Why Weight? What To Do After Massive Weight Loss

You did it. You made it to your desired weight after months or years of diets, exercise, medications, or bariatric surgery.  You look better, you feel better, and you’re happier overall.  But now what? You are left with excess skin in areas that you never knew could hang, rub, sweat, or stick together.  You spent so much time trying to get rid of the fat, not realizing that you would be left with so much skin.

For many people, weight loss is an arduous journey of balancing intervals of weight gain verse weight loss until you’ve finally reached your goal.  With newly discovered diabetes drugs now turned into weight loss medications, such as Ozempic, Mounjaro, and Wegovy, more people are losing extra pounds in shorter amounts of time.  These medications help to reduce overeating and lower appetite, while also controlling blood sugar.  Although more invasive, and sometimes a longer journey, bariatric surgery remains the gold standard for obesity and weight loss.  These lifelong procedures guarantee longer-term results by changing the way food is absorbed or changing the size of the stomach to allow smaller portions of food to feel satisfied. 

No matter which way the weight is lost or how long it took to get there, there is almost always a “part 2” needed to feel your best after all that hard work.  Massive weight loss surgery has tripled for plastic surgeons in recent years since the craze of diet medications and insurance coverage for bariatric surgery.  Here at Greenberg Cosmetic Surgery in Woodbury Long Island, massive weight loss surgery is an integral part of our practice, both in-office and in the hospital.

Most people come to our office after losing weight and are not sure where or what to begin. Patients complain that their “entire body” bothers them, but they don’t know which areas to focus on first.  The surgeons at Greenberg Cosmetic Surgery create a comprehensive surgical plan to map out exactly which body parts should be treated together and the amount of surgery, if more than one, is needed to achieve the patient’s optimal results.  For example, a patient may do an abdominoplasty/breast lift/armlift in one session, followed by a thighlift and liposuction 6 months later.  A patient may want to focus on the upper body (arms and breasts) first, followed by lower body (abdomen and thighs) second.  Everyone’s weight loss journey is different and so is their surgical plan.  Here at Greenberg Cosmetic Surgery, we customize the “part 2” to ensure that you look and feel your best.

An abdominoplasty, also known as a tummy tuck, is the most common, and arguably the most life-changing, weight loss surgery for people.  Excess and low hanging skin, zebra-like stretch marks, itchy/red rashes, and discomfort wearing clothes are only a few of the issues we often see.  A tummy tuck targets both the abdominal muscles and the excess skin, all while contouring and flattening the abdomen through a low inconspicuous incision from hip to hip.  The rectus muscles of the abdomen are tightened using non-dissolvable sutures, while the hanging excess skin is pulled down and removed, leaving a much flatter belly.  For some patients, the abdomen has a rounded protuberance that is caused by intra-abdominal fat, or visceral fat, that we gain as we age.  Visceral fat can develop from what we eat (carbs, sugars), what we drink (soda, high calorie alcohol, beer/wine), a change in hormones (changes in estrogen during menopause), and lack of exercise.  Unfortunately, this “inside” fat cannot be treated with surgery.  Additional weight loss, low carb meals, decreasing alcohol, and daily exercise are the only options to reduce abdominal protuberance.  An abdominoplasty is performed in either our office-ambulatory center in Woodbury, Long Island or a local hospital.  All of our tummy tuck patients stay overnight with a registered nurse to ensure a comfortable and safe first night.  Recovery time for an abdominoplasty is typically 7-10 days of healing at home.

When addressing the excess skin on the arms and legs, an armlift and a thighlift are the best surgical options.  An armlift procedure removes the “batwing” deformity using a horizontal incision on the inner aspect of the arm, while the thighlift procedure targets the bulge that develops on the inner thigh using a vertical incision on the inside of the thigh.  Liposuction is often used in conjunction to remove any residual fat in those stubborn areas.  Both procedures will make you feel lighter and move better.  Our surgeons are Greenberg Cosmetic Surgery in Woodbury Long Island strive for the thinnest incision using dissolvable sutures to promote the best possible healing.  Recovery time for these procedures is about 5-7 days of healing at home.

Weight loss has varying effects on the breasts.  Some women lose all their volume and look deflated, some remain full and too large for their newly thinned body, and some develop droopiness leaving their nipples pointing to the ground.  Luckily, there are surgical options to address all three.  A breast augmentation using a silicone gel implant adds volume and shape to a deflated-looking breast.  This usually complements a breast lift, which repositions the sunken tissue and loose skin to where it once was.  A breast implant with a breast lift is the best option for women who want natural, feminine breasts with added volume and shape.  If a woman is left with only droopiness to her breasts and does not want an implant, a breast lift alone is done to tighten the sagging skin and reposition the nipple to the correct height.  For women with large breasts, a breast reduction is performed to alleviate persistent shoulder grooving, neck pain, and heaviness of their chest.  A reduction removes both volume and skin to make the breasts smaller and lift the tissue.  Each of these procedures share the same type of incision.  An anchor incision located around the areola, down to the breast crease, and under the breast tends to heal nicely and fade over time.  Recovery time for a breast procedure is minimal, requiring only a weekend of relaxing at home.

Although these are the most common massive weight loss procedures, there are additional surgeries that can be done to achieve a patient’s optimal result.  Liposuction, fat grafting, and facelifts are just a few others that we perform.  Our surgeons at Greenberg Cosmetic Surgery will meet with you at your consultation visit where they will examine and discuss your goals, answer questions, and develop a plan to ensure that this “stage 2” leaves you looking and feeling your best.  Please call us today to schedule your next appointment!

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