Post-Bariatric Plastic Surgery

Post-Bariatric plastic surgery or body contouring can assist in improving the aesthetic of your figure after having bariatric surgery. 

Excessive weight loss following bariatric surgery will most likely result in large amounts of loose skin, especially in the stomach region.

Body contouring shapes the body, tightens the skin, and assists you in creating your ideal figure after bariatric surgery. This article will offer information in deciding whether body contouring is right for you.

 

Body Contouring After Bariatric Surgery

The Impact of Bariatric Surgery

Bariatric surgery can provide many benefits. You will see many changes to your body. There are lifestyle changes required after surgery in order to maintain a healthy weight loss journey. Post-operative multivitamins and supplements, like meal replacements and protein shakes, will be required for life in order to prevent common vitamin/mineral deficiencies and malnutrition. It is also likely to see changes to skin elasticity as a result of weight loss surgery. 

Massive weight loss after undergoing bariatric surgery may lead to the development of excessive, loose skin which hangs off the body. Major weight loss has been associated with damage to the skin, specifically elastin fibers and collagen.

Skin elasticity can be affected by genetic factors, aging, sun exposure, cigarette smoking, and rapid weight loss. The regions of the body that held the most weight before surgery are usually the areas that accumulate excess skin after massive weight loss.

Commonly Affected Regions

  • Abdomen
  • Upper arms
  • Chest
  • Buttocks
  • Thighs

Most Common Problem Area

The area that patients complain about is the fold of skin in the lower abdomen. This is referred to as a “pannus”. The “pannus” consists of rolls of excess skin and it may rub together to cause skin irritation and a rash. 

The symptoms of skin irritation are worse during periods of warm weather. The area between these rolls of skin are moist and may become unhygienic. It provides an excellent environment for the development of fungal infections.

Other complications of a “pannus” include bariatric clothing not fitting correctly and back pain. The “pannus” may also interfere with exercise and cause social embarrassment.

Excessive skin on the upper arms may also bother some individuals, especially young women. However, skin rashes are less common in this region of the body.

 

Body Contouring - What is it and How is it Done?

post-bariatric plastic surgery

Body contouring is a group of procedures performed by a plastic surgeon after bariatric surgery. These procedures sculpt the body by removing excess skin, fat and underlying tissue. 

The purpose of these procedures is to improve the appearance of the body.

Body contouring can be done in one session or may require multiple sessions, depending on the region of the body and the amount of work that needs to be done. 

Brachioplasty (Arm Lift)

This procedure is used to treat extra skin and underlying tissue on the underside of the upper arms. 

An incision is made from the armpit to the elbow. Excess skin is removed in order to improve the appearance. With the incision being made on the underside of the arm, any scarring is hidden well. 

Mastopexy (Breast Lift)

This procedure will provide a lift in order to restore a more appropriate position. It may require an implant depending on the amount of fat removed to maintain shape. 

A plastic surgeon is conscientious about cosmetic look, so you can discuss the incision site in order to hide any scarring.

Abdominoplasty (Stomach Lift)

Excess skin that hangs down in the stomach area, known as the "pannus," usually causes the most complications for bariatric patients. Typically, skin rubbing and irritation in this area will cause a rash and hygiene issues that need to be addressed. 

There are multiple procedures for this region of the body because it usually requires more attention. A panniculectomy will take care of the stomach pouch, but there are other procedures for contouring of the waist and back. 

A belt lipectomy can be performed to decrease excess skin surrounding the waist, back, and flank region. This can be used in conjunction with liposuction to improve contours.

Lower Body Lift (Thighs and Buttocks)

The surgeon will make an incision from the inner leg down to the knee for a inner thigh lift. An outer thigh and buttocks lift may be performed with a hip-to-hip incision across the back. Both procedures are used in conjunction with liposuction. 

 

Am I a Good Candidate for Body Contouring?

There are some factors to consider before deciding on bariatric plastic surgery. If you have minimal loose skin or are not as bothered by it and just want to tone up a bit, you may want to try out some non-surgical options before making the big decision.

Non-surgical options may include the use of collagen supplementation incorporated into a healthy diet. Research from 2019 suggested the use of collagen supplements in bariatric patients in order to prevent loose skin and promote natural collagen formation. 

It is important to consider the timing of plastic surgery in order to obtain greater benefits. Plastic surgery after a bariatric procedure can provide significant improvements in quality of life.

