Post bariatric surgery reconstruction emerged as new subspecialty of plastic surgery in the last few years. This constitutes a group of procedures that are utilized to tighten excessively loose skin, frequently after massive weight loss. A smaller group of patients, who are normal weight and have never been overweight, will present with loose enough skin to warrant surgical tightening in the inner arm, posterior trunk, buttocks or thigh regions.

Abdominoplasty, or a "tummy tuck," is designed to correct a protruding abdomen resulting from weak abdominal muscles, weight gain or pregnancy. Obesity and aging cause the skin to lose its elasticity. These conditions may not respond well to diet or exercise if the skin and underlying muscles have been stretched.

With abdominoplasty, the abdominal wall muscles are tightened and excess fatty tissue and skin are removed to improve the body contour. The goal is a narrower, flatter abdomen. Realistic expectations are important. Abdominoplasty is not a substitute for weight loss.

Antibiotics will be prescribed prior to surgery to prevent infection. To minimize the possibility of excess bleeding, you will need to avoid taking drugs containing aspirin. You will also be advised to bathe with an antiseptic soap for several days prior to surgery.

Abdominoplasty is performed using general anesthesia. You may be given medication beforehand so you will feel relaxed. The surgery may take 2-5 hours, depending on your overall condition. You may be released after a few hours, or you may require a couple days of hospitalization.The procedure is most commonly performed by making a U-shaped incision below one hipbone, across the pubic area and under the other hipbone.

A second incision is made around the navel. The skin is then separated from the abdominal wall and lifted up to the hipbone, exposing loose tissue covering the abdominal muscle.

Loose, stretched out muscles are tightened with sutures, and excess skin and fat are removed. The skin is lowered over the abdomen and the navel is reconstructed. The incisions are then sutured together. Drains are often inserted to eliminate fluid buildup, and firm elastic bandages are applied to the area.

You may experience some discomfort immediately following surgery that can be controlled with pain pills. Some swelling is normal. You will be given special instructions for showering and changing your dressings until the surface stitches are removed in 5-7 days. You may also be required to wear a support garment.

The speed of recovery depends on your physical condition prior to surgery; those with stronger abdominal muscles usually recover faster. Allow at least 2-4 weeks to recuperate before returning to work.

Some scarring is also normal. It often takes 9-12 months before the scars begin to fade.

Though the recovery period is longer than that of other cosmetic procedures, the rewards are great for a patient previously distressed by a protruding abdomen. Those who follow a proper exercise routine and healthy diet will benefit from abdominoplasty the most.

Body lift, or belt lipectomy, is performed to remove the excess skin and fat that exists on the body as a result of age or extreme weight loss. The body lift is performed on the lower torso and upper legs and involves the belly, hips, back, buttocks and outer thighs. People who have excess skin or fat in all of these areas may benefit from the body lift procedure.

This procedure involves a tummy-tuck combined with a circumferential excision of excess tissue from around the entire trunk while elevating the buttock and outer thighs. Obviously, this is a very extensive procedure requiring longer operative times and recovery than just a tummy-tuck. A lifting effect is obtained at the level of the buttocks, the outer thighs as well the abdomen and flanks.

Liposuction is a very common, popular procedure. It is designed for the permanent removal of fatty tissue, commonly referred to as cellulite. It is an elective procedure that allows the plastic surgeon to remove undesirable, subcutaneous fat in isolated areas that do not respond to diet and exercise. These areas include the hips, thighs, abdomen, knees, ankles, face, neck, and arms.

Liposuction is most successful in people with good skin tone who have fatty deposits. It is not a treatment for obesity. If weight gain occurs following liposuction, the fat will be deposited in areas that have not been treated. The procedure can be repeated, if necessary. To maintain the safety of the procedure, there is a limit on how much can be done at one time.

A variety of factors can affect the results: Physical condition, genetic makeup, diet, exercise, smoking, alcohol intake, and skin elasticity.

Body contours made irregular by fat can be improved by this procedure; it cannot correct contours that are irregular for other reasons, such as muscle weakness or hernia. However, combined with other procedures, liposuction can correct these other deformities with good results.

Liposuction is done under general anesthesia on an outpatient basis. The surgeon makes small (less than 1/2 inch), discreet incisions in the areas to be treated. A cannula is inserted in a small incision and attached to a suction machine. The procedure may take an hour or more, depending on how many areas are involved.

Recovery from liposuction is relatively easy. Expect a fair amount of swelling and bruising in the following two weeks. You will wear special garments provided to apply pressure, minimize swelling and provide support while healing. These garments also assist in retraction of the skin. Stitches will be removed in a week to 10 days.

Results are recognizable almost immediately and will continue to improve as swelling subsides. The day after surgery you should be up and walking around. Increase your activity daily until full activity is resumed at 2-4 weeks. You will be ready to return to office work in 3-5 days and more active employment at 10-14 days. Avoid the sun until all bruising has subsided. A sunscreen should be used routinely; it is easy to get sunburned during recovery because of decreased sensation.

The results of liposuction are permanent. If you were to gain a large amount of weight you might note rippling in the treated areas, depending on your skin elasticity.

As with any surgical procedure, complications can occur. Cosmetic complications include contour irregularities, skin discoloration, asymmetry, scar tissue, tape burns, collection of blood or fluid under the skin. Uncommon complications include loss of sensation, skin breakdown, fat embolism, serious infection or shock. Bleeding does occur during liposuction.

There is a limit to the amount of fat that can be safely removed in a given procedure. Following liposuction, the scar will go through a maturation process during the first 8-12 weeks they may be red and possibly raised. The scars will mature over 6-2 months and become pale, flat and soft. You may experience numbness, burning, tingling around the incision site. These symptoms are almost always temporary.