Preface

Morbid obesity is a chronic condition that is extremely difficult to treat. Unfortunately it is growing at an alarming rate in all age groups and is becoming a real epidemic in Europe and North America. Bariatric surgery is becoming the current standard treatment for severe obesity and its overall safety and effectiveness continues to improve. Even though success of bariatric surgery can be expressed by net reduction of BMI (Body Mass Index) global patient satisfaction does not usually exceed 6.2 on a visual analogue scale (VAS) of 10. Hand in hand with massive weight loss obtained with bariatric procedures comes the need to effectively and aesthetically manage the excess skin that remains as more patients are at present seeking the help of plastic surgeons to address the resulting aesthetic concerns.

Massive weight loss (MWL) patients present a very different profile than those who have not been obese. Their deformities are more severe and present with bi-dimensional skin excess which is usually poor in tone. Patients who experience massive weight loss are left looking “deflated” with disfiguring skin laxity circumferentially around the torso including the breasts in addition to redundant tissues on the upper arms, buttocks, and thighs leading to poor social acceptance and quality of life. To answer these problems, body contouring is mandatory. When expertly and effectively performed global satisfaction of patients increases to 8.5 VAS.

MWL patients present extremely diverse, disordered, and often complex and unpredictable contour deformities requiring lifts in areas previously rarely seen. Body contouring for these patients is unlike routine cosmetic surgery. It is evolving from traditional body contouring procedures, in particular from abdominoplasties, to a series of very specialized surgical procedures designed to aesthetically improve specific areas of the body. The subspecialty of body contouring surgery after massive weight loss is indeed a rapidly evolving field of plastic surgery and as an individual plastic surgeon continue to gain more experience with the massive weight loss patient and continues to refine their techniques, it is important that new learning and insights are shared within aesthetic surgical subspecialty.