Plastic surgery is fairly common after weight loss surgery in order to correct appearance and complications after surgery. In 2014, it was documented that 45,000 bariatric patients underwent plastic surgery to correct excess skin after weight loss surgery. 

You may qualify for bariatric plastic surgery when your weight has been stable for at least 3-6 months after weight loss surgery. Typically, weight will stabilize around one year after bariatric surgery. 

Plastic surgery is not recommended during the period of rapid weight loss following bariatric surgery. The skin will not heal properly during this time. 

A lower BMI can decrease the risk of plastic surgery complications. You can use non-surgical bariatric weight loss techniques like dieting and lifestyle modification to ensure that you reach your ideal BMI. Lastly, the aesthetic results of body contouring are better at a lower BMI.

After bariatric surgery in children, it is recommended to wait a few years to have plastic surgery, depending on the age of the child and their level of development. 

How to Select a Surgeon?

Bariatric plastic surgery is a very delicate and specialized surgery. You must seek a surgeon who is experienced in body contouring procedures and has the necessary skills. 

post-bariatric plastic surgery

It is important that the surgeon is a board-certified plastic surgeon and a member of the American Society of Plastic Surgeons. 

There are various body contouring procedure types and you must ensure that you select a surgeon that is experienced in the procedure you are looking in to. 

Selecting a surgeon for this life-changing operation is important because revision surgery may become expensive.

Risks of Body Contouring Surgery

As with any surgery, there are risks involved. These risks are relatively rare and include:

  • Body asymmetry
  • Bleeding from the surgical site
  • Blood clots
  • Damage to blood vessels or nerves
  • Anesthetic complications like nausea or vomiting
  • Improper wound healing and infection
  • Surgical scarring

Advantages of Body Contouring Surgery

  • Improvement of skin complications
  • Increased self-confidence
  • Improvement of skin appearance
  • Younger and thinner appearance
  • Improved functioning of a body part

 

What Will the Consultation Involve?

The consultation with the plastic surgeon will involve a thorough evaluation of your current health for surgery. The surgeon will obtain your full medical history and history of weight loss. 

Medical History

post-bariatric plastic surgery

This would include medical conditions and the reason why you had bariatric surgery. Associated medical conditions could include diabetes or sleep apnea.

Physical Examination

Vital signs are obtained and BMI is calculated. A nutritional assessment will be performed to ensure proper nourishment. 

Motive for Surgery

You will have the opportunity to discuss the areas that bother you the most and the complications you have been experiencing. Include any treatments you have already tried, surgical or non-surgical.

Procedure Discussion

There will be discussion on the procedure types. This will include whether you will need a series of different procedures depending on the body regions involved.

Photographs

Photographs are usually taken in order to plan for bariatric plastic surgery. This is helpful in pointing out the difference in your body contours before and after the operation. Photographs are sensitive information that are handled with care and they are not meant to embarrass you.

 

Costs Involved

Insurance companies do not always cover bariatric plastic surgery. You will have to explore your options with the insurance company in order to see what is covered. You may receive authorization if plastic surgery resolves health-related complications, such as skin infection and irritation that could not be managed by other means. 

post-bariatric plastic surgery

Some options for financing may be available through your employer. You will have to discuss these options with them.  Other options for financing include a payment plan from your bank or setting up a savings account specifically for your surgery.

Remember that revision surgery is common and not all surgeons will be able to offer this without charging extra for their time. Hidden costs like anesthesia and operating room charges must be taken into account. 

 

What to Expect After Surgery and in the Recovery Period

General anesthesia (also required for bariatric surgery) will be performed for the surgery and you can expect at least one night in the hospital. Surgical drains will be placed at the incision sites to drain any excess fluid or blood. 

These drains usually remain there for a few days after the surgery. Your surgeon will explain how to care for your drain to prevent any complications, such as an infection. You may need to wear surgical garments for up to 2 months after the surgery.

It is common to feel uncomfortable for around a month after surgery and full recovery will take several months. You should only undergo this type of surgery during a period where you have adequate time to recover.

The outcomes will depend on the type of surgery performed. Revision procedures may be necessary for complications or if there is not satisfaction with the results. 

 

**This blog is for information and education purposes only. This information is not intended to substitute professional medical advice, diagnosis, or treatment. Please consult with your physician or another qualified health provider with any questions in regards to a medical condition.