Body contouring after massive weight loss

The number of patients interested in body contouring surgery after massive weight loss continues to grow. The diversity of body types has created an entire sub-specialty of plastic surgical procedures dedicated to improving form and function in these patients. Appropriate pre-operative work up is essential to the success of surgical treatment due to common nutritional deficiencies and medical co-morbidities. Of equal importance is a lengthy discussion of the scars required to improve the patient's contour, the number of surgical procedures required to achieve the patient's goals, and the length of recovery involved with each stage of treatment. In our center, total body contouring is performed in a staged fashion due to the lengthy operative and recovery times required for successful re-shaping of the skin and tissue. The central trunk is often addressed first, as this is the area of biggest concern for the majority of patients. In secondary and tertiary surgical procedures, the upper body, arms, breasts and medial thighs are treated. Each stage is personalized toward the degree of soft tissue deflation and aesthetic goals of the patient. Common complications such as seroma development and wound dehiscence should be mitigated by the judicious use of drains and tensionless layered closure, respectively. Ultimately, patient satisfaction after body contouring surgery is quite high. Many patients find a new confidence as they discover that their outer appearance finally reflects their more youthful and healthy inner self, which they discovered after weight loss.