Before you decide to undergo body contouring following major weight loss, your weight loss must
be stabilized.

• If you continue to lose weight, sagging pockets will redevelop.
• If you rapidly regain the weight, you will traumatically stress your already weakened and
  thinned skin, causing further stress to the skin, visible stretch marks and wide scars.

If you had weight reduction surgery, your plastic surgeon will work closely with your physician to
determine when it is appropriate for you to begin body contouring.

Good candidates for body contouring are:

• Adults of any age whose weight loss has stabilized
• Healthy individuals who do not have medical conditions that can impair healing or increase
  risk of surgery
• Non-smokers
• Individuals with a positive outlook and realistic goals for what body contouring can accomplish
• Individuals committed to leading a healthy lifestyle including proper nutrition and fitness

What to expect during your consultation

The success and safety of your body contouring procedure depends very much on your complete
candidness during your consultation. You’ll be asked a number of questions about your health,
desires and lifestyle.

Be prepared to discuss:

• Why you want the surgery, your expectations and desired outcome
• The options available in body contouring surgery
• Medical conditions, drug allergies and medical treatments
• Use of current medications, vitamins, herbal supplements, alcohol, tobacco and drugs
• Previous surgeries

Your surgeon may also:

• Evaluate your general health status and any pre-existing health conditions or risk factors
• Examine and measure your body, including detailed measurements
• Take photographs for your medical record
• Discuss your options and recommend a course of treatment
• Discuss likely outcomes of your surgery and any risks or potential complications

Preparing for surgery

Prior to surgery, you may be asked to:

• Get lab testing or a medical evaluation
• Take certain medications or adjust your current medications
• Stop smoking well in advance of surgery
• Avoid taking aspirin, anti-inflammatory drugs and herbal supplements as they can
  increase bleeding

Special instructions you receive will cover:

• What to do on the day of surgery
• The use of anesthesia during your body contouring surgery
• Post-operative care and follow-up

Your plastic surgeon will also discuss where your procedure will be performed. Body contouring
surgery may be performed in an accredited office-based surgical center, outpatient or ambulatory
surgical center, or a hospital.

Procedural Steps:

What happens during body contouring surgery?

The procedures necessary to achieve your goals will be defined along with a plan for the timing of
these procedures. Plastic surgery procedures that may be recommended by your physician include:

• Lower body lift: to correct sagging of the abdomen, buttocks, groin and outer thighs
• Breast lift: to correct sagging, flattened breasts
• Arm Lift: to correct sagging of the upper arms
• Thigh lift: to correct sagging of the inner, outer and mid thigh

Step 1 - Anesthesia

Medications are administered for your comfort during the surgical procedures. The choices include
intravenous sedation and general anesthesia. Your doctor will recommend the best choice for you.

Step 2 - The incision

All body contouring procedures require incisions to remove excess skin. In many cases, these
incisions may be extensive.

Incision length and pattern depend on the amount and location of excess skin to be removed,
as well as personal preference and your doctor’s surgical judgment.

Advanced techniques usually allow incisions to be placed in strategic locations where they can
be hidden by most types of clothing, but this is not always the case.

Body Lift

A complete lower body lift treats sagging buttocks, abdomen, waist, hips and outer thighs in one
procedure or in staged procedures. Incision patterns vary, and may include a circumferential
incision around the body to remove the “belt” of excess skin and fat.

Breast Lift

The incision patterns for lifting a woman’s sagging breasts will be determined based on the
amount of excess skin to be removed.

These may include one or a combination of incisions in a circular pattern around the areola,
in a line extending from the areola to the breast crease, and horizontally along the breast crease.

A breast implant also may be recommended to enhance breast shape and size.

Arm Lift

Sagging skin in the upper arms is treated with an incision from the underarm area extending
along the inside or back of the upper arm. Additional incisions on the arms may be necessary
anywhere excess skin has formed sagging pockets.

The smoother, tighter contours that result from upper arm contouring are apparent almost
immediately, although initially obscured by swelling and bruising. In addition, skin quality
is dramatically improved in both appearance and texture.

Thigh Lift

Reshaping of the thighs is achieved through incisions in the groin that can extend downward
to the knee along the inner portion of the thigh.

Improving contours of the outer thigh may require an incision extending from the groin around
the hip. Through these incisions your plastic surgeon will tighten tissues for a smoother, better
toned thigh.

Important facts about the safety and risks of body
contouring surgery

The decision to have body contouring surgery is extremely personal and you’ll have to decide
if the benefits will achieve your goals and if the risks and potential complications are acceptable.

Your plastic surgeon and/or staff will explain in detail the risks associated with surgery. You will
be asked to sign consent forms to ensure that you fully understand the procedure you will undergo
and any risks and potential complications.

