Lost weight… now what? The skin problem nobody warned you about [Shannon O'Brien, MD, Portland]

Eva Sheie (00:00):
You're listening to Where Before Meets After. The number of people losing weight is much greater right now because of GLP-1s. Is the mommy makeover similar to post-weight loss surgery? Is there anything different about it or is it pretty much the same?

Dr. O'Brien (00:19):
I'd say the difference between mommy makeover and weight loss procedures is it really has to do with how focused the problem area or the area of concern is. Sometimes folks, depending on where they carry extra weight, may have extra skin going into their armpits and going all the way around their hips and their sides and even to the back or buttocks. Whereas mommy makeover related to pregnancy tends to be much more focused in the front, mostly the breasts and the abdomen. And so the scope tends to be a little more focused. Of course, some people gain a lot of weight around pregnancy, some of it intentional and some of it sometimes accidental. So their sick can be a little bit of overlap once ladies get back to their pre-pregnancy body shape and self, but there's a little bit more involved with post weight loss surgery a lot of times.

Eva Sheie (01:26):
That makes sense. It's your whole body that's lost weight.

Dr. O'Brien (01:29):
It's your whole body.

Eva Sheie (01:30):
Not just the front.

Dr. O'Brien (01:33):
Yeah.

Eva Sheie (01:33):
Or if you lose a lot of weight, then maybe you realize now I do need a mommy makeover where maybe you didn't realize it before.

Dr. O'Brien (01:40):
Sometimes the skin laxity becomes more obvious where if you carried a little more weight in your tummy still after pregnancy and then that weight is lost then whether in the breasts, which have fat as well as the abdomen, all of it can become obvious after weight loss.

Eva Sheie (01:59):
Could you do an arm lift at the same time as a tummy tuck and breast surgery? Can you do all of that together?

Dr. O'Brien (02:06):
I usually try to focus attention on two body parts at a time. So if somebody came in and their arms bothered them more than their breasts, for example, I would say, "Let's do your arms and your belly first and then we can come back and do the breasts." But I tend to try to have people who've lost a lot of weight prioritize what bugs them the most and try to get that done in the first operation, just to make sure that they are feeling their best after that and then can come back with subsequent procedures to deal with the next body part.

Eva Sheie (02:41):
I saw an after photo this week of a girl who'd lost a ton of weight and had an abdominoplasty. And so her abdomen looked flat and smooth and really cute. And then if you looked at her legs, she looked like the melted candle.

Dr. O'Brien (02:56):
It happens. Yeah. So there are often after significant weight loss, a series of operations that end up needing to take place. And it's for that reason, one thing looks great and then it makes the next part stand out a little bit more. And so then you go on to do the next thing. That's why folks who've lost a lot of weight tend to kind of keep coming back because they feel good about what they've changed. They feel good about their weight loss. And then there's X body part that's still kind of that outlier.

Eva Sheie (03:34):
Thanks for listening. I'm your host, Eva Sheie. Follow the show and submit questions for our experts at wearbeforemeetsafter.com. Where Before Meets After is a production of The Axis.