Post-weight-loss body restoration (body contouring) is the collective term for surgeries that remove and lift, area by area, the loose skin left behind after rapid weight loss.
After losing a large amount of weight, the fat is gone but the stretched skin often remains. Because the skin's elastic fibers have already been stretched, exercise and skincare cannot restore it. Sagging is most pronounced in areas that once held a lot of fat, such as the abdomen, arms, thighs and breasts.
Post-weight-loss body restoration is the collective term for surgeries that remove this remaining skin and lift it, area by area. Sometimes a single area is treated; sometimes several areas, such as the abdomen and thighs, are treated in stages in a planned order. Which area to treat first, and how much to do at once, depends on the amount of remaining skin and your health.
Timing matters. Surgery performed while your weight is still changing makes the result difficult to maintain. We confirm that your weight has stayed stable for a period after reaching your target, test your nutritional status and check for anemia, and then make a plan.
Through an incision below the navel, the loose abdominal skin and fat are removed, and separated rectus muscles, if present, are repaired at the same time. When the excess skin after weight loss continues around to the flanks and back, the incision may be extended sideways to remove it circumferentially.
An incision along the inner upper arm removes the loose skin and fat. When sagging continues down to below the armpit, the incision is extended along the side of the chest.
An incision along the groin crease or the inner thigh removes the loose skin. In most cases liposuction is performed first to reduce thickness, and then only the skin is tidied.
For breasts that have lost volume and sagged after weight loss, the loose skin is removed and the nipple position is raised. If volume is lacking, autologous fat grafting or implants are considered at the same time.
These may vary depending on your condition; we will give you precise details at your consultation.
Our benchmark is usually a point at which your weight has been maintained for 6 months or more after reaching your target. After bariatric surgery, weight continues to change for a long time, so the timing may be delayed further. Deficiencies in protein, iron and vitamins slow wound healing, so we check for them with blood tests before surgery.
Even on the same body, each area is different. Where fat remains we use liposuction; where skin is stretched we use excision; and where both are present we perform liposuction followed by excision. The direction and length of the incision are also decided separately for each area.
Atelier Plastic Surgery performs only one general anesthesia surgery per day and limits the duration of each surgery to reduce the burden. When several areas need treatment, it is usual to start with the area of greatest change, such as the abdomen, confirm recovery, and then proceed to the next area after an interval of 3 months or more.
Because skin is removed, scars remain. Instead, we place the incision lines where they are concealed in everyday posture — below the underwear line, on the inner arm, in the groin crease — and include scar care in the aftercare schedule.
Surgery is completed with an anesthesiologist, and you are monitored in a private recovery room. You wear a compression garment and the drains are kept in place.
Drain output is checked, the drains are removed and you are discharged. To prevent blood clots, we advise walking frequently, even short distances.
Stitches are removed and the wound is checked. You continue wearing the compression garment and avoid movements that pull on the incision.
You return to light daily activities such as desk work. Lifting heavy objects and bending the torso far backward are still restricted.
Exercise is resumed in stages. This is when scars turn red and raised, so scar tape and laser care begin.
Swelling subsides and the contour settles. We check scar maturation and consider whether to proceed with surgery on the next area.
Bleeding, infection, hematoma and seroma can occur, and because the incisions are long and skin tension is high, the wound may separate or take time to heal. After weight loss, deficiencies in protein, iron and vitamins can delay wound healing, so preoperative testing is needed. Reduced or altered sensation may remain in the excised areas, and asymmetry, renewed sagging of the skin and residual excess skin can occur, which may require a supplementary or revision surgery. Scars are long and distinct, and depending on your constitution they may widen or develop into hypertrophic scars or keloids. During the long surgery and the period of restricted movement there is a risk of deep vein thrombosis and pulmonary embolism, so preventive measures are needed. Smoking increases the risk of skin necrosis, so you must stop smoking before and after surgery, and if your weight rises again or drops significantly after surgery, the result will change. Results vary by individual, and all of this is explained fully at consultation.
The content on this page is general medical information provided in accordance with the Medical Service Act. The results of surgery and treatments and the recovery period may vary by individual. All surgeries and treatments carry a risk of side effects, so please decide after a thorough consultation with a specialist.
Abdominoplasty and diastasis recti repair with the excision planned in advance
Learn more Related Arm LiftAn arm lift that removes loose inner upper-arm skin to refine the line
Learn more Related Thigh liftA lift that excises sagging inner-thigh skin to refine the lower-body contour
Learn more Related Breast liftA breast lift with the incision pattern chosen by the degree of sagging
Learn more Related Academic ActivityPapers · books · conference lectures and chairs · society positions · ORCID
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