Losing weight can be a challenge, and losing a significant amount of weight takes a lot of determination and the right tools over a period of time to succeed. Reaching that goal certainly is an accomplishment to celebrate! Patients who lose 50 pounds or more may have excess skin left behind. That’s when body contouring can help.

Surgical Body Contouring

What is surgical body contouring?

Once a person reaches an ideal weight, body contouring — which is a series of surgeries to remove sagging skin and fat — can be considered. No amount of diet and exercise will rid the body of the excess skin because it does not have the elasticity to shrink. And yet, extra skin can interfere with a person’s daily life in many ways. Body contouring can improve a person’s appearance, hygiene issues and social anxiety, as well as the shape and tone of the underlying tissue that supports the skin.

Body contouring and weight loss

Body contouring is by no means an alternative to weight loss, but is a supplement for patients once they have reached their ideal body weight (IBW). IBW is based on a person's gender and height, and sets a target goal within the normal range of the body mass index (BMI) scale. BMI is determined using a person's height and weight.

Body contouring is a good option when patients have reached a weight that is within the range of overweight BMI (25-30). In some patients, a BMI between 30 and 35 is acceptable. However, your surgeon will make that determination.

Candidates for body contouring

A good candidate usually meets certain criteria:

Body mass index (BMI) less than 30
Weight has been stable — within 10 pounds — for 6 months. (For patients who undergo weight-loss surgery, insurance will not approve surgery before 18 months have elapsed after bariatric surgery)
No nicotine use
Healthy lifestyle with adequate protein intake (at least 60 grams per day)

Surgical procedures for body contouring

Different techniques are used to treat each body part, and at Orlando Health, we create a personalized plan for each patient after thorough discussions about goals and options. Certain procedures can be combined, while others are best performed one at a time. Some of the most common procedures include:

Arm lift (brachioplasty) — treats excess skin of the upper arm
Breast lift (mastopexy) — treats sagging breasts
Buttock lift / lower body lift — treats sagging buttocks
Gluteal auto-augmentation — treats flat buttocks
Tummy tuck (panniculectomy / abdominoplasty) — treats excess skin of the abdomen
Thigh lift (thighplasty) — treats excess skin of the thigh
Upper body lift — treats sagging upper back

Surgical process

At the consultation, each patient and physician will discuss goals and available options for body contouring. The doctor will perform a thorough physical exam, and photos will be taken of the body sites that are discussed. Staff will provide information about documentation needed for insurance submissions.

On the day of your surgery, you will arrive about two hours before your procedure. You will meet the anesthesiologist and your surgeon in the preoperative area, and they will answer any last-minute questions you may have. Your surgeon will use a pen to mark sites for surgical planning. Then, you will be taken to the operating room where you will be given medications to put you to sleep for the duration of the procedure. You are constantly monitored throughout the surgical procedure and only are awakened once the surgeon has completed the operation.

After surgery, your surgical wounds will be covered with skin glue and a medical dressing. Drains are sometimes used to avoid fluid accumulation. A medical grade compression garment is worn over the surgical site to assist with swelling. You will be required to walk on the night of surgery to avoid blood clots in the legs. With surgery on the abdomen, you will walk slightly hunched over for the first week to decrease tension on the sutures.

Typically, patients are back to work after two weeks as long as they avoid strenuous exercise and lifting, pushing or pulling more than 10 pounds for the first six weeks. However, walking and going up or down stairs is acceptable — and encouraged —immediately after surgery.

Liposuction and CoolSculpting

For patients who have lost more than 50 pounds (especially those who have undergone weight-loss surgery), non-invasive fat removal techniques such as CoolSculpt are not an option. Sometimes, if there is a region of a patient's body that is resistant to weight loss, liposuction can be used to treat the area along with a skin excision, either at a separate stage or at the same time.

Cost of body-contouring procedures

Like other surgeries, body-contouring procedures involve multiple costs that may or may not be covered by your insurance. We work with most insurance companies, and typically 9 out of 10 patients are able to be approved for excess skin removal from the abdomen. For other body parts (breasts, arms, thighs), insurance approval is rare. Our institution accepts CareCredit, which is a loan that you apply for through a program and then pay back on your own terms. Depending on the option you choose, interest can be as little as 0%. If you choose to undergo procedures that are not covered by your insurance, you will be responsible for the costs incurred. Among them: