According to Dr. David Hing, the choice of technique will depend upon the patient's distribution of extra fat padding and extra skin after their diet, exercise or surgery. Some patients will retain extra fat and skin in the thighs. They may be candidates for a lower body lift. Some patients will have only extra skin and fat in their trunk and may be candidates for abdominoplasty with or without upper body lift. The closer each patient is to attaining their goal in pounds lost, the better they will be as a candidate for body contouring. That is, if they are where they want to be with their weight loss, they can have their body contouring maintain their surgical appearance. On the other hand, if they intervene with body contouring before they have lost all of their weight, and then lose weight after body contouring, they will be at risk for "loosening up" their surgical result and creating sagging of the skin. The exact technique will depend upon a detailed in person consultation with a board certified plastic surgeon experienced in body contouring for the massive weight loss patient. There is variability from each patient to the next, which requires an individual approach for each weight loss patient. Once you have had your consultation, you will have a much better idea of which techniques you should consider.