Plastic Surgery After Massive Weight Loss

Plastic Surgery After Massive Weight Loss  (greater than 100 lbs)

Many post-bariatric surgery patients experience an extreme loss in skin elasticity that leads them to have body-contouring procedures, which greatly differs from contouring procedures performed on normal weight patients. According to American Society of Plastic Surgeons (ASPS) statistics, more than 52,000 body contouring procedures following massive weight loss were done in 2003. It is expected that this number will continue to increase as more bariatric surgery is performed.

Massive weight loss patients should be aware that body contouring may require surgeons to address the entire body circumferentially and not just one or two specific areas, as is the case with body contouring in more normal weight patients. For someone who loses 100 lbs. or more in a short time, particularly after bariatric surgery, the patient often has sagging skin in a number of areas including the face and neck, breasts, arms, abdomen, back and thighs. The skin and tissue from a gastric bypass patient is different from healthy, normal weight patients because the elastic tissues are usually permanently damaged from being stretched to an extreme degree. After contouring, the patients' skin will still loosen and sag much faster with age. With body contouring, we can improve the shape of the skin but we cannot improve the quality of the skin. Patients seeking body contouring after massive weight loss must be realistic in their expectations. The tissues will give over time, but not to the same degree as before.

A variety of surgical procedures are often necessary and performed at different times. Depending on which area bothers you the most, the surgery is tailored to fit your needs, starting with the area of greatest concern.

Often an abdominoplasty is done first, though a circumferential lower body lift may be needed instead. Breast lifting surgery, arm lifts, face lifts and neck lifts are all additional procedures that can be done at separate times.

Probably the most important determinant of how much loose skin an individual will have following weight loss is age. Younger patients tend to have less loose skin. The next most important factor is the amount of weight loss. An individual who loses 250 lbs. is likely to have more excess skin than somebody losing 80 lbs. Other less important variables include complexion, amount of sun exposure received over a lifetime, heredity and whether somebody is a smoker. Fair skinned people in general tend to develop more loose skin than darker individuals. Sun worshippers tend to sustain more tissue damage over the years and consequently more loose skin following weight loss. Some people tend to have " better" skin than others of similar complexion and lifestyle. This may be the result of hereditary factors that are not readily apparent. Finally, smoking breaks down collagen, a major component of skin and other structural components of the body. Smokers develop more loose skin than their non-smoking counterparts.

Timing and Approach to Plastic Surgery

Plastic Surgery procedures should be considered only after ones weight has stabilized after a bariatric procedure. This is usually 18 months or more, depending on an individual's preoperative weight. Performing a skin tightening procedure prior to weight stabilization may result in the need for further skin tightening in the future. It is preferred to wait to at least three months between operations.

Plastic Surgery procedures following massive weight loss are usually extremely gratifying for both the patient and surgeon. The results are usually dramatic and provide a significant functional and aesthetic benefit to the patient.

Recovery

Depending on the type of surgery that was performed, you may be able to go home after spending a few hours in our surgi-center or you may need to stay in the hospital 2 or 3 days. Showering is permitted on the second or third day after surgery.  Pain is mild to moderate and is mostly gone within 7 days and is controlled by medications. Swelling, which is mild to moderate and peaks at 2 to 3 days, disappears over the next 6 weeks. There is minimal or no bruising. You can usually resume light activities within the first week, and most activities within 4-6 weeks. You can expect to be out of work for 1-2 weeks, but you will be able to be up and about.

Results

You will have a tightened, lifted and improved contour to your abdomen, thighs, buttocks, breasts, arms, and any other areas treated. Touch ups and revisions are often necessary. You will be more confident and comfortable in clothing, especially sportswear and jeans. You will have a more natural and presentable appearance in the first week that will improve over the next 3 to 6 months.

The Best Candidates For Plastic Surgery following Massive Weight Loss

Those patients who desire a more youthful appearance by correcting stretched out sagging skin. Patients with excess folds of skin after weight loss that still consider themselves fat. Candidates for body contouring are people who are looking for improvement, not perfection in the way they look.  If you're physically healthy, psychologically stable, and realistic in your expectations, you may be a good candidate.

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