Patients who have undergone bariatric surgery typically lose a large amount of weight in a relatively short period of time. These patients often find they have "deflated" skin in many areas of their body including the face, arms, breasts, abdomen, thighs and buttocks, particularly in those who have lost more than 100 pounds. This sagging, excess skin can be uncomfortable and can even cause debilitating health issues. Rolls and sheets of excess skin can rub against each other, creating areas of irritation, difficulties with hygiene and can make exercise difficult. 

Fortunately, board-certified plastic and reconstructive surgeon Dr. Saied Asfa performs elective skin reduction surgery (or excess skin removal). About 20 to 30 percent of bariatric surgery patients (both men and women) choose to have skin reduction surgery. Body contouring following massive weight loss includes a series of procedures performed by Dr. Asfa to eliminate and/or reduce excess skin post-bariatric surgery. Body contouring improves the shape and tone of underlying tissue and removes excess sagging fat and skin, resulting in smoother body contours and a normal appearance. 

While body contouring can often be done in a single session, Dr. Asfa usually performs the surgeries in stages while the patient is under general anesthesia. If the patient has a history of smoking, deep venous thrombosis or clotting disorders, a high BMI or other risk factors, additional precautions will be required - or Dr. Asfa may determine that he or she is not a candidate for these surgeries.

Among the areas most affected by massive weight loss and the procedures to correct them include:

• Upper arms, which may sag and appear loose and full. Dr. Asfa may recommend an arm lift (brachioplasty).
• Breasts may flatten and hang with nipples pointed downward. To correct this, Dr. Asfa may recommend a breast lift (mastopexy). 
• The abdominal area may extend around the sides and into the lower back area, resulting in an apron-like overhang. Dr. Asfa will recommend a panniculectomy and/or a tummy tuck (abdominoplasty) to correct this condition. If additional contouring is needed on the waist, back and flanks, Dr. Asfa sometimes performs a belt lipectomy (torsoplasty or circumferential lipectomy). During this procedure, the incision goes all the way around the patient's midsection at the level of the lower waist. Dr. Asfa uses liposuction on the stomach and flanks while trimming excess skin from the patient's back and sides as well. The abdominoplasty and belt lipectomy incisions are placed so that the resulting scar is hidden within most underwear and swimsuit lines.
• Buttocks, groin and thighs can sag and cause hanging pockets of skin. To correct these areas, Dr. Asfa will perform a lower body lift. During this procedure, he trims excess skin on the buttocks and thighs. For an inner thigh lift, Dr. Asfa makes an incision high on the inner leg, starting near the groin and continuing down to the knee. Some fat may be removed with liposuction. Dr. Asfa then removes excess skin and re-drapes the remaining skin before closing the long incision, leaving the patient with tighter and more attractive thighs. The outer thigh and buttock can be lifted through a hip-to-hip incision across the back, above the buttocks.
  

Please visit our Photo Gallery to view examples of some of Dr. Asfa’s work.