Details of Post-Bariatric Surgery

Post-bariatric surgery consists of any of a variety of surgical procedures performed to remove excess skin following massive weight loss. Bariatric surgery, in its various forms, is designed to force a patient to lose weight by either dramatically reducing the size of the stomach or bypass much of the stomach and part of the small bowel so that either less food can be eaten or less food can be absorbed, or a combination of both.

Weight Loss

As a result of bariatric surgery considerably fewer calories can be consumed and absorbed resulting in significant and, sometimes, dramatic weight loss.  Over time, much of the excess fat on a patient’s body is burned as fuel and as a result of marked fat reduction, excess skin remains on the abdomen, breasts, arms and thighs.   Most of the weight loss occurs in the first six months after surgery with the rest being a more gradual process.

Timing of Surgery

Post-bariatric surgery is generally done after a patient has the majority of the excess weight and that weight has been stable for several months. It is important when starting to have post-bariatric surgery to maintain adequate protein intake to prevent wound healing problems.  Although sagging skin will become evident with the initial weight loss, it is advantageous to wait until the vast majority of the excess weight is gone to consider elective plastic surgery.

Types of Procedures

A tummy tuck is generally the first procedure performed after massive weight loss and is often combined with a breast lift in women. The tummy tuck can be a standard tuck, a circumferential tuck, also called a lower body lift, or a fleur-de-lis tummy tuck where an inverted ‘V’ shaped wedge of skin is removed along with the low abdominal horizontal ellipse.  Some liposuction can be performed at the same time as a tummy tuck to remove fat from areas where excess remains despite the significant weight loss.

Extremity Surgery

The next procedure which constitutes ‘post-bariatric’ surgery is often a thigh lift or thighplasty.  During this surgery, excess skin and fat is removed from the upper, inner thigh and the skin on the front of the thigh is pulled upwards and inwards; this is often combined with liposuction when there is residual excess fat on the thighs.

Finally, an arm lift can be performed which removes excess skin and fat from the upper, inner arm and often extends on to the outer portion of the chest. This procedure is also often combined with liposuction; however, other procedures can be performed as well such as breast augmentation, breast lift or revision surgeries.

State of Mind

Of course, it is important to have a proper state of mind going into elective cosmetic surgery.  Many times, while bariatric patients are excited about their weight loss and improved health through weight loss, they may become disillusioned by the excessive sagging skin that remains when the fat is gone.  Getting over that depression and looking forward to the improvements of post-bariatric surgery makes a significant difference in the recovery from elective post-bariatric aesthetic surgery. 

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