Advanced Surgical Techniques

Body Contouring is a procedure that alters the shape of the human body. It includes procedures that eliminate or reduce excess skin and fat that remains after previously obese individuals have lost a significant amount of weight, in a variety of places including the torso, upper arms, chest, and thighs. Dramatic weight loss has many benefits. But after any substantial amount of weight loss due to weight loss surgery and/or lifestyle changes, the skin and tissues often lack the elasticity to conform to the reduced body size.

Surgical body contouring following major weight loss removes excess sagging skin and fat while improving the shape of the underlying support tissue. The result is a better-proportioned appearance with smoother contours. Body contouring procedures may include

Arm lift: correct sagging of the upper arms

Breast lift: correct sagging, flattened breasts

Facelift: correct sagging of the mid-face, jowls, and neck

Lower body lifts: correct sagging of the abdomen, buttocks, inner and outer thighs

Medial thigh lift: correct sagging of the inner thigh

Tummy tuck: correct apron of excess skin hanging over the abdomen Adults whose weight loss has stabilized Healthy individuals without medical conditions that impair healing or increase the risk of surgery

(i) Abdominoplasty (Tummy Tuck) –

The stomach is often considered a “problem area” for many people. It is susceptible to storing excess fat and causing problems like a belly “pooch” that most people are anxious to be rid of. Aesthetic problems of the abdomen often get worse following pregnancy or massive weight loss, as the skin struggles to contract back to its former tight and firm appearance, and the muscles loosen, often becoming separated. When sagging skin, loose muscles, and excess fat in the stomach area become a problem, a tummy tuck can be a solution to regaining a tight and beautifully contoured abdomen, often helping patients regain confidence and self-esteem.


A tummy tuck is a body contouring surgery that is not intended for simple weight loss, but instead for an overall aesthetic improvement of the stomach area. Unlike abdominal liposuction alone, a tummy tuck (also known as abdominoplasty) helps to improve skin, muscle, and fat for an overall comprehensive result. Stomach muscles that are stretched and separated from pregnancy can be repaired, and excess skin can be removed to improve sagging in the skin that is unable to contract back to normal on its own.

(ii) contouring Following weight loss(Bariatric) Surgeries–

Patients who have undergone bariatric surgery often find they have “deflated” skin in many areas of their body including the face, arms, breasts, abdomen, and thighs, particularly in those who have lost more than 100 lbs.

Impact of Bariatric Surgery

Surgery that restricts food to the stomach can have several undesirable effects. One is loose, hanging skin throughout the body. Because previous weight, often hundreds of pounds, have stretched the patient’s skin to the maximum, it has lost its elasticity, i.e., the ability to spring back. Instead, the newly slimmed-down patient confronts layers of extra hanging skin including an overhanging panniculus, a large apron of skin hanging from the stomach that can cover the pubis and groin areas.

Extra inches and sometimes feet of floppy skin may hang from the upper arms, chest, stomach, upper thighs and buttocks.  These rolls and sheets of skin can rub against each other, creating areas of irritation and difficulties with hygiene. They may also make exercise difficult.

Among the areas most affected are:

  • Upper arms may sag and appear loose and full
  • Breasts may flatten and hang with nipples pointed downward
  • Abdominal area may extend around the sides and into the lower back area, resulting in an apron-like overhang
  • Buttocks, groin and thighs can sag and cause hanging pockets of skin


How Body Contouring Plastic Surgery Works

Body contouring following massive weight loss are procedures performed by plastic surgeons to eliminate and/or reduce excess post-bariatric surgery. Body contouring improves the shape and tone of underlying tissue and removes excess sagging fat and skin, resulting in smoother body contours and a normal appearance.

While body contouring can be done in a single session, it is usually performed in stages under general anesthesia. If the patient has a history of smoking, deep venous thrombosis or clotting disorders, a high BMI or other risk factors, additional precautions will be required.

The following are examples of common body contouring procedures:

Arm lift or brachioplasty

The extra flesh on the arms of bariatric patients virtually always appears on the underside of the upper arm and is sometimes referred to as “bat wings”. Surgeons make incisions made from the armpit to the elbow to remove the skin and create a more pleasing contour. Consequently, surgeons open the arm on its underside so that the resulting scar is fairly well hidden. A brachioplasty procedure can employ some liposuction after the incision is made. With the arm opened, the surgeon pulls the skin tight and then trims away the excess skin which, depending on the patient, can be a pound of skin per arm or more.

Breast lift or mastopexy

By trimming excess tissue from the upper breast, the surgeon can move breasts which usually droop to the umbillicus to a more upright and full position. The procedure also often requires an implant to make up for lost fat and tissue inside the breast. Scars on women are almost always hidden inside the area covered by the bra.

Stomach lift or abdominoplasty

Excess skin hanging down over the pubic region is often the distorting feature that most concerns and bothers patients. The stomach pannus retains moisture, and causes rashes due to skin rubbing against itself which usually leads to poor hygiene. While the surgical procedure to remove it is known as a panniculectomy, there is often more work to be done for patients who suffer from large amounts of hanging skin. To provide improved contours on the waist, back and flanks, surgeons sometimes perform a belt lipectomy, (also known as a torsoplasty or a circumferential lipectomy). The incision goes all the way around the patient’s midsection at the level of the lower waist. The surgeon uses more liposuction on the stomach and flanks while trimming excess skin from the patient’s back and sides as well. The abdominoplasty and belt lipectomy incisions are placed so that the resulting scar is hidden within most underwear and swimsuits.

Lower body lift trims excess skin on the buttocks and thighs

For an inner thigh lift, the surgeon makes an incision high on the inner leg, starting near the groin and continuing down to the knee. Some fat may be removed with liposuction. The surgeon then removes excess skin and redrapes the remaining skin before closing the long incision, leaving the patient with tighter and more attractive thighs. The outer thigh and buttock can be lifted through a hip-to-hip incision across the back, above the buttocks.

Why Choose Dr Bheem Nanda for Breast Surgery?

Dr Nanda provides truly integrated clinical care for approachable and malignant breast well as cosmetic breast surgery. Our multidisciplinary program brings together specialists in medical Oncology, Surgical Oncology, and radiation therapy mammography cytology and re constructive surgery to provide women with the most advanced surgical care in a compassionate environment.