Surgery to treat deformities from major weight loss is a major undertaking. This is why it is typically done in stages. There is a saying in surgery, "major surgery = major complications." Some surgeons have reported complication rates as high as 100 percent. Indeed, it depends on how you define a complication. Seromas are relatively common because large areas are often undermined, particularly when done with an abdominoplasty. Complications include infection, delayed wound healing, scar deformities, asymmetry, and contour deformities. The skin deformity is such that perfection is not possible. Scarring is significant and not as good as we'd like. However, these patients are grateful for the improvement, and tend to value correction of the loose skin over scarring, which they consider secondary. Touchup procedures are common and should be expected.

Skin Necrosis Case Study

Outer thigh lifts, buttock augmentation with transposition flaps.

Comments: When this patient's dressing was removed, the adhesive from the tape took off a layer of skin. Unfortunately, this was not just a superficial loss, but caused a full-thickness loss of tissue. This is a very unusual occurrence after simply removing microfoam tape and one that makes the surgeon think, just when you think you've seen it all... The wound was allowed to heal on its own, contracting and shrinking the area. The scar was then removed by re-excising additional skin on both sides. This patient wished to have her scar lowered slightly anyway, and this revision provided some additional lift for the buttocks. Tape was not used again for this patient.