Obesity has become one of modern society’s inevitable epidemics. Thankfully, we have also seen an increasing number of people who are bucking the trend and accomplishing significant weight loss in their lives, whether through natural means of diet and exercise, or after undergoing bariatric (weight loss) surgery.

Although weight loss contributes positively to general wellbeing, one of the likely but negative consequences of losing a lot of weight is that the body can deflate like a balloon, resulting in unwanted loose, saggy skin, which can cause tremendous cosmetic deformity as well as pain and discomfort caused by the skin folding and rubbing on itself. The psychological effect of this new physical state of profuse loose skin is often more disturbing and traumatising for the patient than when they were large and overweight.

Body contouring surgery after weight loss encapsulates a range of surgical procedures aimed at improving and restoring the body’s normal shape and contour by removing the excess skin. Common procedures that fall into this category include tummy tucks, lower body lifts, breast lifts, and arm and thigh lifts. They generally involve removal of large areas of skin, and therefore, extensive scarring is one of the trade-offs that patients need to except. Scars will generally fade however, and are usually placed strategically to minimise their visibility.

In approaching this growing group of patients, my first question will usually be aimed at identifying the area/s on the body which concern the patient the most. This then allows me to give priority in terms of planning and staging surgery. When a patient has several areas that need addressing, one needs to consider whether they can be all treated at the same setting, or whether treatment should be more sensibly broken up into multiple procedures, staged over a period of time. In making this decision, the surgeon and patient need to consider healing factors, recovery, and safety.

Body contouring is considered major surgery, and is not without its risks, which is often potentiated by this group of patients’ pre-existing state of poor nutrition and other health issues. In preparing for this type of surgery, it is best that the patient has reached and is stable in their goal weight, lives an active healthy lifestyle, and has eliminated risk factors such as smoking. They should maintain a positive mindset during recovery, and be focused and motivated by the final outcome, which will close the final chapter in their weight loss journey.

Dr Ray Goh, Valley Plastic Surgery. 12th March 2019.