POST-BARIATRIC AND MASSIVE WEIGHT LOSS BODY CONTOURING SURGERY

Unfortunately, obesity has become a significant public health problem in the United States. It has reached epidemic proportions. According to the National Health and Nutritional Survey, 65% of adults are overweight, and the rate is increasing. The cause of obesity is not only overeating but is far more complex. Inefficient caloric utilization, reduced metabolic activity, genetics, as well as environmental and psychological issues all contribute.

PLASTIC SURGERY AFTER WEIGHT LOSS

How does a post-bariatric patient deal with the abundance of loose, hanging skin? Body contouring for patients who have experienced massive weight loss could be an answer.

If a patient’s goal is to reshape multiple areas, Dr. Miguel Delgado will perform body contouring in two or more stages.

PROS & CONS OF HAVING THE SURGERY IN STAGES

Dr. Delgado and the anesthesiologist will discuss the different options with the patient. Due to the nature of massive weight loss surgery, the surgery will be staged, but the order in which the procedures are accomplished can be customized.

PROS:

  • Less anesthesia time
  • Less risk of blood loss
  • Less risk of surgical fatigue
  • Better avoidance of opposing vectors of pull
  • Second chance to correct areas

CONS:

  • Multiple exposures to anesthesia
  • Increased time off work
  • Increased expense for the patient
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BARIATRIC SURGERY AND MASSIVE WEIGHT LOSS

The goal of bariatric surgeries and massive weight loss is to improve the overall health of morbidly obese patients. The outcome of the surgery is a significant reduction in the absorption of calories consumed. Bariatric surgery has advanced significantly over the years so that it is much safer, with fewer short and long-term complications, and over 60%of the surgeries are performed endoscopically.

Patients who have had bariatric surgery have undergone a major life-changing procedure. Their overall body shape has drastically changed, and the risk of obesity-related health complications has been reduced. Despite this significant improvement in quality of life, patients typically have issues with redundant skin.

Procedure What It Does Surgery Recovery Results
Body Lift Uses a combination of surgeries to lift and tighten the body after significant weight loss Yes (multiple) About 3 weeks, will vary depending on the specific procedures, no exercise for 6 weeks Long-lasting
Mommy Makeover Designed to restore shape and reduce excess skin after a pregnancy Yes (multiple) About 3 weeks, depending on the extent work, avoid exercise for 5-6 weeks Long-lasting

BODY LIFTING AFTER MASSIVE WEIGHT LOSS

The approach for body lifting is to separate the procedures into upper and lower body lifting. The upper body lift is composed of breast surgery, arm surgery, axilla surgery, and lateral chest surgery.

A medial thigh lift completes the lower body component. The medial thigh lift is best performed with a vertical incision down the leg to excise the most tissue and achieve a tighter upper leg. When both upper and lower body lifts are done, the procedure is called a total body lift.

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BREAST SURGERY AFTER MASSIVE WEIGHT LOSS  

For women, breast changes after huge weight loss are very different than those seen in women seeking the traditional breast lift. The deflation of the skin can cause severe asymmetries and flatten the breasts. A short-scar lift is usually not a good choice. An inverted-T technique, which can excise the armpit roll and use it for auto augmentation of the breasts, is Dr. Delgado’s preferred choice.  This technique re-suspends the breast tissue on the chest wall and uses the lateral armpit tissue to enhance the breast volume. A breast implant can also be used for added volume. Men may also wish to consider chest contouring after immense weight loss. Dr. Delgado is particularly skilled in sculpting the male chest as well and has performed many successful cases of gynecomastia reduction (male breast reduction).

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ARM LIFT (BRACHIOPLASTY) AFTER MASSIVE WEIGHT LOSS

The upper arms, axillae, and adjacent chest area of a patient after considerable weight loss can be problematic. Women and men can develop excessively loose skin, extending from the arms to the chest wall and breast region.  The draping of the skin can be awkward to cover up, even in long-sleeved clothing.

An arm lift is a procedure that can help improve this problem. The incision goes from the elbow to the axilla (armpit), down the upper chest area, and blends into the breast region.  This technique helps tighten the entire area of concern. The incision often blends or fuses the breast incisions to achieve a more tapered appearance.

LOWER BODY LIFTING AFTER MASSIVE WEIGHT LOSS

Circumferential body lifting, a procedure that has been evolving since the 1960s, can be used to address severely lax tissue around the torso. Since the incision follows much of the line where a belt might be worn, it is often called a “belt skin reduction.” This approach incorporates a tummy tuck and wide waist excision of tissue extending around both sides to the buttocks crease in the back. This will excise a substantial amount of tissue from the mid-torso region, providing an additional lift to the anterior-lateral thigh and buttock region.

