Surgery after massive weight loss

Surgery after massive weight loss is often not a single procedure, but many.  When patients experience massive weight loss, often designated as 100 pound or more, there is often significant skin loss and sagging in multiple areas of the body including the abdomen, hips, thighs, arms, breasts, neck, and face, all of which may require surgery to correct the effects of this “deflation”.

Surgery following massive weight loss is a relatively new area of plastic surgery.  These cases were fairly uncommon 25 years ago but have increased significantly since that time.  As more people became obese, we saw more patients responding to this problem with medically supervised diets, gastric bypass and banding procedures, and old-fashioned diet and exercise.  The result is that we are now seeing patients after their successful weight loss journey that have lost 100 pounds or more on a fairly frequent basis.

With their weight now controlled and overall health improved many of these patients may be disappointed with the appearance of their loose skin.   The good news, however, is that plastic surgeons have gained increasing experience and have responded to this challenge by developing new and better procedures to correct the affects of massive weight loss.  We are happy to be a part of this ever evolving field and to be able to help patients who have achieved this significant weight loss.

Special considerations

Surgery after massive weight loss must be approached somewhat differently than other procedures to achieve the best possible results while minimizing complications.  Our experience, as well as that of others in this field, has helped us develop several guidelines for approaching surgical correction of the problems associated with weight loss.

  • Patients must be at a stable weight before surgery, usually for 6 months or more.  Not only does this help prevent a patient’s results from being “undone” by weight fluctuations after surgery, but allows the body’s metabolism to stabilize following significant weight loss.
  • Patients should wait at least 18 months after gastric banding or bypass procedures before undergoing surgery,  for reasons outlined above.
  • Multiple staged operations may be preferable to a single operation that tries to do everything at once.  As multiple areas of the body my need to be addressed, it is sometimes not practical or safe to address all areas at once.
  • An overall plan should be developed for correction.  We suggest starting with the area most troubling to the patient, then correct other areas in stages as the patient’s health, schedule, and finances permit.
  • Safety should be the most important consideration.  These operations are sometimes long and complex, and we feel that if they cannot be done safely and with minimal complications they should not be done at all.  We will tell you if we think the risk of the operation you desire outweighs the potential benefit we may give you.

Planning your surgery

Planning begins with your initial consultation at our office.  As stated above, we want our massive weight loss patients to be at a stable weight for at least 6 months before surgery, but can see you before that time to begin discussing and planning your surgery.  At the initial consultation we will evaluate and discuss your problem areas and suggest an operative plan for addressing these areas.  If several areas can be addressed safely in a single operation, we can begin planning and scheduling this.  Alternatively, we may suggest a staged approach and help you prioritize your surgical plan.  We will discuss risks, recovery time, costs, and expectations to help you decide when an how to proceed.  To help you in your decision, we might refer you to other patients who have undergone the same or similar procedures to gain some firsthand insight as to the actual surgery and recovery process.

Our goal is to help you develop an plan for correction that meets your needs, expectations, finances, and your schedule.

Operations we may suggest

 Every massive weight loss patient is unique and may require a single or multiple operative procedures to achieve their goals.  Operative procedures we may discuss include:

All of these procedure are described elsewhere on our website in detail, and we will explain and discuss them with you during your consultation.  We will help you develop a plan so you can address the areas which are the most troubling to you and where we feel you would see the most benefit.

Insurance coverage

We have worked with multiple weight loss patients and their insurance companies over the years and become familiar with most of their policies and procedures.  In fact, your insurance company may have specific policies regarding coverage for surgery following massive weight loss available online and we urge you to read these rules so you will have a better understanding of what may or may not be covered.

Insurance coverage is sometimes available for the removal of the large amount of overhanging tissue on the lower abdomen (pannus) that may result after significant weight loss as this may cause functional problems.  In order to determine if removal of this (panniculectomy) will be a covered procedure, we will send a predetermination letter to your company detailing your symptoms, physical findings, photographs, and our surgical plan so that decisions regarding coverage can be made prior to surgery.  This process usually takes 2-4 weeks.

Other than panniculectomy or abdominoplasty, other procedures are generally are not covered by insurance as they are considered cosmetic procedures with little or no functional benefit.  This list of non-covered procedures includes circumferential abdominoplasty, thigh lifts, breast implants/lifts, brachioplasty (arm lift), liposuction, labiaplasty and facial procedures.  We will give you price information and financing options at the time of your consultation.

Your insurance company may cover part of the procedure, but not all the corrections you desire.  In this case, we will break down the costs for you so you can see what charges will be covered by your insurance company and how much you will be expected to pay for the remainder.

Best candidates

Our most successful and happy patients have been those that have dropped their weight to a normal range, maintained a stable weight, planned carefully for their surgery and recovery, had realistic expectations about their results, and have been otherwise healthy.

Quick fact

From 2000 to 2018 the number of lower body lift procedures performed in the U.S. increased almost 4000% (40x).

5 Reasons why you should see us at Lawrence Plastic Surgery following your massive weight loss.

  • Experience– We have taken a great interest in surgery following massive weight loss for many years and have been excited to be a part of this developing field as it has grown.
  • Accredited facilities– We only perform these operations at Lawrence Memorial Hospital or the Lawrence Surgery Center.
  • Safety– We place your safety above all else.  We have given educational talks at national conferences on safe practices and body contouring procedures and take the issue very seriously.
  • Surgeon certified by the American Board of Plastic Surgery
  • Great staff and office environment–  Our experienced staff, including a Certified Plastic Surgery nurse, work alongside your surgeon every step of the way to give you not just a great operation but a great experience.