Q: Dr. Eppley, I have recently lost 100 pounds. I still want to loose another 50 pounds but would like to get some information about doing an extreme tummy tuck since my skin and fat hang by my mid thighs. I would also like to get information about a breast lift.
A: Thank you for your inquiry. Congratulations on your success at such a significant amount of weight loss. I would agree that you should maximize your weight loss before any body contouring surgery is done to get the best benefit from the procedure. It his likely that the next 50 lbs will be harder to lose than the last 100lbs but the effort will still be worth it.
Anytime a female loses more than 75lbs there are always going to be the sequelae of loose redundant skin on the abdomen and waistline and the development of breast sagging. While weight loss causes the reduction of fat, no skin is lost and how much skin redundancy remains depends on its natural elasticity and its ability to contract which is often very poor. (men do much better in this regard with large amounts of weight loss) In the extreme weight loss patient, a standard type of tummy tuck is always inadequate so you are correct in that an ‘extreme tummy tuck’ is needed. At the least this is an extended tummy tuck but may be a flour-de-lis type of even a circumferential body lift to create the greatest degree of redundant tissue removal. I would need to see smoke pictures to provide you with a more accurate answer as to the type of tummy tuck you need. For the breasts, the vast majority of time one needs a full or anchor style breast lift. Whether implants would be needed to restore volume is the only issue to be determined.
Dr. Barry Eppley