MED0001860545
Read more here This website contains imagery which is only suitable for audiences 18+. All surgery contains risks.
This website contains imagery which is only suitable for audiences 18+. All surgery contains risks.
MED0001860545: This website contains imagery which is only suitable for audiences 18+. All surgery contains risks.
Read more here
Body contouring after significant weight loss is one of the more substantial areas of body surgery.
At a Glance
Post Weight Loss Surgery
Introduction
Body contouring after significant weight loss is one of the more substantial areas of body surgery. Patients who have lost a large amount of weight (whether through diet and exercise, medication, or bariatric surgery) are often left with skin that hasn’t retracted to match their new body shape. The amount of loose skin depends on factors including the total weight lost, the rate of weight loss, the patient’s age, the elasticity of their skin, and where the weight was distributed.
Body contouring after weight loss is typically planned across multiple operations rather than as a single procedure. The reason is partly practical (operating on multiple body areas in a single sitting would produce an operation longer than is safely tolerated) and partly because the procedures involve different anatomical areas with different healing requirements. Patients should plan on a sequence of surgery rather than a single fix, and we’ll work through that sequence with you at consultation.
What can be addressed
Significant weight loss can affect many body areas at the same time, and patients commonly have loose skin or contour changes in several places. Common areas include:
Procedure
The procedures chosen depend on which areas are bothering the patient and on what's anatomically appropriate. The procedures typically considered for post-weight-loss patients include:
Abdominoplasty addresses the front of the abdomen. Where skin laxity extends around the sides and back, a belt lipectomy (also called a 360-degree abdominoplasty) addresses the abdomen, flanks and lower back in a single operation. Belt lipectomy is a larger procedure than standard abdominoplasty and is reserved for patients with significant circumferential skin laxity.
Removes excess skin from the upper arms. The scar runs along the inner side of the upper arm and is permanent. Brachioplasty is one of the most common procedures requested by post-weight-loss patients (see the Upper Arm Lift page).
Removes excess skin from the inner or outer thigh. The scar pattern depends on where the laxity is located and how much skin needs to be removed (see the Thigh Lift page).
A more extensive procedure that addresses the abdomen, hips, outer thighs and buttocks in a circumferential pattern (see the Lower Body Lift page).
Addresses skin laxity across the upper back, sometimes extending to the chest. Less commonly performed than the lower body operations.
May be used in selected areas to refine contour, although liposuction alone isn’t generally suitable as a primary procedure in post-weight-loss patients with significant skin laxity (see the Liposuction page).
Planning
Most patients who have lost a large amount of weight benefit from more than one procedure, performed over a series of operations. The sequence is planned individually based on which areas are bothering you most and on the practical and medical considerations involved.
A common pattern is to start with the abdomen, because the abdomen is usually the area most affected and the area where addressing the skin produces the most noticeable change. Subsequent procedures address other body areas in the order that matters most to the patient. Three to six months between operations is typical, allowing each operation to heal fully and for any need for revision to become clear before the next stage. Some patients work through all the areas they want addressed over the course of one to two years.
Planning the sequence is part of the conversation at consultation, and we’ll set out a realistic timeline for the operations you’re considering, including the costs at each stage and the recovery time you should plan for.
Special considerations
Patients having body contouring after weight loss need to meet some specific requirements before surgery, in addition to the standard pre-operative assessment that applies to all major surgery.
Most surgeons recommend that patients have maintained a stable weight for at least 12 months before body contouring surgery. Further weight loss after surgery can leave the skin looking loose again. Weight gain can stretch the wound and produce wider scarring. Weight stability is particularly important after bariatric surgery, where the rate of weight loss eventually slows, but it’s relevant for everyone.
Significant weight loss, particularly after bariatric surgery, can affect nutritional status in ways that aren’t always obvious. Wound healing depends on adequate protein, vitamins and minerals, and patients with low levels of these nutrients are more prone to wound healing problems. Blood tests to check nutritional status are commonly requested before surgery, and supplementation may be recommended in the lead-up to the operation.
