your suitability for surgery and individualise a treatment plan to address all the areas of concern in post-weight loss body contouring surgery. The intricate details of the surgery will be discussed with you at your consultation where you will have the opportunity to view before and after photos and ask your surgeon and nurse any questions about the surgery and the recovery.