Looking Good after Weight Loss



Losing weight through bariatric surgery is an incredible accomplishment that requires steadfast commitment. In addition to all the health benefits of being lighter and leaner, it’s nice to walk around with a smaller and lighter physique.

The only downfall, for some, is bothersome excess skin that droops and sags off the body after surgery, such that you feel better but look worse. Indeed, patients who have undergone bariatric surgery and the subsequent significant weight loss have numerous but similar areas of concern. These areas usually include:

  • Breast ptosis, or droopiness, as well as a loss of breast volume
  • Sagging of the facial skin
  • Excess abdominal skin and a laxity of the muscles of the abdominal wall
  • Hanging skin under the arm
  • Wrinkling and excessive bagginess of the thighs

I offer several types of cosmetic procedures to treat this problem and this is what I will be talking about this month!



The best candidates for post-bariatric body contouring are people who have lost a large amount of weight, typically 55 kilograms or more, through bariatric surgery or another approach to weight loss.

Post-bariatric surgery is one of the most complex and invasive procedures your plastic surgeon can perform, so patients need to be healthy enough to withstand the rigors of major surgery and an extended recovery period.

Additionally, post-bariatric surgery is not primarily a weight loss procedure. Patients do typically lose some weight as skin, tissue, and minor fat deposits are removed. However, good candidates have already lost most of their excess body fat with the exception of a few localized deposits.

It’s strongly recommended that post-bariatric patients wait about a year after weight loss surgery to have cosmetic surgery. This gives the body enough time to lose the excess weight and stabilize.

Post-bariatric body contouring candidates should be in good physical and psychological health and have reasonable expectations. These are contouring procedures — not meant to take off extra pounds, but rather to help mold the skin so that it “fits” the new curves more tightly.



→Body lift is the most comprehensive procedure for post-bariatric surgery patients. Body lifts improves the appearance of the abdomen, thighs and buttocks. Body lifts can target the upper and/or lower body (when combined together, the procedure is referred to as a “total body lift”).

The lower body lift incision extends around the belt area, through which excess skin above the buttocks and outer thighs is removed and the remaining skin pulled tighter.

The upper body lift involves a bra-line excision and the removal of excess fat and skin from the back and waist. Tummy tucks may be incorporated in a patient’s treatment plan to tighten the abdominal muscles and remove excess skin and tissue.

→Liposuction – Liposuction is frequently employed in conjunction with various skin removal procedures to target localized deposits of residual fat that have not responded to diet and exercise.

In most cases, I can perform the treatment through the incisions required for other procedures.

→Tummy Tuck – The abdomen is usually one of the main areas where excess fat collects on the body. After weight loss, considerable excess skin may remain here.

A tummy tuck trims away this excess skin along with any residual fat deposits. For patients with more far-reaching needs, extended tummy tuck is also available.

→Arm lift (brachioplasty) targets the upper arms which can often look flabby even after massive weight loss. The flab is actually extra skin that hangs from the upper arms and is often described as “bat wings.”

The arm lift incisions are usually made in the armpit and on the inside of the arm from the elbow extending to the armpit, and hidden in the natural shadow of the bicep muscle or on the upper arm. Excess skin is removed and the remaining skin is pulled tight and sutured together.


→Thigh lift. After weight loss, hanging skin is often left on the inner and outer thighs. This skin may rub together, causing irritation or limiting a person’s choice of clothing. With thigh lift surgery, I can remove excess fat and skin using incisions concealed discreetly on the upper and inner thighs.

The incision is made where the thigh meets the groin area, and if necessary, an additional incision is made extending from the groin to the knee.


→Thighplasty is helpful to a number of massive weight loss patients, as the thigh deflates with weight loss, creating excess skin in the horizontal and vertical dimensions. In order to remove this excess and re-contour the thigh into a smaller and shapelier appearance, a vertical excision of skin and soft tissue along the medial thigh is required in addition to the standard groin crease incision. This method allows the skin to be tightened circumferentially around the thigh.


→Breast lift repositions saggy breasts higher on the chest. An incision is made, usually around the areola, extending down the breast to the breast crease and horizontally along the inframammary fold.

Excess skin is excised and the remaining skin is pulled taut around the breast mound and sutured into place. The nipple may be repositioned higher on the chest while it remains attached to the underlying blood vessels.

For patients who have lost more breast volume than they wanted, breast augmentation is also an option.


The buttocks are another common problem area after significant weight loss and buttock enhancement will improve the appearance of a flat or saggy behind. Excess skin is removed and one of two options may be employed. First, implants may be placed to augment the butt and make it look perkier.

The other option is a Brazilian butt lift, in which the area around the buttocks is liposuctioned to make them look smaller, and the liposuctioned fat is purified and re-injected into the upper buttocks, giving it a lifted effect.


Combining several procedures in a single surgery

All of the post-bariatric concerns I’ve spoken about cannot be addressed simultaneously during one operation. However, two procedures usually can be safely combined. During your consultation, I will assess your anatomy as well as your own priorities to help you develop a comprehensive plan for your body contouring.

For instance, it is not uncommon for me to combine a tummy tuck with a breast lift (with or without the addition of breast implants), or a thigh lift with an arm lift, as well as other possible combinations of procedures.

Combining the procedures consolidates recovery into a more manageable timeframe. Most patients and plastic surgeons also agree that this approach produces much better, more natural-looking cosmetic results.


How long is the recovery-period after body contouring surgeries?

Typically, body contouring procedures require at least three months for the overall cosmetic results to be fully apparent. This allows enough time for all residual swelling to resolve and for soft issue to soften. Scars usually require 12 months to go through the remodelling process, and, because body contouring procedures require significant incisions, they often are apparent during this time period.

Because post-bariatric surgery is such a highly involved procedure, you should be prepared for an extended period of rest and recovery. Recovery time varies widely depending on the extent of the procedure, but in general you should be prepared to take multiple weeks away from work, and often full recovery may take several months.


How long do the results of body contouring last?

The major factor that affects the longevity of results in post-bariatric body contouring is weight fluctuations. This is the main reason that these procedures are delayed until a patient’s weight is stable for a minimum of 12 months. If patients are able to maintain their weight, long-lasting results can be achieved.

The main issues in this patient population are related to scar migration and soft tissue laxity leading to contour deformities. These are the result of the altered skin/soft tissue characteristics related to the previous obesity

If you are interested in any of the procedures mentioned whether in the context of post-bariatric surgery or not, you must feel free to phone my Fourways rooms on 011 875 1630 and book an appointment!

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