After Massive Weight LossConveniently located to serve Fairhope and Mobile, Alabama
Obesity is a major health crisis with 32% of Americans classified as obese and 5 % as morbidly obese. Weight loss surgery is the most effective long-term treatment for obesity and approximately 200,000 procedures are performed annually. Unfortunately, the surgery does not take care of all of the problems since markedly stretched skin loses its ability to contract completely. Multiple plastic surgery procedures are necessary to improve hygiene and cosmesis after weight is stable at its new low. The most common procedures include a lower body lift, abdominoplasty, thigh lift, breast surgery, upper arm lift (Brachioplasty), blepharoplasty (eyelids), facelift, and neck lift. A thorough consultation with Dr. Park or Dr. Rebowe is necessary to determine the staging of the needed surgeries based on patient desires and safety. With most health insurance plans, these are cosmetic surgeries not covered by insurance. Certain procedures combined with reconstructive procedures such as hernia repair may allow for partial coverage but clear communication is necessary to avoid confusion.
Patients who have experienced significant weight loss and have been left with hanging skin and pockets of excess stubborn fat are ideal candidates for body-contouring procedures. Candidates must be in good overall health and have realistic goals.
Candidates must not be prone to scarring and must not have any pre-existing conditions that could negatively affect the healing process. Non-smokers are ideal, and smokers must quit weeks before surgery.
Preoperative evaluation of weight, nutritional, physical, and psychiatric status is necessary prior to surgery to maximize safety. These can be evaluated with a history, physical exam, lab tests, and occasionally radiographs. It is important for patients to have proven stability near their goal weight before proceeding with body recontouring, as further significant weight loss or weight gain could negate the effects of otherwise successful plastic surgery. The major weight loss types of surgeries are restrictive, malabsorptive, and a combination of the two. Restrictive procedures reduce the size of the stomach and malabsorptive procedures bypass portions of the gastrointestinal tract to reduce the absorption of what is eaten. Malabsorptive procedures have significant risk for nutritional deficiencies and anemia since nutrients and vitamins are also absorbed in the gastrointestinal tract. Commonly checked labs are Albumin and Prealbumin (measurement of protein levels in blood), Hemoglobin and Hematocrit (blood counts), coagulation times (clotting ability), electrolytes, and vitamin levels (A, B complex including folate and B12, and C).
The surgical plan can be complicated since many massive weight loss patients have numerous needs of varying severity – facial / neck laxity, eyelid bags, sagging of breasts, abdomen, buttock, back, chest, thighs, arms, legs, or genitalia, and deflation of breasts or buttock. Pairing of procedures to minimize the total number of operations needed while maintaining safety is critical. Each operative plan is tailored to the patient but common combinations include:
- Abdomen and Buttock (Abdominoplasty, Panniculectomy, or Lower Body Lift)
- Breast (Gynecomastia, Mastopexy, or Augmentation) and Arms (Brachioplasty)
- Face and Neck (Rhytidectomy), Eyes (Blepharoplasty), and Chin
- Thighs and Legs
- Hands, Genitalia, and Other
Suspension of layers stronger and deeper than skin is critical in maximizing lift and minimizing scar. Due to the large size of the areas treated and the potential malnutrition, complications such as fluid collections (seromas and hematomas), wound healing problems, infection, scarring, and deep vein thrombosis (DVT/PE) are more common and must be given maximum attention and may require additional prophylactic measures such as prolonged drainage and blood thinner injections at home.
In most cases, body contouring after massive weight loss will involve a combination of procedures to achieve the aesthetic goals of the patient. The details of the surgery, including duration, will depend on the exact procedures chosen to be included in the surgical plan.
Generally, the treatment areas will be cleansed and disinfected, and then anesthesia will be administered. Targeted incisions will be made. Depending on the specific procedures being performed, the surgery will not only involve removing excess skin but also suctioning away stubborn fatty tissue.
Once the patient’s body-shaping goals are achieved, the incisions will be sutured closed and bandaged. Post-surgical garments may be worn to control swelling and to keep the results intact during the recovery process. A drain may also be inserted to prevent accumulation of fluids while healing.
The Recovery Process
The patient may stay in the facility for a few hours or even days depending on the extent of the cosmetic procedures performed; this will ensure a safe initial recovery. For the first few days, the patient may experience soreness, bruising, swelling, and pain in the treatment areas.
Prescriptions and recovery instructions will be given before the patient is released. A follow-up appointment will be scheduled to ensure proper healing and address any complications.
The Cost of Body Contouring After Massive Weight Loss
The total price of body contouring after massive weight loss will vary depending on the exact cosmetic procedures involved. We provide our patients with suitable financing through CareCredit.
For more information about body contouring after massive weight loss in Mobile, visit The Park Clinic for Plastic Surgery. Contact us today for your consultation.
The results were more wonderful
I have been trying to find adequate words to express my thanks for all that you did in regards to my recent surgery. The results were more wonderful than I ever imagined. I cannot tell you what a difference it has made in how I feel both physically and more importantly, psychologically. I am continuing on my journey of losing weight and hope to complete it by the end of May. It will mark two years of effort, but I’m sure your gifted hands helped more than you know. Thank you again and thanks to your great staff as well.