In addition to that of the abdomen, the skin of other areas of the trunk and extremities are also subject to the same damaging stresses of time, gravity, and the stretching from weight gain and weight loss. Particularly after dramatic weight loss, often assisted in recent years by the variety of gastric bypass surgeries, the upper arms, back, hips, thighs, and buttocks are additional areas of excess skin and fat for which patients frequently seek recontouring.
The arm lift (or brachioplasty) procedure attempts to procure a more natural and youthful look by removing the fat and excess skin hanging down from the underarms. This is more commonly seen in women, but can also occur in men who have lost significant weight. The incision is made beneath the arm and can extend from the elbow to the armpit, depending on how much skin must be removed. However, most patients are satisfied with the results and believe trading “skin for scars” is worthwhile, especially when scars are efficiently hidden by the surgeon.
The breast lift (or mastopexy) reshapes the breasts and repositions the areolas. The skin below the breast is generally removed and the nipple is moved higher while skin above the breast is pulled around to create a swell. This procedure is usually combined with breast augmentation (enlargement) so as to better fill the empty space vacated by the fat loss. The areolas can also be resized if necessary. Most of the scars associated with this procedure are hidden by a normal bra.
The tummy tuck (or abdominoplasty) tightens the abdominal walls and removes excess skin to create a flatter contour of the abdomen. This procedure is performed under local or general anesthesia and begins with an incision along the bikini-line and the removal of the navel. Once the abdominal walls have been repositioned, the skin flap is pulled down, stretched and cut for the new naval fixture. The procedure is moderately invasive and requires around two to three weeks before exercise can be attempted.
A lower body lift consists of both a thigh lift and a buttock lift, both aimed at resecting as much excess skin as possible. The thigh lift is performed similar to an arm lift, with the surgical incision varying in position based on where most of the skin lies. The butt lift does not make use of implants at all, although some can use fat harvested from other parts of the body to “fill out” the shape. In most cases of body contouring relating to bariatric surgery though, the simple cutting and repositioning of the skin produces satisfactory results.
Often each of those areas may be addressed separately, depending upon the needs and desires of the individual patient. In cases of extreme and extensive skin laxity of the trunk, a circumferential “lower body lift” ( Body Contouring ) may even be performed which incorporates an abdominoplasty with a simultaneous hip, lateral thigh, and buttock lift. Body Contouring procedures are accompanied by rather significant scarring, with the “lower body lift” extending the more common abdominoplasty incision around the waistline and across the upper buttocks below the posterior waistline.
The results of these procedures are often quite dramatic, and the contour improvements are frequently “liberating” for those patients who have worked so hard to lose their excessive weight. Those patients who are judged to be good candidates for Body Contouring procedures usually find the associated scars an acceptable and worthwhile trade-off for their improved comfort and self-confidence when wearing a bathing suit or form-fitting clothes.