Body Contouring After Massive Weightloss

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What is Post Bariatric Reconstruction?

Body contouring refers to a broad field of plastic surgery procedures that address areas of excess fat and/or skin. Body contouring procedures can be performed in normal-weight patients, patients who have lost significant weight through diet and exercise, and patients who have lost weight after bariatric surgery.

Doctors perform roughly 100,000 bariatric surgeries annually in the U.S. Unfortunately, some patients are less than satisfied after the weight loss because they have excess skin and their body contours are saggy or lumpy*.

When a person sheds a large amount of weight quickly the skin’s elasticity cannot always keep up. This creates excess skin that is an aesthetic issue for many patients. In addition, enough excess skin can cause added health concerns. 21 percent of bariatric surgery patients undergo at least one kind of bariatric reconstruction or body contouring surgery following the weight loss.

Why does this happen when you have bariatric surgery? Rapid weight loss is a shock to the body and the skin does not have time to adjust. When people steadily lose weight over a long time, it’s easier for their skin to shrink back down.

What Are The Benefits Of Bariatric Reconstructive Surgery?

Bariatric reconstruction surgical procedures are several surgeries that get rid of the excess skin and fat lingering after remarkable and speedy weight loss. It often combines reconstructive and aesthetic techniques to tighten, boost and shape sagging areas for a more balanced appearance. It is meant to mitigate the effects of the sagging skin and allow for the patient to continue confidently on their journey toward better health.

Although it’s a valuable approach for lasting weight management, weight loss from bariatric surgery is more liable to last if it’s followed up by body contouring surgeries. Patients regularly lose an additional 10 to 15 pounds of just loose skin after a contouring operation. Hygiene problems can also be a concern if reconstructive surgery is not undergone.

What Are The Types Of Bariatric Reconstructive Surgery?

Because everybody reacts differently to bariatric surgery, there are a variety of different skin reconstruction surgeries that patients can choose from. These procedures include:

  • Abdominoplasty – aka. The tummy tuck. Abdominoplasty involves the removal of excess skin from the abdomen and tightens the muscles of the abdominal wall. A full tummy tuck or a mini tummy tuck are options to discuss with a physician.
  • Excess skin hanging down to the thighs is referred to as a pannus. This skin can be removed and tightened. The surgery is more involved than an abdominoplasty. It is also a unique procedure for weight loss surgery patients.
  • Mastopexy. These types of surgeries involve lifting the breast. There’s the crescent lift (for minimal sagging), donut lift (for moderate sagging and full mastopexy (for excessive sagging).
  • Lower body lift. A lot of patients decide to complete their lower body lift in stages. This surgery removes excess skin from the lower body: abdomen, hips, thighs and buttocks with one large incision near the waist extending around the body. This is quite extensive and invasive which is why it is so often done over multiple surgeries.
  • This is an arm lift.
  • This is often referred to as a breast reduction.
  • Thighplasty. This is a thigh lift. Dr Khan will thoroughly consult with you to recognize the specific area you seek to concentrate on and decide the technique that will offer the best results because there are many approaches to this surgery.
  • Liposuction. The process of removing fat from the human body.

What Is Body Contouring?

Body contouring addresses areas of excess fat and/or skin on the body but people do not have to be overweight to undergo them. The focus in this article is about post-bariatric reconstruction but that is not the only time that body contouring can be employed. The body contouring consultation allows the patient to get together with the doctor and articulate their goals for the body contouring procedure. The doctor also explains the process and shares advice, concerns, risks and possible outcomes.  In addition, the doctor will evaluate your overall health.

Patients should maintain a stable weight for a minimum of 12 months prior to body contouring. This is significant because weight fluctuations, both increase or loss, can influence the surgery and lead to poorer results. All of this increases the likelihood of a need for secondary procedures.

Bariatric patients are generally more at risk for nutritional deficiencies. This can affect healing and put them at risk for complications. Nutritional assessments should be administered, and any deficiencies must be addressed. In addition, a lot of post-bariatric patients have weight-associated health conditions prior to their weight loss and these patients will need to be monitored closely. They need medical clearance before ever considering more surgeries.  In order to reduce the risk of significant wound healing complications, smokers should quit. Nicotine causes alteration in tissue perfusion. Patients need to be 6 weeks nicotine free prior to the surgery.

What Are The Risks Of Body Contouring Surgery?

The risks of body contouring procedures are related to wound healing, wound breakdown, and seroma formation. Massive weight loss patients frequently have further health conditions, linked to their prior obesity, including:

  • sleep apnea
  • hypertension
  • and diabetes

These all increase the risks associated with any type of surgery.

In addition, the general condition of the skin of many bariatric reconstruction surgery patients is not great.  In fact, skin quality in patients who were previously obese is often poor and this can lead to increased incidence of:

  • poor wound healing
  • scar-related issues including scar migration
  • skin laxity

What Is The Process Like?

Weight loss patients who have lost massive amounts of weight often necessitate several surgical procedures to attend to excess skin and fat all over their body. From the standpoint of safety and health for our patients, it is not feasible to perform all these procedures in one operation. Dr. Khan will talk to you about what your specific steps might be, and which procedures make sense for you.

One Common Plan Is:

Stage 1: Panniculectomy or lower body lift procedures are performed.

Stage 2: Breast reduction/lift procedures can be combined with either arm or thigh lift.

Stage 3: If facial laxity is significant, a face lift is often the last stage.

Note that the period between stages is generally three to six months. Typically, body contouring procedures need at least three months for the overall aesthetic results to be completely clear. This allows enough time for all remaining swelling to resolve and for tissue to soften. Scars typically need 12 months to go from beginning to end of the remodeling progression, and, since body contouring procedures necessitate significant incisions, a year may be needed.

Life After Body Contouring And Bariatric Reconstruction Surgery

The main issue that affects the longevity of results is weight fluctuation. For this very reason, procedures are routinely delayed until patients are weight stable for a bare minimum of one year. If patients are able to maintain their weight, long-lasting results can be achieved.

What Should I Expect At A Surgical Consultation?

Dr. Khan at Executive Plastic Surgeon will give you an overall exam and discuss your many options. He will collect data and information about you in order to decide if you are a good candidate for surgery. While our Detroit area office staff is passionate about helping as many people as we can some people are simply not good candidates for surgeries based on lots of factors. On the other hand, you can ask all of your questions and get honest answers from a doctor who cares. Reach out today at 734-419-1615 or contact us online.