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The most popular weight-loss surgery in the United States is gastric bypass, a procedure that limits the amount of food your stomach can hold and affects the body's absorption of calories and nutrients. The Lap-Band is another option, but it affects the size of the stomach simply by the placement of an inflatable band around the stomach, without altering the digestive process. This band can be loosened or tightened as required to limit the size of the stomach pouch. Used worldwide for a number of years, it is the only weight-loss device available in the United States, approved by the Food and Drug Administration.

Since these procedures are minimally invasive thanks to advances in laparoscopic surgery, recovery generally is speedy. Gastric bypass still requires at least an overnight hospital stay, but the Lap-Band procedure can be performed on an outpatient basis. While these are reversible in theory, they rarely are because doing so will result in weight gain.

How fast does the weight come off?

Gastric bypass patients generally lose 50 percent of their excess weight in the first year, and up to 70 percent of this excess weight stays off for the long term. Weight loss with the Lap-Band is slower, averaging about three to four pounds per month, with 50 percent to 60 percent of the weight staying off for good. To optimize weight loss, patients need to develop healthy lifestyle habits such as frequent exercise and compliance with their post-bariatric surgery diet.

After surgical weight loss

When someone loses a large amount of weight after weight loss surgery, the excess skin can be equated to a deflated balloon. The body may be toned underneath, yet so much loose skin exists that you may not be able to wear normal clothing. Severe cases of excess skin can also lead to rashes, irritation and physical discomfort. In these instances, body lift surgery is the only recourse, essentially trimming the excess skin so it conforms to the body's new contours.

Before considering body contouring after massive weight loss, patients should be at a stable weight for about six months, which depends on the surgical weight-loss procedure used. Because no two people are the same, skin-reducing reconstruction surgeries must be custom designed for each patient. The procedures, usually performed in stages, can be limited to particular areas of the body. That includes the breasts, arms, multiple regions as with the circumferential body lift, which can remove excess skin and stomach, thighs and buttocks, or address fatty tissue from the middle and lower abdomen, hips, outer thighs, back and buttocks, as well as tighten the muscles of the abdomen wall in one or two stages. A number of patients will also need additional surgery down the line to refine results, but these secondary procedures usually are less extensive.

Body lift surgery is like the completion of a journey. Although the two or three stages of surgery can take a year or more, these procedures bring massive weight loss patients back to the realm of normalcy. Although health insurance does not cover most of these procedures, it may be tax-deductible, so be sure to speak with your accountant.

Paige Herman is an editor at New Beauty, a semi-annual magazine about cosmetic enhancement. Simon Fredricks is a medical doctor. Distributed by Scripps Howard News Service.