plastic surgery revision

Need a Plastic Surgery Revision?

September 17, 2018

Taking the step toward plastic surgery after massive weight loss is a normal part of the weight loss surgery journey. For most, this is the part that completes and restores the body to the natural aesthetic.

When someone has gained a large amount of weight this internally stretches the skin which causes it to lose its strength and quality. Stretched out skin has a higher chance of healing difficulties as well as a higher possibility of developing fluid internally while healing.

Due to the poor nature of this skin, there is also a possibility of the skin re-stretching out over time. Excess skin is difficult to fit into clothing, can become irritated and infected as well as can be painful if repeatedly folded and pressed upon. Furthermore, massive weight loss has the propensity to have vitamins and nutrients deficiencies which could further lead to healing difficulties. These are some of the main reasons why men and women seek out these body contouring procedures.

When To Consider A Plastic Surgery Revision

Are you disappointed with your plastic surgery results? A “do-over” Plastic Surgery Revision is possible!

Plastic surgical body contouring procedures are safe especially when performed by an experienced board-certified plastic surgeon. However, for a multitude of reasons, sometimes the results may need a secondary revision procedure. Our bodies are naturally asymmetric and after body contouring procedures, these asymmetries could become more pronounced. Further weight gain or loss can also affect surgical results in the long run.

One of the more important aspects for anyone to understand prior to undergoing body contouring surgery is to have realistic expectations as to what can be achieved and what cannot. As a surgeon, I always want to give my patients the best results and achieve their goals. However, I have to do this within a safe and conservative manner so as to minimize the chance of complications.

Revision After Plastic Surgery: Be Safe & Be Sure

My practice has seen an increase in the amount of revision plastic surgery over the years. Partly this is due to my compassion and understanding of the mental and physical aspects of taking care of problems. I also have an immense interest in complex plastic surgical reconstructions. I was asked to be involved on the Botched! TV show, and appeared on the show due to my interest in these types of procedures.

The secondary or revision surgery is more difficult. This is because you are dealing not only with the normal amount of healing factors but also with scarring and the placement as well as blood supply to the area, and the normal aesthetic anatomic units we are trying to create.

4 Categories for a Plastic Surgery Revision

When I see a patient for revision of body contouring procedures, I place the patient into one of four categories.

1. Normal Surgical Procedure with Normal Healing, Displeased with Results

ISSUE: These patients tend to have had skin that has stretched out or has an asymmetric outcome.
DIFFICULTY: Minimal/Moderate

I consider these type of revisions to usually be on the less difficult side of the spectrum as well as a lower risk of complications with a better chance of obtaining the desired results.

2. Normal Surgical Procedure with Abnormal Healing

ISSUE: These patients have had a great surgical plan but have experienced a complication such as healing issues, fluid buildup, bleeding or infection.

These types of revision surgeries are considered moderately difficult, with a moderate chance of complications. Depending upon the severity of the complication, the desired results may be achievable.

3. Abnormal Surgery with Normal Healing

ISSUE: These patients have typically gone to an inexperienced doctor who has not performed the type of surgery necessary to achieve the patient's goals. However, they have healed without any complications.
DIFFICULTY: Complex/Severe

These types of revisions are complex and require a complete understanding of the normal anatomy, the type of surgery that was performed and how to best use what we have and make it more aesthetic and/or anatomic. The surgeries are considered very difficult to achieve completely desirable results. The goal here is to not create more problems or complications.

4. Abnormal Surgery with Abnormal Healing

ISSUE: All too often when a poor surgical plan is decided upon there is a very good chance of having higher complications.
DIFFICULTY: Advanced, Complex, Highest Risk

These types of revisions are extremely complex and difficult. A lot of times our goal is to just restore function. These procedures require complex thinking including the use of flaps or tissue from adjacent areas.

Your Body, Your Goals, Your Surgical Plan

Overall, anyone that has had a normal or standard surgical procedure and has experienced an outcome that is less desirable has a better chance of achieving their goals. Anyone that has had an abnormal surgical procedure, meaning the proper procedure for them, can still achieve their goals depending upon the severity of the deformity.

Any surgical revision needs to consider every aspect including the areas that have not been operated on and how it will affect them. These procedures also require even more safety and diligence including the use of liposuction and skin only removal such as my Body LipoLift®.

The average time from procedure to revision is typically about a year. At this point, most of the healing, as well as swelling, is back close to normal. Rushing a revision procedure without allowing ample healing time can increase the risk of complications and less desirable results.

Plastic surgery revision(s) take a specialized thought process to understand the problem, the challenges, and the desired outcomes. It is possible to achieve your desired goals which sometimes may take some extra procedures.

What is the Best Solution for Me?

The best way to get understand the complexity of your case and the best outcomes to expect is to schedule one in-depth consultation. You should expect a plastic surgeon to meet with you and spend the time it takes for you to have a thorough consultation. As an example, we spend a significant amount of time to understand your medical history, your goals, your previous surgeries and then craft a realistic plan for you. Of course, we are by your side every step of the way.

jaime schwartz


Jaime S. Schwartz MD, FACS, is a highly regarded expert & leader in the field of plastic surgery. Dr. Schwartz is known for his compassion & commitment to safety and advancing the field of plastic surgery through new techniques and procedures. From Dr. Schwartz’ values and relentless “patient-first” commitment, his practice is dedicated to both education and safety. Connect with Dr. Schwartz on Instagram.

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