New data released by the American Society of Plastic Surgeons (ASPS) has revealed that an increase in the number of bariatric surgery procedures is beginning to have a ripple effect in plastic surgery, with more patients opting to have including tummy tucks, thigh lifts, breast lifts and upper arm lifts. In 2014, these procedures grew at their fastest rate in four years, mirroring a similar increase in the growth of bariatric surgery procedures, according to the report.

“We think there is a correlation between the two types of procedures, and we expect that trend to continue,” said ASPS President, Dr Scot Glasberg, private-practice plastic surgeon based in Manhattan, New York. “Post-massive weight loss patients are the number one growth area I have seen in my practice, and I’m sure that’s the case in many doctor’s offices across the country.”

In 2013, 179,000 Americans underwent weight loss surgery, averaging nearly 500 procedures every day, and according to the American Society of Metabolic and Bariatric Surgery, that is the most since 2009 and the third highest number on record. Since then, plastic surgeries related to weight loss have also increased.

Thigh lifts and upper arm lifts had their biggest single-year increase in five years in 2014, both up nine percent. Tummy tucks inched up four percent and breast lift procedures posted a ten percent increase, the largest single-year gain since 2009, when the ASPS began tracking procedures performed specifically on massive weight loss patients.

“You can’t attribute that to anything other than the fact that there are more massive weight loss patients out there looking to take care of the problems that they now have after their weight loss surgery,” added Glasberg. “On the one hand they are thrilled to have lost so much weight, but they are trading one dilemma for another.”

Those who experience massive weight loss are often left with excessive amounts of sagging skin, particularly in the thighs, under the arms, around the abdomen and in the breasts. The excess skin can not only be unsightly and uncomfortable, in many cases it can be painful.

“It was hard for me to exercise. I couldn’t do aerobics or even run because the excess skin was so bad, and no amount of compression would change that,” said Jan O’Daniel of Pickerington, Ohio. Six years ago O’Daniel underwent bariatric surgery and lost more than 130 lbs, but no matter how much weight she lost, she still did not like her appearance. “I carried a lot of weight in my abdomen and felt like my stomach was just as big. Even though I knew it wasn’t, even though I knew my clothing size had gone down six sizes, I still focused on my belly and it absolutely drove me nuts.”

“That’s not uncommon,” said O’Daniel’s plastic surgeon, Dr Jason Lichten of Lancaster, Ohio. “These patients have the tremendous psychological burden of looking into the mirror and seeing all of this extra skin that’s hanging off of them, and no matter how much weight they lose, a lot of them still see themselves as heavy because of it.”

In 2014, nearly 45,000 patients who experienced massive weight loss also opted to undergo plastic surgery to reshape their bodies. While those numbers represent the biggest single-year increase in nearly a half decade, it’s still only a fraction of patients who may benefit from it.

“Going forward, we’d like to be a part of the process from the outset, when patients are first starting to consider weight loss surgery,” said Glasberg. “A lot of times patients think weight loss surgery is the answer to their issues, when in reality it may only be one step in the process.”

“If plastic surgeons can get involved with patients earlier, we can not only give them a more realistic idea of what to expect from a physical standpoint, but we can help them devise a plan for any follow up procedures after their weight loss,” said Lichten.

That’s something O’Daniel wishes she’d done. She was so focused on losing the weight, she didn’t realize there could be follow up surgeries. “I didn’t realise plastic surgery was an option,” she said. “I thought it was out of reach for me from an affordability standpoint, but it wasn’t. I’m glad I did it, because it changed my life.”