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Over the last two years, I have lost 130 pounds with a diet and exercise program. I love my new size but am appalled by skin excess I see over my entire body. Where do I start in getting rid of the extra skin? Do you have procedures for guys?

Bill G, Dana Point CA

First of all, you are to be congratulated for doing something very beneficial for your overall health! Overweight people have a much higher chance of having high blood pressure, high cholesterol, diabetes and a score of other diseases which shorten the lifespan! Yes, excess skin is a byproduct of weight loss but there are very successful procedures to address your needs – yes, for male and female patients. Most people who loose so much weight will have lax skin over the face and neck, chest, back, abdomen, arms and thighs but some will have a lot of skin excess in one part and not so much in another. After a thorough consultation with your plastic surgeon, you should come up with a plan to have the skin that bothers you resected. If multiple body parts are involved, frequently the procedures will have to be staged to insure that any one procedure does not exceed 6 hours, our upper limit for keeping patients under anesthesia (above that, the risks of anesthesia rise and it’s not worth the added risk).

Weight can be lost with a diet and exercise program or following bariatric surgery. Either is just the beginning of an ongoing journey toward weight loss through lifestyle changes. Patients have to learn how to eat differently, exercise more – and keep adjusting their ward robe as they shed pounds. Once weight loss has stabilized, most patients decide to undergo a round of surgical procedures to correct the global skin laxity that almost invariably is associated with significant weight loss.

Most patients begin with addressing the skin laxity in the abdominal and back areas with a belt lipectomy (a resection of excess abdominal and back skin) or abdominoplasty (tummy tuck to address abdominal skin excess). At the same sitting, many will also do their arms or breasts, and then return after they have healed for a tightening of the thighs and perhaps a face lift.

The operations are all performed in an outpatient facility under a light general anesthetic, either at the Orange County Surgery Center in Southern California or at the Webster Surgery Center in Northern California. A well trained, board certified anesthesiologist will ensure your safety during the procedure.

We have two basic rules after almost any surgery we perform. First of all, even if you do not have discomfort, take it easy and rest the first two or three days after any procedure – take a walk frequently to avoid the possibility of potentially blood clots forming in your calf veins, but don’t take on any other tasks. After the third day, patients are all over the map in comfort levels – each patient should listen to their body and do what is comfortable, avoid anything that is not! All patients can walk around but no one will be able to run in the first few weeks. Those who wish to run or do a sit up or lift a weight should do so whenever they are comfortable doing so. Generally, it takes six to eight weeks before most patients can resume all their prior vigorous activities. Swelling in the surgical sites takes up to six months or a year to go down and the scars could take a year and a half to finally mature and fade. If a patient keeps their weight down, these procedures will never have to be repeated.

The best way to illustrate this further would be with photos of a male patient in his mid-40’s of Dr. Bunkis following weight loss from 270 to 184 with a diet and exercise program. The patient is shown here before and following a body lift and a liposuction of his chest wall – a “Daddy Makeover”!

If you have any specific questions about the daddy makeover, your best bet would be to see a qualified plastic surgeon to review your options. Pease feel free to contact our office at 949-888-9700 to set up an appointment with Dr. Bunkis; check out the photos section of our website here to see further examples of similar patients.