After a weight loss plateau has been reached, plastic surgery is performed both to improve aesthetics and to alleviate symptoms. Abdominoplasty (tummy tuck), mastopexy (breast lift), brachioplasty (arm lift), or thigh lift may be performed, in which excess skin and soft tissue is removed and tightened leading to a smoother, more youthful, and more natural appearance.

Abdomen, Thighs and Buttocks
After fat beneath the skin and within the abdomen shrink, both excess abdominal wall skin and loose abdominal
muscles result. Often, there are medical symptoms that are produced by the heavy, hanging skin along the lower abdomen
that can lead to moisture trapping, recurrent rashes, and infections (intertriginous dermatitis and panniculitis). When these symptoms are present, insurance companies may recognize the problem and provide coverage for the surgical removal of
the excess skin and fat, or panniculectomy.

Breasts
Women with breasts that sag after bariatric surgery can be treated with breast lift (mastopexy) alone, or in conjunction with enlargement (augmentation mammoplasty). Men may develop breast sagging or enlargement, or gynecomastia. Occasionally, liposuction alone may provide adequate treatment, however skin removal and tightening is
most often required in conjunction with lipoplasty techniques.

Arms
Loose, hanging skin and excess fat of the arms are treated by brachioplasty, or arm lift. Excess fat is removed, and the skin is tightened, trimmed, and redraped to restore a more youthful form to the arms.

Face and Neck
With significant weight loss, wrinkles on the face become more prominent, and neck skin may become excessive. The facelift
is performed through incisions concealed inconspicuously within the hairline and ears. The muscles and deep tissues are tightened and the fat is sculpted to restore a more youthful shape to the face and neck.

Timing and Approach to Plastic Surgery
Body contouring surgery should be performed after a post-bypass plateau has been reached, which is often 12 to 18 months following the bariatric procedure. Several operations will be required to achieve the most pleasing results. A minimum of three months is required between operations. After thorough discussion of your desires and goals, Dr. Wall will suggest a sequence of procedures that best suits you.