Prior to plastic body correction a stable body weight should be attained. The best results are achieved in patients who are close to their ideal weight and are able to maintain this weight. Plastic body correction should typically be carried out 12 to 18 months after bariatric surgery in patients who have been able to maintain a stable body weight for at least 3 and ideally 6 months.

Drawing up a treatment plan guarantees the optimum results and increases safety for the patient. In individual cases the desired result can be achieved in one single operation, however a series of operations is often required over a period of one year to eighteen months. In planning it is important that each region of the body is not only defined by its own anatomy but also by the anatomy of the adjacent regions.

The appearance of the upper arms also incorporates the area of the lateral thorax wall and breast, therefore. This means that an upper arm lift also has an influence on the shape of the breast and in many cases external appearance can only be improved through correction of the breast, flanks and upper arms at the same time (upper body lift). Most patients want a correction of the abdomen first. A lower body lift (circumference abdominoplasty) not only lifts the abdomen, but also has additional positive effects on the thighs, posterior and back.

It is therefore sensible to stagger individual operative steps and allow a certain time to pass between the individual stages (at least 3 months). The patient should be made aware of this concept, above all patients who are looking for a “quick fix”. Attention should be drawn in particular to the extent of expected scarring. The reduction of  excessive skin generally entails long scars. These scars will certainly be positioned as unobtrusively as possible, but a characteristic of patients with massive weight loss is that these scar “wander” or “shift” over the course of time.