The effects of massive weight loss are most evident in multiple areas of the body.

FACE/ NECK: Often the face takes on a drawn appearance, with loss of volume and sagging skin.

Procedures to help rejuvenate the face include non-surgical treatments such as soft tissue fillers (Restylane, Juvederm, Prevelle), Botox or Dysport for wrinkles. Surgical procedures include fat transfer to the face, facelift, necklift, eyelid surgery, and browlift.

BREASTS: The breasts tend to lose volume and shape. Women often notice the breasts are flat ,with sagging skin, nipples that point toward the center, and distorted contour.

Procedures that address these concerns are usually a combination of breast lift and breast augmentation. In women with really large breasts, the treatment instead is a breast lift combined with a reduction.

MALE “BREASTS” (or GYNECOMASTIA): Men may have an increase in chest wall fat or breast tissue, giving the appearance of having breasts. After weight loss, the skin does not shrink back, and some of the extra volume may still be present.

This can be addressed with surgery to correct gynecomastia. Depending on how much extra skin and fat is present, this can be as simple as liposuction, and as involved as a full breast reduction. The criteria for attractive male chest are obviously different than the criteria for women, and tailoring the surgery to an ideal male contour is key to obtaining an aesthetically-pleasing outcome.

ABDOMEN: The abdominal skin usually is damaged to a degree that it cannot shrink back down to fit the new smaller size person inside. The extra skin “apron” can hang down to the knees and even lower, making hygeine difficult, getting in the way of walking, or making it hard to fit into clothing.

Options to address this are panniculectomy and abdominoplasty, with or without liposuction, a circumferential body lift, or a lateral thoraco-abdominoplasty. A panniculectomy simply removes the overhanging portion without addressing the contour of the upper abdomen. An abdominoplasty takes into account the contour of the entire abdomen, and includes repairing muscles that are spread apart, and repositioning the belly button. A circumferential body lift (or “belt lipectomy”) addresses not only the extra skin and fat on the front of the abdomen, but also the part on the back. This helps lift the buttock and upper lateral thigh as well. The lateral thoraco-abdominoplasty takes the extra skin and fat out from both sides of the abdomen, leaving a scar that would run along the side (as it does on a shirt), and helps decrease the width of the abdomen. This can also be accomplished through a scar that runs down the center of the abdomen.

UPPER BACK: The upper back skin can be loose, and bulge out under clothing, especially in women where it creates “rolls” above and below the bra.

Liposuction may help reduce the volume of this area, but if there is loose skin, an upper back skin reduction can be performed, with scars that are placed to fall beneath a bra-line.

ARMS: The upper arms tend to have excess loose hanging skin described as a “bat-wing” appearance.

An arm lift can reduce the excess skin, in exchange for a scar that runs along the inner arm from the axilla down to the elbow.

THIGHS: The thighs tend to vary in degrees of cellulite and extra skin. In some patients the extra skin along the inner thighs leads to chafing, skin breakdown, and difficulty with walking and hygeine.

A thigh lift addresses the extra skin, and can be combined with liposuction to sculpt the thighs. The cellulite will not be completely removed with any procedure, but the contour will be improved.