Body Contouring at The Hague Center

After people do the hard work before, during and after weight-loss surgery, they’re not finished reshaping their bodies. They may have lost 100 pounds or more of fat, but they’re left with sagging skin from head to toe. That’s where body contouring comes in to change lives, says Dr. David Gilbert of The Hague Center for Cosmetic and Plastic Surgery in Norfolk.

“They change their diet, change their sleep habits, change their exercise program,” Gilbert says. “They’ve lost 100 pounds on average and they may weigh 160 to 220 pounds. When they come to see me a year later, they’re in tune with their bodies. They know what to expect and how much needs to be removed. This is not weight loss surgery—this is body contouring to shape the body back to where it used to be.”

That leftover excess skin has lost its elastin, the tissue that allows it to spring back, Gilbert says. For example, the patient’s big belly has been replaced by a large apron of skin that droops down. That large flap of skin makes it difficult to urinate and to keep the area clean, he says.

“They get a lot of skin rashes and skin breakdown,” he says. “They start to get infections and odors. These surgeries are an overall relief to these patients.”

Patients often need several procedures. In a buttocks surgery, often called a Brazilian butt lift, the surgeon injects fat and lifts tissue and muscles up to achieve a more youthful, natural appearance he says. At the same time, surgeons often can do a tummy tuck as well to eliminate that flap of excess skin.

“They don’t have to wear big pants to cover up that skin,” Gilbert says. “They can use the bathroom in a normal fashion and don’t have to worry about hygiene to the same degree.”

Once that skin is eliminated, women wearing a size 16 jeans can drop down to a size 12 or 10 while men often go from a 44 waist to a 38 waist, he says.

Post-bariatric surgery patients may seek surgery to eliminate a so-called turkey wattle neck with a now noticeable droop, he says. They also may get surgery to tighten up the skin on their faces.

“Weight loss can make you look old—it’s not a good look,” he says. “Patients can be 35 or 40 years old and look like they’re 60 because of all this droopy skin. It’s an unnatural look. We lift the neck up to where it used to be and redefine the chin-neck angle. Once you elevate the skin and tighten their face, they get back their youth.”

Another popular body contouring surgery is getting rid of the flabby upper arms, Gilbert says. “Teachers will come in and complain that when they go to write on the blackboard, their arms wiggle and jiggle and the kids laugh,” he says. “Things you wouldn’t even consider become focal points.”

Patients also may get surgery to reduce and/or lift their breasts, he says. “Some of my most appreciative patients are breast reduction and breast lift patients,” he says. “They’ve been living with these large breasts for so long, they have shoulder strap grooves and back pain. They are very appreciative.”

Patients can have two or three procedures in one surgical session, which is limited to six hours, he says. Patients may have their upper arms and torso done in one operation and then a breast lift and thigh lift in a later procedure.

Recovery usually takes four to six weeks, Gilbert says. During recovery, patients wear a girdle to reduce swelling, reduce pain, speed the healing and lessen the scars, he says. People can usually go out in public within three weeks, he says. They can return to a sedentary office job within three weeks, probably working half days until they get their full strength back, he says. People with manual labor jobs usually can return to work within six weeks.

“These patients are very thankful for the surgery,” he says. “These surgeries improve their overall health.”

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