Body Contouring After Gastric Bypass Surgery
With the growing popularity of bariatric, or gastric bypass, surgery as a treatment for obesity, body contouring after significant weight loss has become a field of special interest for many plastic surgeons.By applying the latest techniques in body sculpting individualized to each patient’s specific needs and priorities, your plastic surgeon can help you realize the new shape that is hidden beneath the excess skin that remains after your goal weight has been achieved.
With significant weight loss over a relatively short period of time (usually 15-18 months), the remaining skin often does not retain the elastic qualities necessary to “shrink back down” to your new underlying shape. This often leaves patients with excessive amounts of hanging skin that creates a multitude of problems such as daily hygiene and finding clothes that fit properly.
A comprehensive approach to the bariatric patient is necessary to achieve the optimal figure following weight loss. One of the most important considerations for a plastic surgeon to realize is that a bariatric patient must be treated differently from non-bariatric body contouring patients. What has worked well for many years on other patients simply does not provide adequate shaping and contouring for the bariatric patient.
Patients who have undergone gastric bypass surgery and the subsequent significant weight loss may have numerous but similar areas of concern. These areas include:
-Breast ptosis, or droopiness, as well as a loss of breast volume (Mastopexy is a procedure to lift the breasts and may be performed with or without the addition of breast implants to improve shape, fullness and cleavage.)
-Sagging of the facial skin (Facelifting, forehead lifting and eyelid surgery may be necessary to achieve complete facial rejuvenation, or you may be a candidate for endoscopic or minimally invasive techniques)
-Excess abdominal skin and a laxity of the muscles of the abdominal wall, sometimes with an accompanying hernia. (Abdominoplasty or a lower body lift procedure can contour the abdomen, hips and buttocks)
-Hanging skin under the arms (Brachioplasty is a technique to lift the arms)
-Wrinkling and excessive bagginess of the thighs (A medial thigh lift can lift the inner thighs)
The cornerstone of a successful approach to body contouring is to individualize treatment to your specific circumstances and goals and to ensure that you have an adequate understanding of the issues involved so that you are able to make a fully informed decision. This will help you achieve the appearance you desire with the least invasive procedure available, thus creating a mutually rewarding experience.
Depending on the combination of procedures you choose, surgery will probably last between four and eight hours. After you are properly anesthetized, your plastic surgeon will make the incisions necessary for removal of excess skin and fat. After the incision has been made, he or she gently elevates the skin and fat off of the underlying structures. For a tummy tuck, the muscles of the abdominal wall are usually tightened using strong, permanent internal sutures. Some patients have hernias in the abdominal wall, and these may also be repaired during a tummy tuck.
After removing the excess skin and fat, your plastic surgeon will redrape the skin over the underlying structures. One or more drains may be placed beneath the incisions. These slender, rubber tubes assist in draining any fluid that may accumulate beneath the incisions and delay your healing. Your plastic surgeon may also chose to use a new product called Tissue Glue. This product helps your body heal and minimizes the fluid that may empty into your drains, allowing the drains to be removed earlier.
At the completion of the operation, a sterile dressing is applied to the incisions, and a compression garment is applied to the region of the body being treated. This compression garment helps support your incisions during healing, decreases postoperative swelling, and helps decrease any bruising that may occur.
You will notice an improvement in your body contour immediately. However, your shape will continue to improve in the following weeks as the mild swelling subsides. You should be up and walking the day following surgery, although you will be sore for several days. You should be able to resume your normal daily activities within several days following surgery, and you should be able to resume all of your physical activities within three to four weeks of surgery.