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Many of these surgeries are "same-day" procedures that are performed under a "twilight" sedation at the University Cosmetic Surgery Center. As with any operation, plastic surgery carries some risks that will be explained by the surgeon.

The Face

Weight loss is often dramatically evident in a person's face. But hanging folds of skin around the face and neck can make a person appear older and tired. During a facelift, the extra skin and fat are removed, muscles are tightened, and the skin is repositioned. Unlike the facelifts of several years ago, today's procedures have been refined to produce a more natural look.

For the upper one-third of the face, a browlift can remove creases and furrows. This minimally invasive surgery is done using tiny, hidden stitches. Eyelid surgery can be performed on the upper lids, lower lids, or both to correct such problems as "bags" under the eyes or heavy, drooping lids.

The Arms

A problem area for many people after losing weight is the upper arms. The extra skin hangs from the arms, creating a "batwing deformity;" this can be especially embarrassing for women who want to wear sleeveless garments. Weight-bearing exercise, while important for improving muscle tone, does nothing to counter the extra skin.  A cosmetic procedure can remove the excess fat and skin from the arms. There is scarring that is potentially visible along the inside of the arms.

The Chest

For both women and men, sagging breasts can be an undesirable result of weight loss. Women can opt for a breast lift, which does not increase or reduce size, but molds and repositions the breasts and nipples. Or, to increase breast size and add fullness, saline-filled implants can be inserted through breast augmentation surgery. Men can also have residual fatty tissue and skin removed from their breasts. The surgery for post-gastric bypass men, unlike the procedure to correct gynecomastia (prominent breasts), contours the chest and requires a larger incision.

The Abdomen and Thighs

Abdominoplasty, or a "tummy tuck," removes extra skin and tissue and tightens the abdomen's muscle layer. The focus is on the middle and lower abdomen. If the patient needs "all around" contouring, a circumferential body lift addresses the front and back areas.

With a thigh lift, the skin is tightened to make the thigh look more attractive. Thigh lifts have the potential for visible scarring, but can, nevertheless, produce great results.

Liposuction, which removes fatty deposits from either the abdomen or the thighs, can enhance these procedures by creating a more pleasing contour. Liposuction by itself is rarely a procedure of choice in people who have lost a lot of weight.

Insurance

About two-thirds of the time, insurance companies will not cover the cost of these procedures. Cash or credit cards are acceptable methods of payment, but the University Cosmetic Surgery Center at University Hospital is developing a way to make paying for these surgeries easier. It is sponsoring a special savings club that enables gastric bypass patients to place the amount of money they would normally spend on food into an account that they control. It is similar in concept to a Christmas club. By the time their weight loss has stabilized, participating patients have money in an account to use for cosmetic surgery, if they so choose.

For more information about these procedures or others, call the University Cosmetic Surgery Center at (973) 972- 8071 or visit the University Cosmetic Surgery Center Website: www.TheUniversityHospital.com/plastics/

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