Regional dermolipectomy as treatment for sequelae of massive weight loss.

Dermolipectomy is the most important procedure for treatment of the deformities engendered by massive weight loss. It remains the only treatment for excising redundant skin. Although liposuction is useful for removing fatty deposits without traditional surgical incisions, its application is limited by the ability of the skin to contract and conform to the newly sculpted figure. Thus liposuction may serve as an adjunct when treating the sequelae of weight loss but not as a primary procedure. In response to changing expectations, reconstructive surgeons have developed increasingly ingenious and specific dermolipectomy procedures to minimize or hide scars, lessen morbidity, and enhance function. Liposuction in combination with dermolipectomy has expanded the applicability of traditional procedures to a wider variety of patients. Surgical history, patient selection, surgical planning, a spectrum of regional dermolipectomy procedures, and potential complications are discussed herein.