Weight Loss Surgery and Plastic Surgery

Weight loss surgery patients often put plastic surgery on their “To Do” list after they shed the excess pounds — and face the prospect of flabby skin. Plastic surgeon Dr. Mitchel Krieger explains how body contouring procedures can help bariatric patients get the look they truly want.

Excess skin after significant weight loss is not just a cosmetic issue. Sure, when patients lose more than 100 pounds, they would like their body to reflect the change they feel inside. But excess skin can also limit mobility, cause medical and hygiene problems, and make daily chores difficult. It can make physical activity uncomfortable due chaffing and rashes, which can discourage patients from adopting healthy changes to their lifestyles.

Dr. Mitchel Krieger, a board certified plastic surgeon in Fairfax, Virginia, uses body contouring procedures, such as liposuction, tummy tucks and breast lifts, to help weight loss patients return to a normal life after such a dramatic physical change.

Dr. Krieger says up until about five years ago, nearly all his patients were coming in after open gastric bypass surgery, having lost around 100 to 200 pounds in about nine to 12 months. “From a surgical standpoint, these patients were the easiest to treat, because it was all loose skin,” he says.

However, today more patients are having the less invasive Lap-Band procedure, which means slower, more steady weight loss over a longer period of time. “Many of these patients, because they haven’t lost all their excess weight, may still have some residual fat or residual weight in their extremities,” Dr. Krieger explains. “And so their arms and legs sometimes require liposuction as an initial staging procedure before we can go in there and remove the excess skin.”

Patients need to have a realistic concept of what they will look like after weight loss surgery. Although the change will be dramatic, Dr. Krieger stresses that different people have different starting points before the procedure, and therefore will come out at different sizes after surgery.

“In an ideal world, we’d like to see patients have a BMI of under 30, but sometimes we see patients who are in that [over 30] range,” he says, “and as a result they have to temper their expectations that you can’t generate as thin a contour as you could in a patient who had started off at a lower weight.”