What techniques are used to remove extra skin around the trunk after massive weight loss?
Patients who lose large amounts of weight usually have more extra skin than fatty tissue around the abdomen, flanks and lower back. Unlike fat that can be removed with liposuction, extra skin should be surgically cut away. The extra skin is often poor quality, and has lost the ability to contour once underlying fat has been removed. This is why cosmetic surgery after weight loss requires long incisions to remove this skin.
Although these incisions are relatively long, and are frequently carried around the body like a belt, they are made relatively low so underwear, bathing suits and most other clothing can conceal them. The most common procedure to contour the lower trunk after massive weight loss – the lower-body lift – incorporates a scar that is carried over the pubic area, curves up slightly as it travels towards the flanks, and then runs at the interface of the buttocks and lower back as it wraps around the body.
The lower-body lift serves to remove redundant skin from the front and sides while lifting the buttocks. Individuals who are also troubled by redundant skin in the armpits and bra-strap area can benefit by an upper-body lift procedure that, when combined with a lower-body lift constitutes a total-body lift. The upper-body lift incision is placed at the level of the upper back skin rolls near the bra strap region and can effectively remove this redundant skin.
Some individuals have redundant skin in the front and along the sides but do not have as much redundant skin in the back or buttocks. These patients may benefit from an extended abdominoplasty, in which the incision is carried from across the lower abdomen to the flanks, but avoids an incision on the lower back.