Q: Dr. Eppley, I am interested in body contouring after weight loss. I have 2 very large, deep atrophy dents, one on each hip from kenalog injections. I have arthritis and fibromyalgia in my hips. The pain is unbearable, and has left me disfigured. I also have lost 100 pounds over the past 3 years and have bags of fat instead of breasts. And I have a giant stomach that is all skin and fat that hangs dramatically.
A: Body contouring after weight loss, also known as bariatric plastic surgery, is commonly done today. When one loses 100lbs or more, as often happens with successful bariatric surgery or great personal diet and exercise efforts, many expected body changes occur. The large stomach deflates and become an apron that hangs over the waist line, the breasts lose their volume and hand down onto the stomach like two empty bags of skin, and the once larger arms and thighs sag. These common extreme weight loss concerns are treated with extended tummy tucks or abdominal panniculectomies and sagging breasts are changed with full anchor scar pattern breast lifts with implants in most cases. By getting rid of these tissue overhangs, combined with the weight loss, back and hip pain is often lessened. At the same time the large hip dents, which have occurred as a result of subcutaneous tissue atrophy from the steroid injections, can be treated by fat injections or even dermal-fat grafts depending on its depth and degree of skin tethering.
Dr. Barry Eppley
Q: Hello, I have had three very large children (all between 9 pounds and 10 pounds) and have had a very large weight gain/loss after each child. I am getting closer to my goal weight at this time from my youngest child. (Currently 165 pounds-my highest weight was 214 pounds) and my goal weight is around 150. Because of the large multiple pregnancies and weight gains/losses, I am in the need of some body contouring. I have multiple areas that need addressed, my loose tummy, excessive skin in my upper arms, sagging breasts and excess skin and resistant fat deposits in my legs. I am interested in a consultation to start the process of repairing some of the damage to my body that my healthy diet and daily exercise will not fix. I plan to have the surgeries over a few years, rather than all at once, due to cost and my schedule.
A: Body changes that have occurred either from bariatric surgery, extreme weight loss or the impact of multiple pregnancies requires thoughtful consideration about the type and timing of surgical corrections. Sitting down with a plastic surgeon and going over all the surgical options is an obvious first place to start. Having had many of these discussions in my Indianapolis plastic surgery practice, most women will focus first on their tummy and waistline often combining it with another procedure such as an armlift.
These more substantative body problems are more substantial that the more traditional Mommy Makeover which is directly to two combined procedures, breast enhancement (implant with or without a lift) and some form of a tummy tuck.
Dr. Barry Eppley