Coastal Center for Obesity :: Reconstructive Surgery

Reconstructive Surgery

After weight loss, reconstructive surgery is sometimes necessary to remove excess skin. When weight is lost, the fat disappears but the skin does not. This can result in hanging, loose skin in characteristic areas of the body, including the upper arms, breasts, inner thighs, abdomen, lateral thighs, and buttocks. Skin does have some ability to contract and tighten, so excess skin is not the inevitable outcome for everyone who loses weight. Those who don’t develop a skin problem after weight loss tend to be young, tend to not smoke, and tend to have lost less weight (<100 pounds).

When a person develops an excess skin problem after weight loss, the abdomen tends to be the most affected area. Therefore, the abdomen is usually the first area addressed with reconstructive surgery. Options include the abdominoplasty (ie tummy tuck) and the body-lift. Before any operation is considered, weight loss should be complete, and weight should be stable for a period of three months.

Abdominoplasty

In an abdominoplasty procedure, skin and fat are removed from the lower abdomen. The underlying muscles are tightened and flattened, and the umbilicus is re-implanted. Plastic drainage tubes are placed. The incision can be placed within the bikini line. Other operations such as hernia repair and cholecystectomy can be done at the same time. The operation takes about two hours and can often be done on an outpatient basis. Recovery time is 4-6 weeks.

The abdominoplasty operation is best suited for people with localized excess skin along the lower abdomen. Most bariatric patients, however, don’t have excess skin limited to the lower abdomen. It extends to the thighs and around the back to the buttocks. A better operation for these patients is the body-lift operation.

Body-lift

The body-lift combines an abdominoplasty with a thigh lift and a buttock lift. The incision extends around the entire body within the bikini line. The operation can be visualized as the removal of a roll of skin around the entire body. After the roll is removed the bottom skin edge is brought up to the top skin edge. This results in the thighs and buttocks being lifted. Plastic drainage tubes are placed. This operation takes about four hours and requires a two day hospital stay. Recovery time is 6 weeks.

Other

After the lower torso is reconstructed, other areas can be addressed, like the arms, breasts, and inner thighs. Coastal Obesity does not offer operations for arms, breasts, or inner thighs, but we can assist in finding an appropriate surgeon.

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