Plastic surgery after major weight loss

Plastic Surgery After Major Weight Loss – When the Body Needs to Be Adapted to Its New Weight

Major weight loss can have a significant positive effect on health, mobility and quality of life. However, the skin does not always adapt fully to the body’s new shape.

After substantial weight loss, excess and sagging skin may develop around the abdomen, back, breasts, upper arms and thighs. This excess skin can affect body proportions and, in some patients, may also cause physical problems such as skin irritation, a feeling of heaviness and discomfort during movement.

At AGATA, the aim is not to correct the entire body in a single operation, but to adapt the skin and proportions to the patient’s new body shape through an individually planned treatment programme.

When Can Surgery Be Performed?

Plastic surgery should generally be planned only once the major weight loss has been completed and the patient’s weight has remained stable for a period of time.

The number on the scale is not the only factor that matters. The patient should also be metabolically and nutritionally stable, so that the body has the best possible conditions for healing after major surgery.

Patients who have undergone bariatric surgery or experienced very substantial medically assisted weight loss may develop deficiencies in protein, iron, vitamins or other nutrients. These should be assessed and corrected before surgery.

Blood Tests Before Surgery

Before major surgery following significant weight loss, the patient’s general health and nutritional status are assessed.

Blood tests will typically focus on haemoglobin, iron and ferritin, vitamin B12, folate, vitamin D, albumin and other markers of protein status, as well as electrolytes, kidney function and liver function.

In patients who have previously undergone bariatric surgery, additional vitamins and minerals may need to be assessed depending on the type of previous surgery and any known deficiencies.

Any deficiencies should be corrected before surgery, as poor nutritional status may affect wound healing, the risk of infection and the postoperative recovery period.

Surgery is therefore planned only when the patient is considered to be weight-stable, metabolically stable and nutritionally well prepared.

Which Areas Can Be Treated?

After major weight loss, excess skin may affect several areas of the body. Treatment is therefore tailored to the areas causing the greatest physical or cosmetic concern.

A lower body lift focuses on the lower part of the body and may include the abdomen, flanks, back and buttock area. In patients with significant abdominal skin excess, a more extensive abdominoplasty may be required, sometimes with an additional vertical scar if the skin is loose in both horizontal and vertical directions.

An upper body lift is used when there is excess skin around the upper body and may be combined with correction of the breasts and excess skin of the back.

After major weight loss, the breasts may lose both volume and firmness. Treatment may therefore include a breast lift, breast reduction or, in selected cases, additional volume with an implant or the patient’s own fat.

An arm lift removes excess skin from the upper arms, while a thigh lift is used to correct loose and sagging skin, particularly along the inner thighs.

More detailed information can be found on the separate pages describing each individual procedure.

Treatment Is Often Divided into Several Operations

After massive weight loss, several areas of the body may require correction. It is therefore rarely appropriate or safe to treat the entire body in one operation.

Treatment is usually planned in several stages.

The areas causing the greatest physical or functional problems are often prioritised first. Once the patient has healed and the body has stabilised again, the next area can be treated.

The sequence depends on factors such as the location of the excess skin, the patient’s general health, previous surgery and which procedures can reasonably be combined in the same operation.

This staged approach makes it possible to limit operating time and physical stress on the body, while planning each procedure with the overall final result in mind.

The Consultation – Creating an Overall Plan

During the consultation, the extent of excess skin, body proportions, the amount of weight lost, weight stability, nutritional status, any previous weight-loss surgery and the patient’s general health are assessed.

An overall treatment plan is then created, including consideration of:

• which areas should be treated
• which procedures can be combined
• the most appropriate sequence of operations
• how much time should be allowed between the different surgical stages

The aim is not simply to remove excess skin, but to achieve better function, more harmonious proportions and a body shape that is better adapted to the patient’s new weight.