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Shedding Excess Skin and Fat Through Body Contouring

February 2016

Whether you’ve experienced massive weight loss from lifestyle changes like diet and exercise or through bariatric surgery, what’s still hiding under your clothing may be making you feel self-conscious and not like your true self.

The excess skin and fat that remains after losing a significant amount of weight is often the final barrier for both men and women to feel better about themselves, but they can overcome this barrier through body contouring.

Both male and female patients often see themselves as obese even after undergoing massive weight loss, says C.B. Boswell, MD, plastic surgery specialist with BodyAesthetic Plastic Surgery & Skincare Center and chief of staff at Barnes-Jewish West County Hospital.

“It’s hard to see the results even after losing the weight, exercising and eating better because of extra skin and fat,” he says. “In addition, patients may be at risk for common concerns associated with extra skin, such as yeast infections, being physically uncomfortable and feeling uncomfortable about their appearance.”

Dr. Boswell sees approximately 50 percent of his patients for some type of body contouring procedure to eliminate excess skin and fat that remains. The majority have lost weight following bariatric surgery (weight loss surgery), while the remaining 25 percent have lost weight with diet and exercise.

Dr. Boswell performs several common body contouring procedures at Barnes-Jewish West County Hospital, which has a private wing for plastic surgery patients with private rooms and highly trained nurses who work regularly with plastic surgery and bariatric surgery patients.


Common Body Contouring Procedures

The procedures include:


  • Brachioplasty (arm lift)
  • Thigh lift
  • Facelift
  • Circumferential body lift, which includes removing loose skin in the abdomen, flanks and back.

Each patient is unique and can require one or several of these procedures to address their needs. We prioritize based on what bothers them the most,” Dr. Boswell says. “For most patients, removal of excess skin of the abdomen is their most important issue and this is addressed by a circumferential body lift. This is usually combined with a brachioplasty to address the excess arm skin.

“As a secondary procedure we commonly address the breasts and thighs. The breasts may require a lift, reduction, or augmentation as people lose their weight in different ways. If necessary, a facelift or necklift can be performed to address the loose skin of the neck,” he adds.

Dr. Boswell often sees patients both during their weight loss phase and after weight loss to discuss whether they are both physically and emotionally ready for this next step in their journey. His patients are typically in their 30s, 40s and 50s, but he has seen patients both younger and up to their 70s.

“We meet personally with patients to ensure they have reached their goal weight and remained at a stabile weight for three to four months prior to any procedure,” he explains. “It’s important to wait until they have reached their plateau for weight loss, since additional weight loss could lead to more loose skin.”

Being able to help patients feel more confident after losing the weight is why Dr. Boswell calls this the “most rewarding aspect of his practice.” He continues to see these patients for up to two years, with many coming back for additional procedures and becoming “patients for life.”

“These patients have worked hard to get where they are,” he says. “The body contouring procedures often make them feel like they’ve truly lost the weight.”

Dr. Boswells’s practice—BodyAesthetic Plastic Surgery & Skincare Center—is accepting new patients, with same-day appointments available. To schedule an appointment with Dr. Boswell or another specialist, call 314.542.WEST (9378) or toll-free 844.542.9378 or request a call for an appointment.


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