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Adam G. Tattlebaum M.D.

Massive Weight Loss Surgery

Featured case 200 pound weight loss:

Excess Skin Surgery Cosmetic Surgery Group in Washington DC
The patient in the before and after photos above lost almost two hundred pounds before seeking plastic surgery. I start here with this complex example because she has had three very common surgeries for a massive weight loss patient. She has had a Brachioplasty or arm lift, a mastopexy or breast lift, and a Fleur de lis Abdominoplasty or tummy tuck. This special kind of tummy tuck tightens skin both vertically and horizontally and is more common in the weight loss patient.

General concepts I share with my massive weight loss patients.

My weight loss patients are what I call works in progress. There is always something that needs tightening. The key to approaching my weight loss patients is to make a safe and common sense game plan. As we orchestrate multiple skin tightening procedures we want to make sure that we can do so in an orderly way so that one procedure does not take away the possibility of another. Multiple procedures can be performed at the same setting depending upon the patient’s health and the extent of the surgery. As a general rule I prefer to keep my patients out of the hospital. I plan surgeries that are reasonable and safe for outpatients. Below are examples of some of the common surgeries in the mass of weight loss patient.


After massive weight loss fat in the face disappears, the skin becomes loose and the neck and jowels can become more prominent. Facelift and other formas of facial rejuvenation can tighten the neck and jaw line.
Facelift after weight loss

Brachioplasty or arm lift:

Brachioplasty tightens loose skin of the arms after massive weight loss: There are different types of brachioplasty depending on the amount of skin laxity.

Brachioplasty standard

Brachioplasty standard This patient had a full brachioplasy excising loose skin under the arms. The scars are hidden underneath. Brachioplasy removes skin and fat. Liposuction would have made this skin looser.
Brachioplasty after weight loss

Extended Brachioplasty

Extended brachioplasty removes loose skin beneath the armpit as well. This scar is about 6 months old. While clearly the scar is a trade off in this operation for patients who carry this much extra skin after massive weight loss it is a worthwhile trade.
Extended Brachioplasty
Before Brachioplasty Surgery


After Brachioplasty Surgery


Brachioplasty Short scar:

Short scar Brachioplasty takes a wedge of skin out under the arms. It gives a limited amount of vertical pull and a subtle result.rejuvenation can tighten the neck and jaw line.
Short Scar After Massive Weight Loss

Breast Lift:

This post partum woman lost almost 100 pounds.* With weight loss the fat in the breasts can be lost as well and the breasts become droopy and saggy. This patient had a full mastopexy or breast lift. She also had a tummy tuck. While there are smaller kinds of breast lifts that can leave smaller scars, a full breast lift, as in this case tightens the skin the most and is most common after significant weight loss.
Breast Lift After Weight Loss
Excising Skin
Surgery After Significant Weight Loss
*Results May Vary: Causes for being overweight or obese vary from person to person. Whether genetic or environmental, it should be noted that food intake, rates of metabolism and levels of exercise and physical exertion vary from person to person. This means weight loss results will also vary from person to person. No individual result should be seen as typical.

A Word From The Doctor

Welcome to my new and updated website. I hope you find it not only better than my old one, but different from the many others you may be looking at.

As a Maryland plastic surgeon I worry that there is not only too much plastic surgery information on the internet to sort through, but that much of it is more hype than substance. I hope you will consider this new site a teaching tool. I have put it together in an effort to answer the most common things my patients want to know.

I hope as you read this site, you will have a sense of how I think cosmetically and how I have approached my patients. By no means is my way the only, but the thinking that I have used and honed over the past 18 years has served me well. I hope it will be of benefit to you.

Each patients results will be different depending upon their goals and starting situation, but I try to present here concepts that will be helpful in considering what is right for you.

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