At his heaviest , James weighed 485 pounds . Four years later he lost 300 pounds without the use of surgery .

“ I just woke up one morning and decided that I was tired of being the fat guy ,” James , who will be identified by first name only to grant anonymity , said .

From that moment on , James did everything he could to lose the weight naturally . Losing 300 pounds is quite the accomplishment but it did come with a price . James was left with excess and loose skin .

Every year nearly 220,000 people undergo bariatric surgery and whether the weight was lost through diet and exercise or surgery , it typically ends with the same result . The weight is gone , but the leftover skin remains .

Coincidentally , the more weight one person gains , the less elastic it becomes . Skin is naturally very elastic , but once its limit is reached the body begins to produce more skin cells . The sagging skin after someone undergoes massive weight loss are the over produced cells . Age is also an important factor in one ’ s skin elasticity . The younger someone is , the more

Photos Courtesy of James

James , on the far right , before his weight loss and body contouring procedure .

collagen is present in their cells and the more likely they are able to regain their original shape .

Unfortunately for James , the extra skin began keeping him from enjoying his everyday life . One of James ’ s favorite activities was road biking , but sitting in that position brought attention to his problem . “ As I would bend over you ’ d feel ( the skin ) especially in the abdominal area , you ’ d feel that skin as I was bent over biking ,” described James . He was ecstatic to lose more than half of his own weight , but his situation still left him feeling uncomfortable .

Back when James began his weight loss journey , he reached out to a friend , plastic surgeon Dr . Richard Ha . James ’ s wife and

Dr . Ha ’ s wife had grown up together , so James sought him out to do the plastic surgery after he was done losing the weight . Dr . Ha is certified by the American Board of Plastic Surgery and received his plastic surgery , craniofacial , and pediatric plastic surgery training from UT Southwestern Medical Center . He practices at Ha Plastic Surgery and the Pediatric Plastic Surgery Institute in Dallas and Frisco respectively .

Dr . Ha described his meeting with James saying , “ I was able to sit down with him and we came up with a very tailored specific plan for him . His primary concern was around his trunk , his arms and his breasts .”

According to the American Society of Plastic Surgeons , the abdominal , arm , breast and buttocks are the most common areas addressed in a body lift . A comprehensive body lift includes upper and lower body lifts . The body lift should always come at the end of any massive weight loss experience . Because every patient ’ s body is unique , a customized procedure is necessary in order to achieve the best results .

Dr . Ha continued , “ We addressed all those areas through a comprehensive body lift and his results are outstanding .”

James agreed saying , “ Now it ’ s just a natural curve and feels normal .”

Understanding and maintaining expectations plays an important role when undergoing any type of plastic surgery .

“ He ’ s going to let you know what you ’ re up against , how it ’ s going to work and the way it ’ s going to all pan out . Everything he told me in the beginning is exactly how it went ,” says James .

Now when James wakes up in the morning , he no longer has to worry about “ being the fat guy ” and he can continue participating in his favorite activities without hesitation .

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Best Docs Network Magazine Summer 2013 | Page 28

LIVING IN EXCESS How body contouring helped one man fit in his skin again .

At his heaviest , James weighed 485 pounds . Four years later he lost 300 pounds without the use of surgery .