What is Body Contouring Surgery?

Body Contouring Surgery is often referred to as Plastic Surgery after massive weight loss.

People who are carrying a large amount of excess weight may choose to lose that weight, either through diet and exercise or via surgical assistance – such as lap band, gastric sleeve and gastric bypass surgery. No matter the cause, individuals who have lost a massive amount of weight experience the same issue – their bodies become smaller, but their skin does not. Skin does not contract, or ‘shrink wrap’ around a smaller body. Metaphorically, excess skin represents the former self – or an old dress. Individuals who have lost a massive amount of weight become smaller, fitter, and healthier but they are essentially wearing a dress that is too big. The bigger the loss, the baggier the dress.

Body Contouring Surgery is effectively surgery designed to tailor your skin to fit your body.

All Body Contouring Surgical procedures are complex reconstructive procedures and just like any surgery, they should never be trivialised. However, in order to help patients understand the patterns and scars necessary for these surgeries, Dr Dona will often use dressmaking as an analogy. In dressmaking, you remove material and run a seam; in surgery, you remove skin and the ‘seams’ are the scars. The greater the amount of excess skin to be removed, the more scars necessary.

Although the necessary scar patterns from these surgical procedures after massive weight loss can be compared to dressmaking, it is course far more complex. Skin and tissues are not rigid – they swell, stretch, shrink and sag. Additionally, the body beneath the skin also changes, which is especially true during the first few months after surgery. Therefore, as a surgeon, Dr Dona needs to reconstruct and reshape things that are 3D, and not static. He also needs to ensure that he does not make things too tight because that can result in serious problems with wound healing and breaking down. Therefore, after the initial post-surgery swelling starts to decrease and the skin settles into position, it is normal for your skin to not feel as tight as it did initially. Given this, it is not uncommon to require further surgery to fine-tune the results.

Although massive weight loss affects skin in every area of the body, the common areas are the arms, the breasts and chest area, back, buttocks, stomach, and the thighs. However, there is a limit to how much can be achieved in one day so you typically cannot have every procedure done at one time.

Basically, we start with the areas that most concern an individual and then we continue in stages depending on the degree of concern and other considerations such as lifestyle and financial constraints. The minimum time between each surgery is three months.

Any form of Reconstructive Surgery is complex and carries risks. However, to compound these risks, the skin and tissue quality of many of these patients is often poor, which increases the potential for issues such as poor wound healing. This leads to a higher risk of wounds breaking down with skin and tissue loss. Therefore, there is a high risk of further surgery being required in the postoperative stage to address these issues. Higher-risk patients must accept the possibility of experiencing wound healing issues that will warrant further surgeries and downtime.

Overall, the surgery required to address the issues experienced by patients who have undergone massive weight loss is Total-Body Reconstructive Surgery.

What procedures are involved in Body Contouring Surgery?

There are a diverse range of surgical procedures that fall under the umbrella of Body Contouring Surgery – these procedures all follow the letter B:  

BRACHIOPLASTY (Arm Reduction) – removes unwanted excess and loose skin along the upper arm.

BREAST SURGERY (especially Breast Lifts and Breast Reductions) – reduce the size of the breasts by removing excess breast tissue and skin, and address issues with the overall size, shape and form of the breasts.

BRA LIPECTOMY – an operation performed to address excess skin rolls and associated fat in the upper and middle part of the back around the bra strap area. There are several names and variations for a Bra Lipectomy which include:

• Bra Line Back lift
• Upper Body Lift
• Upper Truncoplasty

BELT LIPECTOMY – the surgical removal of rolls of excess skin and the associated fat in the lower back, flanks, and abdominal region. It also lifts the buttock and pubic regions. A Belt results in one continuous circumferential scar contained within the belt line. The Belt Lipectomy can also be referred to as a:

• 360 Tummy Tuck
• Lower Body Lift
• Total Body Lift
• Lower Truncoplasty

BELLY SURGERY (Abdominoplasty, aka Tummy Tuck) – refers to various types of Abdominal Surgery. The type of Abdominal Surgery required will be determined by the amount of excess loose skin and fat, in the middle and lower abdomen. There are three main types of tummy tuck procedures:

• Standard Tummy Tuck (Abdominoplasty)
• Fleur De Lis Tummy Tuck (Abdominoplasty)
• OPEN BOOK TUMMY TUCK™ (Abdominoplasty)

BUTTOCK LIFT – is an operation designed to lift and tighten the buttocks, remove excess skin from the lower back, and create far more comfortable form from along your back and buttocks. If combined with an Abdominoplasty (Tummy Tuck) it becomes a Belt Lipectomy and can also help create a far tighter waistline. Buttock Lift surgery is also referred to as:

• Gluteal Lipectomy

BELOW THE WAISTLINE – THIGH LIFT (medial Thigh Lipectomy)– is surgery performed to tighten the skin and improve the form along the inner thigh. Excess skin and fatty tissue are removed, leaving a scar hidden along the fold where the thigh and the groin meet, and often down the inner aspect of the thigh to the level of the knee.