This is a significant surgical procedure, and it is sometimes done in two stages. Dr. Delgado’s patients are typically pleased with the results of this procedure.

FACIAL REJUVENATION AFTER MASSIVE WEIGHT LOSS

Vast weight loss can affect the face as well. The loose body skin can often be hidden under clothing, but it is not so easy to conceal loose skin on the face. Significant weight loss can cause slack skin in the forehead, drooping of the upper eyelids, bags under the eyes, new lines in the cheeks, and a sagging jawline and neck. Although the patient may feel in better health and more energetic, weight loss may age an individual’s facial appearance. For these patients, a facelift or neck lift may be a good solution. For a balanced and natural appearing result, upper and lower blepharoplasty may be indicated as well. All these procedures can be done at the same time. Recovery is approximately two weeks.

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SUMMARY

A skilled plastic surgeon has much to offer a patient who has undergone bariatric surgery or significant weight loss. Reconstructive plastic surgery may help the patient to complete his/her transformation and enjoy his/her new shape–and healthier life–to the fullest.

FAQ

When is the best time to consider having body contouring surgery?

Can I have all of the procedures at the same time?

How much does a full body lift cost?

When can I resume normal activities/work?

What is the best type of surgeon to perform body contouring surgical procedures?

Is there any way to avoid scarring?

Should I expect any complications?

When is the best time to consider having body contouring surgery?

The weight loss process usually stabilizes at about one year, so we look for a fairly stable weight history for this duration of time. Ideally, your age is less than 55 years old, and you have a healthy blood count. The age requirement is not absolute, as no doubt, some 60-year-olds are healthier than some 40-year-olds. Nevertheless, due to the extensive amount of surgery entailed with body contouring after considerable weight loss, a person needs to be strong and healthy to tolerate the physical stress of the post-operative recovery period.

Can I have all of the procedures at the same time?

Usually not. If you require just a few procedures, such as a breast reduction or breast lift and a tummy tuck, these two procedures can be done simultaneously. However, many body-contouring patients, after immense weight loss, request multiple surgical procedures. The amount of surgery and the time needed to complete the procedures may dictate that they be done in two or three stages. In Dr. Delgado’s mind, safety is the most important aspect of body contouring surgery. He will work with you to put together a plan that is both safe and affordable.

How much does a full body lift cost?

The cost varies greatly. The out-of-pocket expense will be fairly substantial for multiple areas of body contouring surgery. The cost will include the surgeon’s fee, use of the operating room facility, and services of a board-certified physician anesthesiologist, compression garments, and all follow-up care. You should expect an additional fee for overnight nursing care for the first night after your surgery. The cost depends on the time required for the procedures, which will vary from patient to patient. Approximate prices would be $8500 for a breast reduction, $9500 for a tummy tuck, and $9000 for an arm lift, to give just a few examples.

When can I resume normal activities/work?

It depends on what procedures are done. A tummy tuck or a body lift will require the longest recovery. Even so, you can drive a car, return to work or school, and do most of your everyday activities, other than exercise, usually by two to three weeks after surgery. Exercise can be resumed after six weeks. The breast reduction, medial thigh lift, and arm lift require shorter recovery times. After those surgeries, you can drive, return to work or school, and do most of your normal activities after one to two weeks, though exercise cannot be started until after six weeks. However, each patient’s situation is different and recovery time is a function of age, health, and pain tolerance.

What is the best type of surgeon to perform body contouring surgical procedures?

A board-certified plastic surgeon certified by the American Board of Plastic Surgery is the best choice. Plastic surgeons, like Dr. Delgado, perform these procedures frequently and, most importantly, have the experience to manage you preoperatively and postoperatively. You should study a physician’s before and after photographs to evaluate his/her artistic skill with body contouring.

Is there any way to avoid scarring?

No. A primary issue with body contouring after massive weight loss is the excessive amount of skin. This requires the removal of skin to obtain a better shape and contour. Undergarments and most styles and cuts of clothing, however, will cover most of the incisions.

Should I expect any complications?

As with all surgical procedures, there is a chance of complications. This is even more so with body contouring after considerable weight loss. Complications include wound breakdown, fluid accumulation, skin loss, infection, bleeding, and blood clots. The rate of these complications is approximately 25%-30%, depending on the health of the patient and the amount of weight loss. This is why an experienced plastic surgeon, like Dr. Delgado, is the wisest choice for this type of procedure.

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165 Rowland Way, Suite #300 Novato, CA 94945

415.898.4161

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450 Sutter St #2433 San Francisco, CA 94108

415.989.2221
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