the patients that we see who have had a
massive weight loss either from their
own hard work or with the little
assistance from a procedure like a
gastric bypass or a gastric sleeve those
patients tend to have loose skin almost
head to toe and they will have gone
through this wonderful life changing
weight loss they've gotten rid of high
blood pressure they don't have diabetes
anymore they're working out and they
still have this skin that's the reminder
of what they had been through when
you've lost 150 or 200 pounds what
happens is you lose the skin elasticity
and it doesn't go back and you're loose
mostly everywhere and so we do facelifts
arm lifts breast lift tummy tucks or
lower body lifts thigh lifts and the
question always is well what do you want
to do and how much do you want to do and
what order do you want to do it in we
will end up over several procedures to
make sure that we can be the safest for
them operating in each of those areas
that concern them and patients often
inquire what the scars look like or
where we will the scars be and that's very
individual so if you've lost lots and
lots of weight we're talking a couple
hundred pounds and you have lots of
extra skin underneath the arm odds are
you'll need a pretty long incision to
remove skin if there's a little skin
it's a little scar sometimes it's a
small scar that is just in the armpit
area so it really depends on the
individual but we're trying to put
scars in places that are well hidden
if we're going to do a thigh lift and we
need someone's lost a lot of weight and
have a lot of extra skin we want to do
that incision on the inside of the thigh
so if you were a skirt you can't see it
now if you were a short enough shorts
you'll still be able to see it but the
scar has to go somewhere and so we can
compromise as well if someone is
absolutely committed to not having a
scar on their thigh we can do a lesser
surgery we can remove less skin now it
comes with a little bit less result but
we can tailor that to what the patient
wants so people often come in concerned
about stretch marks and
and with good reason if you catch
stretch marks early sometimes we can
laser them if there's a color
distinction in other words if they're
still red we can use a laser perhaps to
help soften the distinction between the
stretch mark and the surrounding skin
but once they've matured once they've
become actual stretch marks that look a
pale kind of like the skin around them
they're the best option at that point is
really cut them out and that's often
done with the tummy tuck now a tummy
tuck is going to get rid of all of the
stretch marks below the belly button but
sometimes people have stretch marks
above it and what's remarkable about a
tummy tuck is not only do we get rid of
the ones below the belly button but by
pulling down and stretching the ones
that are above the belly button we make
them look better it's really kind of
remarkable they're brought lower and
they seem to improve so a tummy tuck is
a wonderful procedure for stretch marks
often patients want to know whether we
do liposuction at the time of
weight-loss surgery and will that help
them lose more weight the short answer
is yes the long answer is it depends on
where the fat is if there's just a
problem area and lots of people have
problem areas even people that have lost
lots of weight there's just some areas
they can get rid of the fat and in that
problem area we can do some liposuction
and we can remove the fat from that one
area and then also maybe remove some
skin because usually weight loss
patients are coming in because of extra
skin but if there's extra fat deposits
there at the same time yes we remove
that and will you weighed less afterward
yes you will because we'll be removing
that fat deposit from that area and it
won't ever come back there so we do a
lot of body contouring it's it's one of
those things where patients afterwards
are incredibly grateful they've worked
hard to lose all that weight and now
this is sort of the icing on the cake
really important