Possible risks of body contouring following major weight loss include:

• Unfavorable scarring
• Bleeding (hematoma)
• Infection
• Fluid accumulation
• Poor wound healing
• Skin loss
• Blood clots
• Numbness or other changes in skin sensation
• Anesthesia risks
• Skin discoloration and/or prolonged swelling
• Fatty tissue found deep in the skin might die (fat necrosis)
• Major wound separation
• Asymmetry
• Recurrent looseness of skin
• Pain, which may persist
• Deep vein thrombosis, cardiac and pulmonary complications
• Persistent swelling in the legs
• Possibility of revisional surgery

My recovery

After your body contouring procedure is completed, dressings or bandages will be applied to the
incisions. A small, thin tube may be temporarily placed under the skin to drain any excess blood
or fluid that may collect.

Be sure to ask your plastic surgeon specific questions about what you can expect during your individual
recovery period.

• Where will I be taken after my surgery is complete?
• What medication will I be given or prescribed after surgery?
• Will I have dressings/bandages after surgery?
  • When will they be removed?
• Are stitches removed? When?
• When can I resume normal activity and exercise?
• When do I return for follow-up care?

When you go home

If you experience shortness of breath, chest pains, or unusual heart beats, seek medical attention
immediately. Should any of these complications occur, you may require hospitalization and
additional treatment.

The practice of medicine and surgery is not an exact science. Although good results are expected,
there is no guarantee. In some situations, it may not be possible to achieve optimal results with
a single surgical procedure and another surgery may be necessary.

Be careful

Following your physician’s instructions is key to the success of your surgery. It is important that
the surgical incisions are not subjected to excessive force, abrasion, or motion during the time
of healing. Your doctor will give you specific instructions on how to care for yourself.

The results will be long-lasting

The results of a body contouring following aggressive weight loss are visible almost immediately.

However, it may take as many as one to two years or more for the final results of all the
recommended body contouring procedures to fully develop. Visible scars will remain, but
the overall results are long lasting, provided that you maintain a stable weight and general fitness.

As your body ages, it is natural to lose some firmness. However, most of your initial improvement
should be relatively permanent.

How much will body contouring surgery cost?

Cost is always a consideration in elective surgery. Prices for body contouring procedures
can vary widely.

A surgeon’s cost for body contouring procedures may vary based on his or her experience,
the type of procedure used, as well as geographic office location.

Many plastic surgeons offer patient financing plans, so be sure to ask.

Cost may include:

• Surgeon’s fee
• Hospital or surgical facility costs
• Anesthesia fees
• Prescriptions for medication
• Post-surgery garments, and
• Medical tests

Your satisfaction involves more than a fee

When choosing a plastic surgeon for body contouring surgery, remember that the surgeon’s
experience and your comfort with him or her are just as important as the final cost of the surgery.

Words to know

• Areola: Pigmented skin surrounding the nipple.
• Arm lift: A surgical procedure, also known as brachioplasty, to correct sagging of the
  upper arms.
• Breast implants: Medical device placed in your body to enhance an existing breast size
  or to reconstruct your breast. Breast implants can be filled with either salt water (saline)
  or silicone (elastic gel).
• Breast lift: Also known as mastopexy, surgery to lift the breasts.
• Breast contouring: A surgical procedure following massive weight loss to improve shape
  and tone and remove excess fat and skin.
• Circumferential incision: A surgical incision around the body to remove the “belt” of
  excess skin and fat and additional incisions that may resemble a bikini bottom pattern.
• General anesthesia: Drugs and/or gases used during an operation to relieve pain and
  alter consciousness.
• Hematoma: Blood pooling beneath the skin.
• Intravenous sedation: Sedatives administered by injection into a vein to help you relax.
• Local anesthesia: A drug injected directly to the site of an incision during an operation
  to relieve pain.
• Lower body lift: Surgical procedure to correct sagging of the abdomen, buttocks, groin
  and outer thighs.
• Macerated skin: Excess skin that hangs and becomes wet or infected underneath.
• Medial thigh lift: A surgical procedure to correct sagging of the inner thigh.
• Outer thigh lift: A surgical procedure to correct sagging of the outer and mid-thigh.
• Sutures: Stitches used by surgeons to hold skin and tissue together.

Questions to ask my plastic surgeon

Use this checklist as a guide during your consultation

• Are you certified by the American Board of Plastic Surgery?
• Are you a member of the American Society of Plastic Surgeons?
• Were you trained specifically in the field of plastic surgery?
• How many years of plastic surgery training have you had?
• Do you have hospital privileges to perform this procedure?
  • If so, at which hospitals?
• Is the office-based surgical facility accredited by a nationally- or state-recognized
  accrediting agency, or is it state-licensed or Medicare-certified?
• Am I a good candidate for this procedure?
• What will be expected of me to get the best results?
• Where and how will you perform my procedure?
• What surgical technique is recommended for me?
• How long of a recovery period can I expect, and what kind of help will I need during
  my recovery?
• What are the risks and complications associated with my procedure?
• How are complications handled?
• How can I expect to look over time? After pregnancy?
• What are my options if I am dissatisfied with the cosmetic outcome of my procedure?
  
• Do you have before-and-after photos I can look at for this procedure and what results
  are reasonable for me?