What is Body Contouring after Massive Weight Loss?

As the prevalence of obesity has increased in the United States, so has the number of people who have sustained massive weight loss. Many people have lost an excess of 100 lbs. through healthy eating choices and exercise, sometimes in combination with bariatric surgery (roux-en-Y gastric bypass, duodenal switch, sleeve gastrectomy, and/or gastric banding). This dramatic shift in weight causes significant changes to the appearance of the breasts, abdomen, arms, and legs for both men and women.

Body contouring procedures after massive weight loss are meant to improve the appearance of the body by removing excess skin and fat. You are a good candidate for body contouring procedures if you are relatively healthy and have excess skin and fat folds from weight loss. It is imperative that weight loss has plateaued before undergoing body contouring procedures as further significant fluctuations in weight can alter the results.

Postsurgical results are visible immediately after the procedure, but improve over time as swelling subsides and incisions fade. Maintaining a healthy weight and lifestyle will help the longevity of your results. Significant weight loss after body contouring surgeries will cause recurrent skin laxity in areas that were previously tightened by surgery. Conversely, weight gain after surgery will cause recurrent fullness/fat deposits, and can lead to contour irregularities.

About the Procedure:

Surgery is commonly performed under general anesthesia for your comfort. All body contouring procedures require incisions of various lengths to facilitate removal of excess skin and fat from different areas of the body. Common body contouring procedures after weight loss include breast lift (mastopexy), abdominal panniculectomy or abdominoplasty (tummy tuck), arm lift (brachioplasty), thigh lift, lower body lift, and facelift. Dr. Hewell and Dr. Fischer often operate together on body contouring procedures to maximize safety because numerous procedures can be performed together with shorter time under anesthesia.

Breast Lift
Tummy Tuck (Abdominoplasty)
Arm Lift
Thigh Lift
Lower Body Lift


Safety is the most important factor for all of Dr. Hewell and Dr. Fischer’s patients.  During your consultation, the doctors will discuss strategies they implement to minimize complications, including postoperative deep vein thrombosis (DVT) and pulmonary embolism (PE).  Strict adherence to their recommendations is important to maximizing safety of all procedures.

Some insurance providers cover abdominal panniculectomy, which is removal of all excess skin and fat from the umbilicus (belly button) to the pubis. This procedure differs from abdominoplasty (tummy tuck) in that the rectus abdominis muscles are not sewn together, and the umbilicus (belly button) is not routinely moved during a panniculectomy. It is importance to check with your insurance plan regarding coverage benefits for body contouring surgery.

You may be required to get lab tests and/or clearance from your bariatric surgeon and/or primary care physician prior to surgery.  Dr. Hewell and Dr. Fischer will discuss preoperative testing and clearance needs with you at your consultation.

Dr. Hewell and Dr. Fischer see all of their body contouring patients the day after surgery.  Their specialized team takes care of all dressings at this visit, and reviews incision care instructions with you.

Procedures 3



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