Post Bariatric Surgery in Baltimore, MD

You have put in the hard work and effort to lose all that weight or may even have undergone medical treatment such as bariatric surgery. Yet, you are still unhappy when you look at your body. Sure, the weight may be gone, but folds of loose and sagging skin still remain and the contours of your body may look disharmonious and irregular.  For the men and women of Baltimore, MD, and the surrounding communities, double board certified and fellowship-trained plastic surgeon Dr. Steven J. Rottman offers surgical body contouring as a solution to give you the fit and healthy body image you desire and deserve.

Body contouring helps minimize the excess skin and fat that often remains following weight loss. The procedure reduces these problem areas, resulting in a smoother and more attractive body contour. Undergoing body contouring following significant weight loss is the next step in your goal of achieving a healthier and more aesthetically pleasing body, resulting in an enhanced body image and self-esteem.

What Is Body Contouring As It Relates To Major Weight Loss?

The condition of being significantly overweight can cause stress on your health in many ways. If you had restricted physical activity because of your weight, you probably also have poor skin and muscle tone, and your skin probably has a stretched appearance.

The different types of bariatric surgery represent one technique for generating significant weight loss for those who have a clinical diagnosis of obesity. After any significant weight loss or weight reduction surgery, the skin often loses elasticity and no longer conforms to the smaller body size. This causes the skin to be overly stretched and unsupported, commonly leading to sagging in the following areas:

  • The face, jowls, and neck, resulting in a haggard, sad appearance
  • Upper arms, causing a “bat wing” appearance
  • Thighs, buttocks, and groin, leading to hanging skin pockets
  • Breasts, resulting in a flattened appearance with nipples pointing downward
  • The abdomen, leading to an apron-like overhang that extends onto the lower back and sides

Sagging skin that is wet or infected, in addition to being unattractive, presents a health threat that should be addressed.

The tone and shape of the underlying tissue supporting skin and fat can be improved with surgical body contouring. These procedures remove excess skin and fat, resulting in a healthier body appearance that has smoother contours.  Body contouring is essentially the last step in your weight loss experience.

It is important to understand, however, that prior to your decision to have a body contouring procedure, you should stabilize your weight loss. Otherwise, a continual process of weight loss will cause sagging pockets to reappear. If you should quickly regain your lost weight, your already weakened skin with be further traumatized, leading to more skin stress, wide scars, and visible stretch marks.

If you undergo weight reduction surgery, Dr. Rottman will work in close consultation with your surgeon to determine if body contouring is right for you.

Generally, appropriate candidates for body contouring are:

  • Adults with a stabilized weight
  • Healthy people without certain medical conditions that slow healing or increase the risks of surgery
  • Those who have a positive outlook and goals that are realistic
  • People who commit to a healthy lifestyle
  • People who do not smoke

Where Do I Begin?

Your first step is a consultation with Dr. Rottman to understand the ways that body contouring can improve your appearance and help you achieve better health. A consultation provides you with the opportunity to learn about your surgery in a relaxed environment and includes:

  • An evaluation of your individual case and a discussion of your goals
  • Body contouring options
  • Likely outcomes of the procedure and any related risks
  • Rottman’s recommended course of treatment

Evaluation

Your personal outlook and general health can significantly affect the outcome of your surgical procedure. These will be discussed and examined during your consultation. In order for your procedure to be successful, you should openly discuss your expectations, completely disclose your medical history, and carefully follow the instructions of Dr. Rottman.

Surgery Preparation

Your body contouring plan will be thoroughly explained by Dr. Rottman. Before surgery, you will receive specific instructions, including information on medications, diagnostic testing, day-of-surgery instructions, anesthesia instructions, and post-operative care information.

The steps needed to meet your goals will be discussed, as well as a timetable for the procedures. Dr. Rottman will discuss and may recommend the following plastic surgery procedures as a solution to your specific post weight loss situation:

  • Lower body lift: For correcting abdomen sagging, and sagging of the outer thighs, groin, and buttocks
  • Breast lift: Used to correct flattened, sagging breasts
  • Arm lift: Corrects upper arm sagging
  • Thigh lift: Corrects thigh sagging in the inner, outer, and mid-thigh

What Happens During My Body Contouring Surgery?

