Dr. J. Peter Rubin, the surgeon who built UPMC's Life After Weight Loss Center, has played a big role in the development of the special field of body contouring after massive weight loss, which came in response to the growth of bariatric surgery in the mid-1990s.

The increased bariatric surgeries were prompted by the introduction of laparoscopic techniques.

"Prior to 2000 or 2001, very little was written about [body sculpting]," Dr. Rubin said of body contouring, or the body lift, in a recent interview. "I was in Boston doing my residency [in Harvard University's plastic surgery program] about 1999 to 2000, and I became aware of innovations that people were having with [gastric] bypass surgery and recognizing problems with excess skin."

The latter piqued his interest, and during his residency he used an elective period to learn more about it.

"I spent time with some of the gurus of body contouring, doctors on the leading edge. I learned good principles and techniques. That was around 2000, 2001," he said.

"The most influential was [the late] Ted Lockwood, who was in Kansas City. He was a very forward-looking thinker. He very much inspired me. He developed core techniques in body contouring. Everything evolves, but he laid down the foundation of what we do today.

"He's very well recognized as the father of the body lift."

And now Dr. Rubin is known as the father of the "bra lift," a procedure that uses the patient's own tissue to create an internal brassiere and better support the new shape of the breast. Additionally, tissue from the side of the chest can be used to both increase breast size and eliminate extra skin alongside it. The scar is hidden beneath the breast.

But the surgeon minimizes the import of that achievement.

"We definitely have innovated new techniques, but we're concerned with the care of the entire program. It's one thing to do the surgery, but you have to ask, 'Is it time for surgery? ... Is this the right procedure that we're doing?' Remember, this is a really new field," he said.

"During my residency I was already thinking that's what I wanted to do. It's really exciting to be on the frontier of a new field," he added.

"I came out to Pittsburgh with the idea to set up a program in body contouring. That was in 2002."

Now he has a team of eight. Members include researchers, medical weight management specialists, psychological and behavioral specialists and a nutritionist. The program also includes visiting fellows, who stay for a year. "We attract the top graduates from plastic surgery programs," Dr. Rubin said.

"I have a wonderful team in the [operating room], and this surgery is best done with a team approach."

Just as the introduction of laparoscopic gastric bypasses increased the number of bariatric procedures, it has done the same for body lifts.

"There were approximately 200,000 gastric bypasses and gastric bindings in the United States last year," Dr. Rubin said.

"Now we're starting to address the skin problems. Plastic surgery after weight loss is the fastest growing area of plastic surgery. U.S. plastic surgeons did 65,000 of them last year.

"It's wonderful to be a part of this process and have such a positive impact on people's lives," he said.