Plastic Surgery after Weight Loss

Home » Doctor Article » Plastic Surgery after Weight Loss

With massive weight loss, in a short period of time, patients are often left with a significant amount of excess skin. Because of the rapid weight loss, the patient’s skin doesn’t “bounce back” adequately, resulting in a multitude of problems including problems with moisture, skin break down, hygiene and body image problems (aesthetic concerns). This excess skin remains a reminder of the person’s past problem with obesity and limits the patient’s satisfaction with the weight loss he/she has achieved. Although patients are often very pleased with the improvement in their medical issues (such as diabetes and high blood pressure) achieved after weight loss, they are still not happy when they look in the mirror. Plastic surgical procedures after weight loss may help the patient achieve their goals and significantly improve their self-image. It is important to work with a plastic surgeon with extensive experience due to the fact that treatment of the post-bariatric surgery patient is unique in that the patient’s skin elasticity has been permanently decreased; potentially resulting in faster recurrence of some of the patient’s presenting complaints. Dr. Pousti has helped many patients in this situation.

As patients lose weight, their face and neck skin often show signs of weight loss often associated with aging. They may notice loose skin of the eyelids, lower face (jowl) or neck area. Face and neck lifting surgery help eliminate loose skin and the underlying muscle and fatty tissue. The re-suspension of the tissues helps rejuvenate the face and neck area.

Many patients complain of “empty, droopy, saggy” breasts after weight loss – in fact, patients often say that they were happier with their breasts before weight loss than after (just like some patients are happier with their breast during pregnancy than after). Most patients after massive weight loss, benefit from breast augmentation (saline or silicone gel breast implants) along with breast lifting (mastopexy) surgery. The mastopexy operation serves to raise the nipple-areola complexes higher on the chest wall (by removing redundant or loose skin) while the breast augmentation serves to increase fullness of the breasts especially along the superior pole of the breasts. Usually, after significant weight loss, both breast implants and breast lifting are required for optimal results.

Saline Implants

Saline implants have a silicone rubber shell that is inflated to the desired size with sterile saline. The implants are placed under the pectoralis muscle deflated and therefore, the incision used for this type of implant is minimal. These implants can be overfilled to achieve a more rounded appearance.

Saline implants have some advantages over silicone implants. Silicone implant ruptures are harder to detect. When saline implants rupture, they deflate and the results are seen almost immediately. When silicone implants rupture, the breast often looks and feels the same because the silicone gel may leak into surrounding areas of the breast without a visible difference. Patients may need an MRI to diagnose a silicone gel rupture. Saline implants are also less expensive than the silicone gel implants.

Silicone Implants

Silicone implants have a silicone rubber shell that is filled with a fixed amount of silicone gel. Most silicone gel-filled implants are not adjustable and therefore, the incision used to place the silicone gel implant is larger than the incision needed for saline implants. The silicone gel implant cannot be overfilled – it comes in an exact size that cannot be manipulated. Silicone implants vary in shell surface (smooth/textured), shape, profile, volume, shell thickness, and number of shell lumens.

Some surgeons feel that silicone implants have a more natural look and feel than saline implants because silicone gel has a texture that is similar to breast tissue. Each patient differs in the amount of breast tissue that they have. If a patient has enough breast tissue to cover the implant, the final result will be similar when comparing saline implants versus silicone gel implants. If a patient has very low body fat and/or very little breast tissue, the silicone gel implants may provide a more natural res