Karol Gutowski, MD, FACS

Questions? Call Ellen: 773-985-3993

Body Contouring after Weight Loss

Do you have loose skin after weight loss? Learn about body contouring & what to expect before you meet Dr Gutowski in person.


Dramatic weight loss, whether achieved by proper nutrition and exercise or as the result of bariatric surgery or other forms of medical treatment, can be very rewarding. However, once you reach your weight loss goals, you may not have the fit and healthy body image you desire. Following weight reduction surgery or any substantial weight loss, the skin and tissues that have been severely stretched often lack elasticity and cannot conform to the new size of the body. As a result, sagging pockets of skin may form around the face, neck and jawline, at the upper arms, in the abdominal region and the lower back or around the hips, buttocks, groin and thighs. In addition, women who have lost large amounts of weight may find their breasts have flattened and now sag significantly.

Body contouring after major weight loss is an important and rewarding phase of your progress to a healthier, more proportionate body and can help you to further enhance your body image and self confidence. In general, surgical body contouring following major weight loss improves the shape and tone of the underlying tissue and removes excess fat and skin. The result is a more normal appearance to the body with smoother contours. This is, in essence, the final phase of your long weight loss experience.

Before you undergo body contouring following major weight loss, it is important to understand these very important considerations. Your weight loss must have stabilized. If you continue to lose weight, sagging skin will redevelop. If you rapidly regain the way you have lost, you will stress you're already weakened and thinned skin. Weight gain may create new stretch marks and widen existing scars. Your body contouring will take time, often requiring multiple procedures that are staged for your health, safety and comfort. Many months of recovery may be required between each stage. In total, your post weight loss body contouring may last as long as or longer than your weight loss experience. In order to remove excess sagging skin multiple large incisions are required. In general, they may be placed in strategic locations where they can be hidden by most types of clothing and swimsuits, but this is not always the case.

This program presents an overview of body contouring following major weight loss. It is not a substitute for a complete consultation with a plastic surgeon certified by the American Board of Plastic Surgery or the Royal College of Physicians and Surgeons of Canada. A consultation with a board certified plastic surgeon, a member of the American Society of Plastic Surgeons who may also be a member of the American Society for Aesthetic Plastic Surgery, is the first step to learn how body contouring after major weight loss can enhance your appearance and improve your self image. In general, a consultation will include a discussion of your goals, an evaluation of your individual case and the options available to you. Your surgeon will also discuss the course of treatment recommended for you, the likely outcomes of post weight loss body contouring and any potential risks associated with the procedure or procedures you elect to undergo. Your plastic surgeon will answer any questions you may have about post weight loss body contouring.

During the consultation, you will be asked to share your expectations for surgery and your personal health history. Full disclosure of your health history is important for your safety. You should inform your physician of any life threatening illness or medical conditions in your family. You must also be candid about your current medications, vitamins, herbal supplements, alcohol, tobacco and drug use.

Post weight loss body contouring is best performed on healthy adult men and women who are generally close to their ideal body weight. Good candidates are individuals who do not have a life threatening illness or medical conditions that can impair healing. A positive outlook with specific and realistic goals for improvement of your appearance is essential. Pregnancy or significant fluctuations in weight can affect the improvement achieved by body contouring procedures. You may be advised to postpone certain body contouring procedures if you are planning future pregnancies or if you are not at or able to maintain a stable and relatively normal weight for your height.

If you smoke, you are at increased risk for poor healing and more visible scars and therefore it is advisable to stop smoking for several weeks before and after surgery. Certain health conditions may preclude you as a candidate for some body contouring procedures or requires special precautions. These conditions include cardiovascular disease, high blood pressure, or certain other circulatory disorders and diabetes.

By making the decision to consult with a board certified plastic surgeon and following physician recommendations, you are taking an important step in helping to ensure your safety. A board certified plastic surgeon is a physician who is specifically trained in plastic surgery of the face and entire body. Prior to any procedure or procedures, you'll be asked to sign informed consent documents. These documents assure that you fully understand the procedure or procedures you will undergo and the potential risks and complications. In addition, you must commit to precisely following all of the instructions you are given. Instructions include pre-surgical considerations, such as testing and medications, day of surgery requirements, medications and specific information related to anesthesia. Prior to surgery, it is important to discuss all your questions and convey to your surgeon any concerns you may have regarding your surgery.

Post weight loss body contouring procedures may be performed in an accredited office based surgical facility, an ambulatory surgical facility or a hospital. Body contouring procedures are more commonly performed under general anesthesia. However, in some cases local anesthesia with sedation may be used. The decision for anesthesia will be based on the requirements of your specific procedure, any additional procedures that may be performed in the same surgical session and considerations for patient and surgeon preference.

Your body contouring following major weight loss will be individualized to your specific concerns and the regions to be treated. Your concerns, goals, health, safety and comfort, as well as the surgical judgment of your surgeon, will define a surgical plan for you.

