Joshua Fosnot, MD
For many patients, plastic surgery and body contouring are topics of conversations, following bariatric surgery. To learn more about the process, we caught up with Joshua Fosnot, MD, board-certified plastic surgeon at Penn.
Can you tell us a bit about body contouring surgery?
Body contouring is a category of procedures (including abdominoplasty, breast lift, arm lift, thigh lift) that can be performed on patients not just from an aesthetic prospective, but also massive weight loss patients who have a lot of excess skin, and sometimes there's fat that's still there.
I tell patients it's all a trade-off. With body contouring, you improve upon the contour and excess that they have in certain areas, in exchange for long scars. All of the procedures involve pretty long incisions.
Who is a candidate?
Body contouring is an option for many people. {The case} doesn't necessarily have to just be a massive weight loss patient. Massive weight loss patients, in general, are good candidates for it because of the nature of how we lose weight. When you have a significant weight loss, you lose the fat, but the skin doesn't recoil the way an 18 year old's would if they were to have gained and loss weight.
How long after weight loss should patients start thinking about body contouring?
Since bariatric patients generally continue to lose weight for a full year after the procedure, I like to see patients when their weight has been stable for about six months. So, if they're still losing weight after a year, then maybe a year and a half after their surgery is an appropriate time to start thinking about these things. We also have to make sure they're healthy, from a medical and nutritional stand point. Since this is an elective procedure, we want to try to optimize their results by having them in the best shape that they can be in.
What should patients expect after body contouring surgery?
First, the thing about the body contouring consult that can be challenging is sorting out who is a good candidate for surgery. Not everyone that comes in the door is a great candidate for different reasons.
Second, is financial coverage. Most patients don't realize that insurance is not going to cover body contouring; it's actually probably a minority of procedures that we're able to get covered by insurance.
Third, all procedures involve pretty long incisions, so the recovery period can be long.
What's the best part of this job?
These patients can be some of the happiest patients I've had in plastic surgery. They're very grateful. And that's one of the reasons why I do this work. Because the patients are very happy with the results.
You can learn more about ways to prevent and minimize excess skin here.