Contour Deformities After Massive Weight Loss
Pp. 39-49 (11)
Steven Rueda, Mari Rebane and Seth Thaller
Popularity of bariatric surgery has increased exponentially over the past several years. As a result,
a new patient’s population has emerged seeking plastic surgery: the Massive Weight Loss (MWL) patient.
Patients who experience MWL present with bi-dimensional skin excess and are left looking “deflated,” with
disfiguring skin laxity circumferentially around the torso, including the breasts, redundant tissue on the
upper arms, buttocks, and thighs leading to poor social acceptance and quality of life.
The strength with which the superficial fascia attaches to the underlying muscular fascia varies
throughout the body. Areas of high strength are called zones of adherence and usually excessive tissue
laxity are especially evident in these zones of decreased adherence. Post-bariatric weight loss contour
deformities well exceed contour deformities plastic surgeons have ever encountered previously. These
deformities are diverse and often severe in nature. It is not possible however to predict where body
contouring deformities will materialize because they may be present anywhere on the body.
Nevertheless their accurate classification can assist the surgeon in operative planning.
Body contour deformity, superficial fascia, skin laxity.
The DeWitt Daughtry Family Department of Surgery, University of Miami School of Medicine, Miami, Florida, USA.