Body Contouring after Weight Loss

Q: Dr. Eppley, I am interested in body contouring after weight loss of 75lbs after prior bariatric surgery. My desired breast look, which was once a size D cup, is to get back to the size I was before the weight loss. I want to get rid of the extra skin sag on stomach and belly button frowns. I do not want my inner thighs touching, thighs ripple and skin above knees. My butt sags and my back legs ripple. So I don’t know what procedure/ procedures would be best and most cost effective. The lower 360 degree lift? I’m 100% getting breast implants no matter what. The rest is just if I can afford. Thank You.

A:Thank you for sending all of your pictures, they are very helpful in determining what can and can not be done for your body contouring after weight loss. Based the description of your goals, I can make the following comments:

1) While breast implants will be needed to enlarge your breasts to the size you desire, the current state of your breast shape will require some form of a lift. They have sag and asymmetry and placing implants in them will just make them top heavy and drive the nipples down, a look that no patient will find very acceptable. Depending upon the size of implant needed, you would either have to have a breast lift first (with a larger implant) or a vertical lift can be done at the same time if a smaller implant is used.

2) A full tummy tuck is needed to get rid of the loose skin on the entire abdomen. This wold be combined with flank liposuction around the waistline into the back. The 360 circumferential tummy tuck is an option but the benefit of wrapping the skin cut out completely around your body is probably not worth the back part of it since its benefits on the back side would be very limited.

3) While thigh liposuction can be done, achieving an inner thigh gap is not possible. That is not a realistic goal for just about any patient whose thighs touch.

4) There are no effective treatments for thigh or back of leg rippling or skin above the knees, short of a knee lift. But that scar has to be considered very carefully.

In summary the two most effective procedures on you are your breasts and stomach. That is where the value of body contouring surgery is for you.

Dr. Barry Eppley
Indianapolis, Indiana