Benefits of Body Contouring Surgery

 Understand the risks and complications

No surgical procedure is risk free, and understanding the possible complications is essential so that you can consider the benefits and risks before you undergo treatment.

For massive weight loss individuals, the skin and tissue quality are often poor, which increases the potential for complications to arise, such as poor wound healing and infection. This leads to a higher risk of wounds breaking down with skin and tissue loss. Therefore, there is an increased risk of further surgery being required in the postoperative stage to address these issues.

All surgeries carry general potential risks, and surgery specific potential risks.

The general potential complications for surgery can be found here – LEARN MORE

The operation specific potential complications can be found on our website on each of the specific surgical procedure’s pages.

Factors to consider before undergoing Body Contouring Surgery – Am I a suitable candidate for Body Contouring Surgery?

You may be a good candidate for Cosmetic or Reconstructive Surgery if you are in good health, have realistic expectations and know the risks of the procedure you are considering. Contouring procedures, like an Abdominoplasty (more commonly known as a Tummy Tuck), are not weight loss procedures. If you need to lose weight before plastic surgery, then you should be close to or have plateaued at your sustainable weight well before the procedure. Smoking can also sabotage your surgery as nicotine constricts blood vessels reducing oxygen levels at the surgical sites, hindering the healing process and increasing your risk of complications. Smokers also face an increased risk of complications under anaesthesia; therefore, you need to give up smoking and all nicotine-based products well before surgery.

Maintaining results post-surgery

It is important after surgery that you make a conscious effort during the initial recovery phase to have a healthy diet and return to physical activity sensibly and as guided by your surgeon. Maintaining a calorie neutral state is important so that you don’t gain weight during that initial period when you will be typically far less active (burning less calories) than you ordinarily would.

What happens if I lose weight after surgery?

It is best that you achieve your optimal and stabilised weight before undergoing surgery. Losing an excessive amount of weight after surgery may lead to further excess, overhanging skin again, and ultimately, compromise your previous results. If this situation were to occur, you may require further surgery. In the event of slight postoperative weight loss, there may be no effect on the surgical outcome. This largely depends on the individual patient’s anatomy including the quality of the skin tissue.

What happens if I gain weight after surgery?

Body Contouring Surgery remove excess skin and fatty tissue to address issues after weight loss. However, removal of the excess skin associated with these procedures will not prevent you from gaining additional weight.

Gaining an excessive amount of weight after surgery can damage your weakened skin, leading to stretch marks and wide scars. Gaining a small amount of weight after your procedure will inevitably cause fat cells to enlarge, but the overall enhanced body form provided by the surgery should still be visible.

Body Contouring Surgery is not an alternative to weight loss, a healthy diet or exercise. Severe weight fluctuations can reverse and compromise the results of your surgery, and in extreme cases, cause the same problems that caused you to seek out and undergo body contouring surgery in the first instance. That is why it is best to achieve a stable weight for a period prior to your surgery.

Choosing the right surgeon for your  Body Contouring procedure

Body contouring surgery is essentially a subspeciality within a specialty. As with any profession, you want your surgeon to have the appropriate proven and demonstrable skills that they are very competent in this wide and complex field of surgery.

• How long have they been a specialist plastic surgeon?
• How long have they been performing these surgical procedures?
• Do they have a large volume of cases and examples to showcase their expertise in delivering results?
• Do they genuinely understand your concerns and put together a surgical plan to address your concerns with confidence?
• You want a surgeon that dedicates a large part of their profession to attending to patients that have these concerns. You do not want a “jack of all trades, and master of none!”

Other frequently asked questions

What does Body Contouring do?

In the context of plastic surgery after massive weight loss, Body Contouring surgery essentially all the excess skin that weight loss will not change. Indeed, it is the weight loss that has resulted in the problem. As stated earlier, Body Contouring Surgery is effectively surgery designed to tailor your skin to fit your body.

Does Body Contouring remove belly fat?

Body Contouring Surgery can address excess belly fat. However, as a rule this is only a secondary benefit. The primary issue that is being addressed with body contouring surgery is the removal of excess skin. The fat associated with the relevant skin is also removed. Of course, areas of the body that has excess pockets of fat without excess skin can potentially be removed with some additional liposuction if that is surgically appropriate and safe to do so.

Body Contouring vs Liposuction?

In the context of massive weight loss, the primary objective of Body Contouring Surgery is to remove excess skin.

In contrast, the primary objective of Liposuction is to remove excess fat. Liposuction does not remove excess skin. Liposuction addresses excess fatty tissue in areas of the body that do not respond well to weight loss. In doing so, liposuction helps to contour the body in these regions. To achieve good results in the area of liposuction, you need to have good-quality skin that is thick and tight. Otherwise, liposuction, much like weight loss in general, can result in the overlying skin becoming loose and saggy.