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Cosmetic Surgery After Tremendous Weight Loss

Abdominoplasty and Body Lift in Leesburg, VA

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People who have lost a tremendous amount of weight should be applauded!  It is not easy! 

Whether you did it on your own, or whether you did it with the assistance of bariatric surgery being overweight predisposes you to numerous medical problems. They can include: high blood pressure, diabetes, heart disease, the list goes on. And there are many psychosocial problems associated with being overweight such as not wanting to expose your body to friends or intimate partners or even to go to the gym.

So well done for reducing your weight. Losing all of that weight immediately and dramatically reduces the risk of most of these medical problems.  

There is, however, a tremendous downside. Once the fat is gone, the skin will unfortunately remain and there will be lots of excess. And because you have lost weight everywhere, the skin will sag… everywhere.  Tremendous weight loss patients will show excess skin in their face, breasts, arms, body, and legs.  

Thankfully, there are very effective and powerful procedures to help you look and feel better after your weight loss journey. We can lift and remove that excess skin to take away the last vestiges of weight and leave you looking and feeling like a new person.

Obesity is an epidemic in the United States. It is fueled by the encouragement of overly processed carbohydrates by large companies (with government assistance) as well as taking in foods and drinks with high sugar content such as sodas, wine, and deserts regularly.

The medical consequences of being overweight can be catastrophic. Diabetes, high blood pressure, and a limited life expectancy are very common in obese people. Losing weight can alter a person’s health path dramatically.  

Losing weight can almost immediately reduce your medical risk factors and many people report feeling better emotionally and physically.

Unfortunately, although your body loses fat and weight, the skin does not shrink back to fit your new physique. It has lost much of its elasticity and will not shrink down to properly envelope the body again. The skin of the breast, abdomen, arms, thighs, buttocks, and even face will sag.  

Treatment of tremendous weight loss patients is directed at re-tailoring the skin to fit the new body frame. 

Some common procedures include:

  • Breast lift, breast augmentation, breast reduction, or combination
  • Abdominoplasty
  • Total body lift (also known as a circumferential body lift)
  • Thigh lift
  • Arm lift
  • Face and/or neck lift

Insurance will often pay for bariatric surgeries such as gastric bypass, gastric stapling, or gastric banding. This is because obesity is known to be responsible for highly expensive medical problems including diabetes, hypertension, congestive heart failure, and obesity-related infections.  

But once that weight is lost, medical insurance is very reluctant to pay for cosmetic procedures after tremendous weight loss; it is their stance that the excess skin that is left after the fat is gone is not a “medical necessity” that they should be responsible for. This is not to say that they would refuse to do so. It always depends upon your individual policy. 

We would recommend that the following people not undergo cosmetic surgery after weight loss:

  • those with multiple medical problems
  • those with cardiac problems
  • those who have a poor understanding of the risks involved
  • those with poor nutrition who aren’t prepared to change their diet
  • those who continue to suffer from obesity
  • those who have a sedentary lifestyle and are not prepared to change

You have probably put in a lot of time and effort to lose the weight. Before undergoing cosmetic surgery we would suggest you wait at least six months to ensure you can sustain a stable weight. Why have the surgery if you end up with significant weight gain or you plan to lose more?

Limitations to how many procedures you can have at the same time revolve completely around being able to perform the cosmetic surgeries safely. Factors that contribute to safety include the duration of the procedure and the potential for blood loss.

According to recommendations from the American Board of Plastic Surgeons, procedures should be limited to about 6 hours. The longer the procedure, the greater the degree of fluid shift, and the higher potential for blood pressure and clotting disorders.

In addition, surgical removal of tissue obviously increases blood loss. Blood loss in turn also increases the degree of fluid shifts and a higher potential for blood pressure problems during the surgery.  

For safety reasons, cosmetic procedures for after tremendous weight loss should be limited to about 6 hours and about 2-3 body areas (which is about how much can be completed in the 6 hour time frame).

It is very important to improve your health before any kind of surgery. It is even more relevant, however, when considering elective cosmetic surgery. 

Some thoughts to consider:

Optimizing your weight loss:

Most patients will not complete and stabilize their weight loss for 6 months to a year after their weight loss surgery. You should be happy with your weight and be confidant you can stay at that weight for years before undergoing a cosmetic reconstruction in order to optimize the amount of tissue that can be removed.

Optimize your nutrition:

Many patients will have problems with vitamin and nutrients absorption after weight loss surgery. You will also want to improve protein intake. Vitamins and adequate protein are necessary to help you heal your incisions and fight infection after surgery. Some important labs to check include…

  • Vitamin levels including B, C, and D
  • Protein and albumin
  • Iron
  • Hemoglobin

Optimize your strength and endurance:

Patients will not be able to exercise for about 3-4 weeks after surgery.  Optimizing strength and endurance before your surgery will give you a cushion to tolerate the surgery. 

While several vitamins, minerals and amino acids are used during healing, there are specific ones that are known to specifically support the normal response to healing, and to support the immune system’s response to infection.

Herbal supplements, in general, are to be avoided prior to surgery because they can cause bleeding or other operative complications. A few commonly taken herbal supplements to avoid are: Ginko Biloba, Garlic, Ginseng, Ginger, Dong Quai, Ephedra, Feverfew, St. John’s Wort, and/or Omega 3 fatty acids.