Step 1 – Anesthesia

The first step of the procedure involves the administration of anesthesia so that you will remain comfortable during your procedures. Anesthesia may include general anesthesia and intravenous sedation. Dr. Rottman will select the best option for your individual needs.

Step 2 – The Incision

Incisions are required in all body contouring procedures involving the removal of excess skin.

The pattern and length of the incision can vary, depending upon the location and volume of over-abundant skin tissue that needs to be removed, personal preference, and Dr. Rottman’s surgical judgment.  The incisions will be placed in areas where they will go unnoticed, if possible.

Body contouring may be done in phases. The development and timing of your surgical plan will depend on your own individual needs and goals, as well as the best judgment of Dr. Rottman. Although it may have taken years to lose all the needed weight, patience will be required for your body contouring results to be complete.

Body Lift

A body lift consists of treatment for sagging buttocks, waist, abdomen, outer thighs, and hips either  in a single procedure or in phased procedures. The patterns of the incisions may vary, including removing the layer of excess skin and fat.

Breast Lift

The patterns for the incisions involved in this procedure depend on how much excess skin must be removed. This could include a single incision or a number of incisions around the areola. These incisions would be formed in a line that extends from one’s areola to the crease of the breast, as well as a horizontal incision along the crease of the breast. Breast implants may also be recommended to augment the size and shape of the breasts.

Arm Lift

Upper arm skin that sags can be treated using an incision that extends from the underarm area to the inside and rear of the upper arm. Other arm incisions may be needed in areas where excess skin has sagging pockets.

The tighter, smoother contours resulting from the contouring of the upper arms will be evident almost immediately, after the initial bruising and swelling from the procedure subsides. Skin quality is also significantly improved in texture and appearance.

Thigh Lift

Thigh reshaping is accomplished using groin incisions that can run down the length of the knee alongside the inner thigh. Outer thigh contour improvements may require an incision that runs from the groin to the hip. Dr. Rottman uses these incisions to tighten tissues for a better toned and smoother thigh.

Post Surgery

After the completion of your procedures, bandages or dressing may be placed over your incisions. Treated areas of the body may be wrapped in elastic bandages to reduce inflammation and brace your new contours during the healing process. Very thin tubes may be temporarily placed underneath the skin to drain any excess blood or fluid that may collect. Prior to your release, you will be given specific instructions which may include:

  • Medication instructions for drugs to be taken orally to reduce infection risk or speed healing
  • Instructions on how to care for the surgical site and drains
  • Specific areas of concern to anticipate at the surgical site or your overall health
  • When to have a follow-up visit with Dr. Rottman

Progress and Healing

At first, healing at the incision sites will be accompanied by some swelling. It is common to experience some discomfort at this point, which can be relieved by medication. You will need to resume minimal walking when you are able, to reduce any chances of developing blood clots or other complications.

You may also be instructed to not bend, strain, or lift for several days to weeks. If thigh or abdomen tightening is involved, Dr. Rottman may also inform you that you should not stand fully upright or stress internal sutures while they are healing. He may also instruct you to sleep with your knees elevated by pillows.

Follow every instruction carefully – they are designed to support the healing process.

The first phase of wound healing can last from seven to 14 days. At this time, your sutures, if required, are removed.  You should be able to resume normal and work activities within a few weeks, as long as you refrain from engaging in any vigorous exercise or heavy lifting.

The healing process may take quite a number of weeks to resolve swelling and improve incision lines. A firm feeling and numbness of your skin will gradually improve with the passage of time. After you have recovered thoroughly from one group of procedures, you can begin preparing for any follow-up procedures needed in other areas.

Results and Outlook

Body contouring results after major weight loss can be seen almost immediately, but depending on the procedure(s) performed, it may take up to two years before the final results are fully visible. Scars are to be expected in order to achieve a body contour matching your new proportions and body weight.

You can expect your results to be long-lasting, as long as you maintain a stable weight and overall level of fitness. It is natural to lose some firmness as your body ages, but the majority of your initial results should remain relatively permanent.

Dr. Steven J. Rottman is a cosmetic and reconstructive plastic surgery expert who serves the men and women of Baltimore and surrounding areas. Dr. Rottman is recognized for his approach to plastic and reconstructive surgery that gives his patients exceptional natural-looking results. Because each patient is unique, Dr. Rottman uses both traditional and advanced techniques for his procedures. Please contact us today to schedule your personal consultation with Dr. Rottman.

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