While it may have taken you 18 to 24 months or more to lose all the excess weight, it may take equally as long for your body contouring to be completed. In addition to preparing yourself for stages of contouring and recovery following your procedures, you must also accept that a single procedure to treat a specific area may not achieve the results you desire. Uneven contours may remain or can develop following your body contouring surgery. And in some cases, skin elasticity is so poor that relapse of the excess skin is possible.

Specific plastic surgery procedures that may be recommended for your individualized post weight loss body contouring plan include facelift to reduce sagging of the mid face, jawline and neck, breast Lift, with or without implants, to correct sagging flattened breasts, tummy tuck to correct the apron of excess skin hanging over your abdomen, body lift to correct sagging at the abdomen, buttocks, groin and outer thighs, thigh lift to correct sagging along the thighs, arm lift to correct sagging at the upper arms.

All body contouring procedures require incisions to remove excess skin, and thereby improve body contours. In many cases, these incisions may be extensive. Incision length and location depend on the amount and area of excess skin to be removed, as well as surgeon preference. Through these incisions, your plastic surgeon may remove excess fat, reshape and reduce excess underlying tissue, re-drape the skin over the newly shaped contours and reduce excess skin. Sutures, skin adhesives, tapes or clips, close the skin incisions. Following body contouring procedures, you may have small thin tubes placed in or near your incisions to drain any excess fluid that accumulates or you may be placed in a compression garment or wrapped in elastic bandages to reduce swelling.

Before being released home following your procedure, you and an accompanying family member, friend or caregiver will be given specific instructions and signs to watch for in the treated regions or regarding your overall health. If you had your abdomen or waistline contoured, standing fully up right maybe uncomfortable and may stress internal sutures as your incisions heal. If the buttocks have been treated, it may be uncomfortable for you to sit or lie flat. For these reasons, you may be instructed to maintain a somewhat bent position and to sleep with pillows elevating your knees. Your plastic surgeon will advise you to begin light walking soon after your procedure and to engage in light walking every two to three hours regularly in the first few days after surgery. Other instructions may include drain care, wound care and wearing compression garments. Follow all instructions carefully. This is essential to the success of your outcome. You will also be instructed when to follow up with your plastic surgeon.

Following body contouring procedures, you may experience numbness, swelling, bruising and soreness. In addition, your skin may feel unusually firm. These are all common conditions. Any discomfort you experience can be controlled with medications. Complications associated with post weight loss body contouring procedures include blood pooling beneath the skin, called a hematoma, fluid accumulation under the skin or seroma, infection or poor healing of the incision, blood clots in the legs, excessive or widened scars, numbness and other changes in skin sensation and irregular or asymmetric contours or scars. All surgery carries risks associated with anesthesia. These risks will be fully discussed prior to your consent.

Depending on the extent of your procedure or procedures, you can expect to be up in about within a few days following surgery. Initial healing of incisions may take five to 10 days, at which time any sutures or clips will be removed if necessary. Healing will continue for several weeks to months as swelling continues to resolve and your new contours take shape. During this time, it is important to remain active. However, you should not engage in any lifting, bending, pushing or strenuous activities until your plastic surgeon has given you clearance.

The smoother tighter contours that result from post weight loss body contouring procedures are apparent almost immediately, although initially obscured by some swelling and bruising. In addition, skin quality is dramatically improved, both in appearance and feel. The resulting incision lines are permanent, although they may be concealed by many styles of undergarments. The results of post weight loss body contouring are generally permanent, as long as you maintain a stable weight and healthy lifestyle, including eating well and a regular exercise routine.

Once you have completely recovered from one series of procedures, it may be time to begin preparing for additional procedures to target other areas of the face or body. During the entire course of your body contouring, you must practice diligent sun protection until the healing process of all incisions and the resulting scars are fully complete. It may take a year or more following a given procedure for scars to refine and fade to some degree.

Choosing to undergo a body contouring or any plastic surgery procedure, whether cosmetic or reconstructive, is an important decision, so is selecting a plastic surgeon. Not all doctors who perform plastic surgery, or who use the title of plastic surgeon, are board certified in plastic surgery. In order to be certified by the American Board of Plastic Surgery, a physician must graduate from an accredited medical school and then complete a minimum of five years of surgical training, including an accredited plastic surgery residency program. The physician must pass a comprehensive written and oral exam in order to become a board certified plastic surgeon.

The American Society of Plastic Surgeons and the American Society for Aesthetic Plastic Surgery have prepared this educational program to supplement your personal consultation with a plastic surgeon who is certified by the American Board of Plastic Surgery or the Royal College of Physicians and Surgeons of Canada. Plastic Surgeons with this certification have completed approved surgical training and rigorous examinations in plastic surgery, including both cosmetic and reconstructive procedures of the face and entire body.