Surgery After Weight Loss in New York City

After fat stores beneath the skin and within the abdomen shrink, both excess abdominal wall skin and loose abdominal muscles result. The optimal procedures to treat the excess of the torso will directly remove excess skin and fat, tighten the muscles and fascia of the abdomen, and remove regional excess fat and restore contour to the abdomen with liposuction. Occasionally, when the excess is limited to the front of the abdomen, an anterior abdominoplasty, tummy tuck, or "classical" abdominoplasty is in order. More frequently, the excess progresses around the sides to the back, and a lower body lift is indicated. The lower body lift not only removes the excess skin and fat of the abdomen, flanks, and back, and tightens the abdominal wall, but provides a lift to the buttocks and lateral thighs as well.

Occasionally, there are medical symptoms that are produced by the heavy, hanging skin along the lower abdomen that can lead to moisture trapping, recurrent rashes, and infections (intertriginous dermatitis and panniculitis). When symptoms are present, and courses of medical treatment have been documented to have been ineffective, insurance companies may recognize this problem and provide coverage for a portion of the lower body lift or belt lipectomy (the portion known as a panniculectomy, or the direct removal of the hanging excess below the navel).

Women in whom the breast sag and "involute" after bariatric surgery and massive weight loss can be treated with breast lift (mastopexy) alone, or a breast lift and a breast enlargement (augmentation mastopexy) to both lift the breasts and to restore breast volume lost after bypass. Breast implants are most often used to restore breast volume, however in selected individuals with excess skin and fat of the sides of the chest wall, your own excess tissue in the region (maintaining its own nourishing blood supply) may be used to give you a breast augmentation without the use of breast implants during the breast lift (mastopexy) procedure (this is most often performed during an upper body lift).

Men may develop breast sagging or enlargement, or gynecomastia. Occasionally, liposuction alone may provide adequate treatment, however skin removal and tightening is most often required in conjunction with liposuction techniques.

Loose, hanging skin and excess fat of the arms are treated by brachioplasty, or arm lift. With the brachioplasty or arm lift procedure, excess fat is removed, and the skin is tightened, trimmed, and redraped to restore a more youthful form to the arms.

When there is droop or ptosis of the breasts, excess skin and fat of the arms, and excess tissue of the sides of the ribcage and upper back, an upper body lift procedure should be considered. An upper body lift combines the breast lift (mastopexy) and arm lift (brachioplasty) procedures, while at the same time removing the skin and soft tissue excess of the upper torso in one confluent incision line.

The excess skin and fat of the thighs is removed with one of several procedures. The medial thigh lift, or isolated inner thigh lift, is geared for those individuals with only mild or moderate excess limited to the inner thigh area. The medial thigh lift removes a crescent of inner thigh skin, leaving an incision line in the inner groin crease only. A circumferential thigh lift combines removal of not only medial thigh excess (medial thigh lift), but the removal of excess from the front (anterior thigh lift) and sides (lateral thigh lift) of the thighs as well as the thigh beneath the buttock area (posterior thigh lift). Most often, the circumferential thigh lift is preceded by a lower body lift to serve as a foundation for thigh lift.

With significant weight loss, wrinkles on the face become more prominent, and cheek and neck skin may become lax. The facelift and neck lift are performed through incisions concealed inconspicuously within the hairline and around the ears. The muscles and deep tissues are tightened and the fat is sculpted to restore a more youthful shape to the face and neck.