What they DONT tell you about Plastic Surgery after massive weight loss.
Plastic Surgery After Weight-Loss Surgery
Many bariatric patients, after they lose weight, undergo cosmetic surgeries such as tummy tucks, liposuction, and the removal of loose skin.
By Cynthia Ramnarace
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Despite losing 135 pounds, Anne Caldwell, 56, from Phoenix, wasn't happy with her appearance. Although she was far from her heaviest weight of 270 pounds and the fat was gone, loose skin remained.
"I did not want to wear shorts or bathing suits, because my legs were just hanging down around my knees," says Caldwell.
Like Caldwell, many patients who have undergone gastric bypass surgery, or similar procedures, are left with loose skin around the stomach, buttocks, back, arms, or thighs. Rashes and sores can develop on loose skin that folds onto itself. In addition, the hanging skin creates an awkward shape that makes it hard for these patients to find clothes that fit properly. And then there's the unsightly dangling arm skin. For all these reasons, bariatric patients often go on to have further, corrective surgeries.
Preparing for Plastic Surgery
People who want a body-contouring procedure after gastric bypass must stabilize their weight before they can qualify for the surgery. Surgeons require this so as to minimize the risk of complications, according to the American Society of Plastic Surgeons (ASPS).
"Four to six months of stable weight is what I like to see," says Lyle Leipziger, MD, chief of plastic surgery at North Shore University Hospital and Long Island Jewish Medical Center in New York. "For postbariatric patients, this often means they wait a minimum of a year — and usually more like 18 months — before undergoing [body-contouring] surgery."
The optimal patient, according to the ASPS, is a nonsmoker who has reached his or her optimal BMI of 18.5 to 25 and is committed to maintaining it. She should also have no medical conditions, such as cardiac and pulmonary problems, that could impair healing or increase surgical risk.
Plastic Surgery Options After Weight-Loss Surgery
Patients' body-contouring goals tend to vary based on the amount of weight lost, age, and where the fat had been stored. Here are four common body-contouring procedures that are performed after gastric bypass surgery:
- Breast lift:Loose skin is removed, and the breast and nipple are lifted. Implants may be used to improve the shape of the breast. In 2007, 30,000 patients had this procedure done after massive weight loss, according to the ASPS, at an average cost of ,236.
- Lower body lift:This combines a tummy tuck with removal of skin in the buttocks, groin, and outer thighs. An incision is made at the bikini line to minimize scarring, and in some patients this incision continues all the way around the body. The skin is lifted and the excess removed. Liposuction removes any remaining fat deposits. While some other body-contouring procedures don't require an overnight hospital stay, the patient having a lower body lift is often hospitalized overnight, and typical recovery time is two weeks. In 2007 surgeons performed 19,500 of these procedures, at an average cost of ,073.
- Upper arm lift:Surgeons remove sagging skin by means of an incision that starts at the armpit and progresses to the elbow. In 2007 surgeons did 9,300 of these procedures, at an average cost of ,574.
- Thigh lift:An incision is made at the groin and continues to the knee, if necessary. Excess skin is removed and liposuction is done as needed. In 2007 surgeons performed more than 8,000 of these procedures, at an average cost of ,464.
It's important for patients to have realistic expectations from their surgical procedures. No matter how skilled the surgeon, body contouring leaves scars. Also, patients who seek multiple procedures may have to stretch their surgeries over a few years. Dr. Leipziger does no more than two procedures at a time (such as a breast lift and a thigh lift), and he recommends a minimum of six months between operations.
In Caldwell's case, it took three years for all her surgeries: a lower body lift, a tummy tuck, inner thigh contouring, and arm work. The tummy tuck was covered by insurance because of rashes she'd developed, but she paid out of pocket for the arm and thigh surgeries. Still, despite the cost and time, Caldwell has no regrets.
"I can buy shorts," she says. "I can buy sleeveless shirts.
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