Excess Skin Removal After Extreme Weight Loss
Excess Skin Removal Overview
Obesity is a growing epidemic in developed countries throughout the world. Obesity causes significant public health problems, including an increase in type 2 diabetes, cardiac disease, and degenerative joint disease. A simple indicator of obesity is the body mass index (BMI), which is the weight of an individual in kilograms divided by height in meters squared. A total of 60 million Americans are obese (BMI >30), and 9 million Americans have severe obesity (BMI >40).
Over the short term, diets can be effective for losing weight; however, only about 5% of people maintain long-term weight loss from dieting. Because of this, many people who are severely obese have turned to bariatric surgery as a more definitive treatment. Approximately 100,000 bariatric surgical procedures were performed in the United States in the last year.
Bariatric surgery for weight loss in individuals who are obese is becoming a safer and more commonly performed surgery. During weight gain, the skin expands to contain the underlying fat and can often lose elasticity. If older individuals or people whose weight was excessive for many years lose weight, the skin and underlying tissue do not naturally return to their original size. A number of surgical procedures for removing excessive skin and fat are available.
Surgical techniques for excess skin removal began in Brazil and France more than 40 years ago but were fraught with complications, poor scarring, unnatural contours, long recovery time, and inconsistent results. Over the past 15 years, with the large increases in the number of people with excess skin, skin removal surgery has undergone several improvements. One innovation, the body lift, which was developed by Dr. Ted Lockwood in Overland Park, Kansas, has produced aesthetically pleasing results in selected patients.
The treatments of excessive tissue can involve extensive surgical procedures. The procedures vary from commonly performed procedures such as abdominoplasty (tummy tuck), mastopexy (breast lift), inner thigh lifts, and brachioplasty (arm lift) to the more complicated procedures such as high lateral tension abdominoplasties and lower body lifts.
Advantages of body lifts include improved skin quality, long-lasting results, smoother natural contours, and better control of results. Disadvantages of body lifts include more complex surgery (requiring more expertise), longer operating time, long scars, longer recovery after surgery, and increased cost.
Gregory Caputy, MD, PhD
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