Vitamin E and surgery do not mix because Vitamin E is associated with increased bleeding, and this can lead to collection of blood (called a hematoma) which could result in serious complications. Most surgeons will instruct you to avoid Vitamin E before surgery, so it is important to check your dietary supplements/multivitamin carefully. After the surgery, your health care professional will likely indicate that Vitamin E is again acceptable.

As with any surgery, there are associated risks. Only you can decide whether a after weight loss surgery can achieve your goals and whether the recovery and risk is acceptable to you.

Complications can happen and include:

  • Hematoma
  • Seroma
  • Blood loss
  • Infection
  • Nerve damage
  • Blood clots
  • Organ damage
  • Scarring
  • Dissatisfaction with appearance
  • Anesthesia complications
  • Delayed healing
  • Extra skin or dog tags that are created by the surgery

Unsatisfactory results may require additional procedures. Patients will generally be responsible for any associated facility fees.

Ideally, you will have lost the weight you wanted to lose many months prior to your surgery. However if you want to lose weight after your surgery, we recommend doing so after your initial recovery process is completed — about 2 months after surgery. Your results will then continue to ‘settle in’ over the next 12 months, so for optimum results, make sure that your rate of weight loss is slow and steady. Ideally, 1-2 pounds of weight loss per week is a good rule of thumb for most people.

Once again, we recommend avoiding any rapid or dramatic weight loss as this may affect your results.

If you lose roughly 10 pounds after your surgery, and you notice some lost volume in your cheeks or under the eyes, please ask your surgeon about minimally invasive, non-surgical options such as a fat transfer (fat grafting), or injectable fillers such as Restylane®.


Also called a tummy tuck, an abdominoplasty is a surgical procedure whose goal is to remove the excess abdominal wall fat and tissue, remove abdominal stretch marks and flatten the abdomen

Lower Body Lift

The lower body lift is a surgical procedure designed to lift the buttock and outer thighs.  While an abdominoplasty lifts or tightens the front side, the lower body lift lifts and tightens the back side.

Thigh Lift

Thigh lift surgery procedures are designed to remove extra skin and fat from the thighs, particularly the medial thigh.  Skin excess of the lateral thigh ( saddle bag area ) is addressed by a lower body lift.  

Circumferential Body Lift

Circumferential body lift describes the combination of an abdominoplasty and a lower body lift.  As such, it addresses sagging of the abdomen, buttock, and outer thighs

Thigh Lift

Thigh lift surgery procedures are designed to remove extra skin and fat from the thighs, particularly the medial thigh.  Skin excess of the lateral thigh ( saddle bag area ) is addressed by a lower body lift.  

Circumferential Body Lift

Circumferential body lift describes the combination of an abdominoplasty and a lower body lift.  As such, it addresses sagging of the abdomen, buttock, and outer thighs

Arm Lift

Arm lift ( brachioplasty ) surgery procedures are designed to remove extra skin and fat from under the arms.  Learn more about the different options


Thigh Lift

Circumferential body lift describes the combination of an abdominoplasty and a lower body lift.  As such, it addresses sagging of the abdomen, buttock, and outer thighs

Total or Circumferential Body Lift

Starts at $8000

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Abdominoplasty and Body Lift in Northern Virginia

Dr. Chang Featured in a Maagazine

Dr. Phillip Chang is a leading plastic surgeon in Loudoun County who specializes in surgical and nonsurgical cosmetic procedures for the breast, body, face, and skin. He is board certified in plastic surgery by the American Board of Plastic Surgery and is the founder of Aesthetica Cosmetic Surgery & Laser Center in Leesburg, VA. Dr. Chang is dedicated to providing high-quality service that concentrates on the unique needs and concerns of his patients. He believes combining attentive care and minimally invasive techniques is the best avenue for achieving beautiful, natural-looking results. Dr. Chang is thrilled to be serving the greater northwest area of Washington, D.C. with top cosmetic care that is dependable and trustworthy.

Interested in learning more about Dr. Chang? Click here.

We are based in Leesburg, VA. Located as part of the Lansdowne medical complex, you have access to our 24-7 state-of-the-art facility as well as access to Lansdowne hospital. We are based directly across the road from INOVA hospital. There is ample parking, elevators to bring you to our third floor offices, and welcoming staff to sign you in.

We are proud of our surgeries and cosmetic procedures and love that our patients are happy too. They like to shout it out on Google, Yell, Facebook, and right here on our website. Check out our reviews here.

Yes we do!

All potential patients receive either a phone, virtual, or in-consultation for free.

During the consultation we will discuss your treatment wishes and expectations. This is the time to ask us lots of questions to really understand what is involved, what the costs will be, and what is expected of you. This is also a great time to get to know Dr. Chang.

Aesthetica has received numerous awards from the Loudoun County Chamber of Commerce, New Beauty, Best of Loudoun, Posh 7 Top Picks, and Dr. Chang is internationally known for his lectures and advances in precise surgical technique as demonstrated through his unique mini-facelift procedure.

We have three execeptionally talents cosmetic nurses:

  • Melanie Schwarz, RN, BSN
  • Katy Down, RN, BSN
  • Angela Westbrook, RN, BSN

Read more about us – we can’t wait to meet you!

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