Smoking significantly affects blood supply to skin flaps and dramatically increases the risk of wound healing complications, including skin loss. Patients are asked to stop smoking well before surgery and to remain off cigarettes through the healing period. This applies to nicotine in any form, including vaping and patches.
Body contouring after weight loss can produce significant improvement in contour and reduce the burden of loose skin. It can’t produce a body that looks as it did before the weight gain, and the scars from these operations are extensive and permanent. Patients who go into surgery with a realistic understanding of what’s achievable are generally more satisfied with the outcome.
The procedure
Each procedure is performed under general anaesthesia in an accredited hospital. Operating times vary from approximately two hours for a brachioplasty to seven hours or longer for a belt lipectomy. Hospital stays range from one to four nights depending on the procedure and the patient. Drains are commonly used and are removed as fluid production reduces. Compression garments are worn for several weeks after each operation.
Risks
Post-weight-loss body contouring carries the recognised risks of the individual procedures performed, with some risks particularly relevant in this patient group. The recognised risks include:
Every risk that applies to your situation will be discussed in detail at consultation, and you'll have written information to take away before any consent is signed.
Medicare
Body contouring after significant weight loss may attract a Medicare rebate where specific clinical criteria are met. Eligibility depends on factors including the amount of weight lost, the duration of weight stability, the specific procedure being performed, and the documented clinical findings. Not every patient qualifies, and qualification is assessed individually rather than assumed based on history of weight loss alone.
We’ll assess your likely eligibility at consultation and provide a written quote covering all surgical, anaesthetic and hospital fees, including the gap between Medicare and private rebates and our fees if a rebate does apply. Because most patients have multiple operations, the total cost across the planned sequence of surgery is worked through with you at consultation so you have a clear picture of the financial commitment.
Results vary
Honest counsel on outcomes
Final body contour, scar appearance, sensation at the operative sites and durability of the result are all individual outcomes that depend on the specific procedures performed, the patient’s starting anatomy following weight loss, the techniques used, and individual healing characteristics. The result is also affected by what happens to your body in the years after surgery through weight changes and ageing. There’s no guaranteed result, and we don’t promise specific outcomes.
FAQs
Weight stability matters. Most surgeons recommend waiting until you’ve maintained a stable weight for at least 12 months, and ideally longer. After bariatric surgery, this generally means waiting until your weight has plateaued, which usually takes 12 to 18 months after the bariatric procedure. We’ll discuss your weight trajectory at consultation to work out the right timing.
It varies. Patients with skin laxity in one or two areas may need a single operation. Patients with more extensive changes typically need two to four operations spread over one to two years. We’ll set out a realistic sequence at consultation based on your specific situation and priorities.
Some procedures may attract a Medicare rebate where specific clinical criteria are met. Eligibility depends on the procedure, the documented clinical findings, the amount of weight lost and the duration of weight stability. Not every patient qualifies. We’ll assess your likely eligibility at consultation.
Scars from post-weight-loss surgery are extensive and permanent. The exact pattern depends on which procedures are performed. We position scars to sit within or close to underwear and swimwear lines where possible, but they’re typically more visible than scars from simpler procedures. How they end up looking is influenced by individual healing characteristics.
No. Operating on multiple body areas in a single sitting would produce an operation longer than is safely tolerated, with cumulative risks (including blood clots and bleeding) that would be unacceptable. Body contouring after weight loss is staged across multiple operations for safety and for technical reasons.
Yes, well before. Smoking significantly increases the risk of wound healing complications, including skin loss. Patients are asked to stop smoking at least six weeks before surgery and to remain off cigarettes through the healing period. This applies to nicotine in any form, including vaping and patches.
Practitioner
Dr Henry Shepherd, BMed MD MS (Plast.) FRACS (Plast.) | Specialist Plastic Surgeon | AHPRA registration: MED 0001860545