Surgery after Massive Weight Loss
Surgery after massive weight loss is often not a single procedure, but many. When patients experience massive weight loss, often designated as 100 pound or more, there is often significant skin loss and sagging in multiple areas of the body including the abdomen, hips, thighs, arms, breasts, neck, and face, all of which may require surgery to correct the effects of this “deflation”.
Surgery following massive weight loss is a relatively new area of plastic surgery. These cases were fairly uncommon 25 years ago but have increased significantly since that time. As more people became obese, we saw more patients responding to this problem with medically supervised diets, gastric bypass and banding procedures, and old-fashioned diet and exercise. The result is that we are now seeing patients after their successful weight loss journey that have lost 100 pounds or more on a fairly frequent basis.
With their weight now controlled and overall health improved many of these patients may be disappointed with the appearance of their loose skin. The good news, however, is that plastic surgeons have gained increasing experience and have responded to this challenge by developing new and better procedures to correct the affects of massive weight loss. We are happy to be a part of this ever evolving field and to be able to help patients who have achieved this significant weight loss.
Surgery after Weight Loss Overview
At your initial visit we will evaluate your areas of concern and discuss options for treatment, recovery time, and the potential for scarring. In some cases, we may recommend no treatment at all, particularly if we feel the potential difficulties involved in treatment outweigh the benefit of removal. If there is uncertainty of the nature of the skin lesion, a biopsy may be recommended. Once a treatment plan has been developed, we will schedule a convenient time to perform the procedure in our office.
The No-Drain Technique
For many years we routinely placed drains following abdominoplasty. However, a few years ago we changed our technique, placing progressive tension sutures internally to both better shape the tissues, avoid tension at the incision, and make drain placement unnecessary. The benefits to our patients have been dramatic. Many people who have undergone abdominoplasty in the past said that having a drain was one of the most bothersome aspect of their recovery. We now find we are able to do all types of abdominoplasties (described below) without drains.
Our most successful and happy patients have been those that have dropped their weight to a normal range, maintained a stable weight, planned carefully for their surgery and recovery, had realistic expectations about their results, and have been otherwise healthy.