Introduction Obesity is a major health concern for many people in different countries around the world, and the United States is no different. Bariatric surgery is a solution for obesity that more and more people resort to either because they don’t feel good with themselves anymore or just because they are confronted with health issues that can’t be solved unless weight loss occurs. In a vast majority of cases, people don’t undergo bariatric surgery for aesthetic reasons as they often get used to the appearance of their bodies in time, but only because they need to get relief from the medical issues combined with obesity or because they finally understand how obesity is threatening their lives. The aesthetic part usually occurs after weight loss when the patients of bariatric surgery want to look their best, and they notice there is a considerable amount of skin sagginess on the body that doesn’t allow for a beautiful shape. In this article, we will discuss more about undergoing plastic surgery after bariatric surgery, especially breast reduction surgery. Plastic surgery after bariatric surgery Despite the fact that plastic surgery was never used for or provided methods for weight loss, many people still tend to believe that if they undergo plastic surgery, they can get thin and lose weight. This is not true, and we can’t say this often enough. The part of medicine that deals with weight loss is bariatric surgery, while plastic surgery is only concerned with the aesthetic part of the body. But in a certain way, plastic surgery and bariatric surgery are connected. We can even say that nowadays there is a new line of post-bariatric surgery that has developed due to the development of bariatric surgery and as a result of the increased rate of obesity in people worldwide. Patients that choose bariatric surgery can lose a considerable amount of weight, like tens of kilograms in a short period of time, sometimes in weeks or just a few months. Their transformation can be absolutely spectacular in terms of how much they weigh; however, this doesn’t mean that after weight loss a harmonious appearance of the body occurs instantly. What happens after bariatric surgery and weight loss is that the patient is left with a massive amount of saggy skin that distorts the contours of the body and creates issues such as difficulties in finding clothing and dermatological conditions due to the rubbing of skin on skin in the areas with a cutaneous excess. To understand what happens after weight loss and why the patient won’t be able to regain the beautiful contours of the body without help from plastic surgery, you need to have an idea what happens when we gain weight. When weight gain occurs, the fat cells of the body increase their volume, sometimes exponentially. With their growth, there are the other tissues of the body that are affected, mostly the skin. The skin of a person who is obese is stretched over the limits for a long period of time, and this means that the skin has a poor tonus and little elasticity. In other words, the skin won’t jump back and retract on the new contours of the body, even if the patient is young. Some patients believe that if they exercise and wait long enough, the skin left behind after bariatric surgery will retract. This can’t happen because physical exercises help with muscle tonus, but can’t improve the tonus of the skin that is already saggy. The only real and effective solution to contour the body and improve the features after bariatric surgery is to have plastic surgery in areas affected by the skin excess. In some cases, the skin folds that are saggy after bariatric surgery can be so massive that they weigh a few kilograms. After plastic surgery, they are removed and the life of the patient will also be much improved. The procedures offered for patients who had bariatric surgery target all areas of the body such as the abdomen, flanks, thighs, breasts, arms, and even the buttocks. Generally speaking, we are talking about body lift procedures that aim to reduce the excess skin and underlying layer of fat. In a vast majority of cases, the plastic surgeon will also recommend liposuction to be combined with these procedures in one operation as compared to having them performed separately. Depending on the complexity of each case, the amount of skin sagginess, and also the placement of skin folds, the plastic surgeon might decide that one procedure is required or two. The procedures are often performed about six months in between to allow the patient to recover from the previous procedure. These procedures can take up to five or six hours and are performed with the patient under general anesthetic. So when it comes to plastic surgery after bariatric surgery, we are mostly talking about an excess of skin combined with an underlying layer of fat that also needs to be eliminated to contour the body better. But when it comes to the breasts, things can be more complex. Breast reduction after bariatric surgery The common procedures necessary after a significant weight loss are body lift procedures, so you might think that a breast lifting would make your breasts look just great after you had bariatric surgery. But it can be the case that you actually need a more complex procedure, and breast reduction can allow you to get the breasts that you want and which are proportionate to the rest of your body. Breast reduction surgery will eliminate a part of the mammary gland as well, together with the skin and fat tissue. This procedure is sometimes performed on women who had bariatric surgery (and even men) as obesity is one of the factors that can cause the overdevelopment of the mammary gland due to the hormonal changes that occur in the body. When breast reduction is performed after bariatric surgery, it is often combined with liposuction of the abdominal wall and the sides and even with a tummy tuck or brachioplasty (lifting of the arms). After combining these procedures, the patient can enjoy an enhancement and improvement of the whole upper body which can considerably change the image of the patient. Unlike the breast lift that only deals with the skin and fat tissues, breast reduction addresses the mammary gland. This means that there will be long term consequences after this that are more notable compared to the breast lift. The main long-term consequence after having a breast lift after bariatric surgery is that scars are left behind. After breast reduction, we also have permanent scars, but also consequences combined with the woman’s ability to breastfeed. When breast reduction is performed, a part of the mammary gland that is in excess is removed. But this part of the mammary gland also has milk ducts, and this means that the milk duct network can be severely injured when eliminating a part of the mammary gland. Moreover, the nipple and areola complex need to be repositioned. This means that we need to section the connection that the milk ducts have with the nipple, hence breastfeeding can be problematic or impossible. Breast reduction after bariatric surgery might be recommended to make the body more harmonious and not to be left with overly large breasts that could cause difficulty for the patient to become physically active. Before scheduling breast reduction after bariatric surgery, make sure to discuss all the details of the procedure with your plastic surgeon. Conclusion Bariatric surgery is a method we use nowadays to help people with obesity to lose weight. However, when weight loss occurs suddenly and in a short span of time, the skin becomes saggy and the overall appearance of the body is not very contoured or aesthetic. This is the reason why many patients of bariatric surgery need to resort to plastic surgery to enhance the appearance of their bodies and get rid of the saggy skin folds. But it is not only the skin folds and the underlying layer of fat that could be a problem for patients of bariatric surgery. One of the causes of the overdevelopment of the mammary gland is obesity and hormonal changes. This means that it is frequent for people who used to be obese to be left with an excess of mammary gland after weight loss. This can happen to both men and women. When performed on women, the procedure is called breast reduction and will eliminate the excess of skin and fat, but also the surplus of the mammary gland. When the procedure is performed on men, we call it a gynecomastia.