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The Ripple Effect of Weight Loss Surgery

Can one weight loss surgery lead to another? Yes, according to a surprising new report from the American Society of Plastic Surgeons.

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Statistics about plastic surgery typically present some intriguing insight into the greater culture of a country: Knowing that women are clamoring for butt implants (ahem, Brazil) or cutting their eyelids to look more Western (Korea) can explain so much about the standards of beauty in those societies. The American Society of Plastic Surgeons (ASPS) just released their 2014 report, and, sure enough, the findings shed a light on what beauty means to Americans.

It turns out, the fastest-growing plastic surgery isn’t breast augmentation or lip filler or general plumping of any kind, but instead the exact opposite: There’s been a rise in the procedures associated with weight loss surgeries, namely tummy tucks (which increased by 9 percent since 2013, the biggest one-year jump in half a decade), thigh lifts, and similar surgeries to deal with excess skin. And this increase correlates with the greater cultural trend of massive weight loss, as aided by gastric bypass or other bariatric surgeries. (You won’t believe How Many People Got Butt Implants Last Year.)

Why the rise in weight loss surgeries now? Look at several factors, says Scot Glasberg, M.D., the president of the ASPS and a plastic surgeon based in New York City. “There has been enormous media attention on obesity in recent years, and the classification of obesity as a disease,” he says. The latter amendment came from the American Medical Association at their annual meeting in 2013, after the organization pondered the change for years. It was a symbolic change—obesity has always carried health risks—but the ASPS report reveals that 179,000 Americans underwent weight loss surgery that same year (according to the American Society of Metabolic and Bariatric Surgery, that’s the most since 2009 and the third highest number on record). (Has Body Image Become Oppressive? A Look at the Backlash Against Beauty.)

TV shows like The Biggest Loser, Extreme Makeover, and Extreme Weight Loss don’t always depict the lingering effects of those major changes. Extra skin is left behind, and it’s not just cosmetically undesirable. “After patients lose weight, the hanging skin can rub and chafe,” Glasberg says. “They get rashes, or even infections. The skin can easily interfere with your daily activities.”

 Thus the rise in lifts and tucks. “Typically, it starts in the trunk area,” Glasberg says, or the lower waist, thighs, back, and even upper arms. Brachioplasty, or arm lifts, saw their biggest single-year increase half a decade, as did thigh lifts. These surgeries typically involve removal of the extra skin and tightening of the area beneath.

“There is certainly a ripple effect from pop culture,” Glasberg admits, but these follow-up surgeries are less of the Real Housewives-style plastic surgery obsession, and more of a necessary step after a healthy change to one’s weight. “Clearly, once [patients] start and have a pleasant experience, they’re likely to go on to additional surgeries.”

So while there are plenty of surgical trends that might herald the cultural apocalypse—vaginal rejuvenation, really?—this particular rise correlates with a greater attention to one’s health. And that’s certainly something we can understand.

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