Body lifting Surgery after Massive Weight Loss (MWL).
Patients with a history of massive weight loss usually have a pannus or an ‘apron’ of skin and fat which hangs down over the pubic and upper thigh area (figure A and B).
This is uncomfortable and may lead to a rash under the skin fold. The first corrective surgery is usually directed at removing this pannus and repairing any splitting and relaxation of the vertical rectus abdominis, abdominal muscles. The excision of the pannus is continued around to the midline of the back (figure E), lifting the outer thighs and buttocks at the same time. This procedure is known as an ‘Abdominoplasty combined with a Circumferential Lower Body Lift’.
The second procedure, after addressing the lower body and the pannus, is to remove excess skin in the upper back and chest and the arms, from the axilla to the elbow. This procedure is known as an ‘Upper Body Lift with a Brachioplasty’. (figure C, D and E). Depending on the extent of the surgery, the brachioplasty or arm lift may be performed separately from the Upper Body Lift.
The ‘Vertical Thigh Lift’ is often the last body contouring procedure to be performed. This consists of a removal of extra skin along the vertical axis of the inside of the thigh from the groin to the knee.
Patients with MWL frequently have loss of tone of the neck and face which may also require corrective surgery in the form of a facelift.