Post Weight Loss Surgery

After bariatric surgery patients will recover their health and have a New Life!  This life includes new health habits with healthier diet and exercise choices. The most successful patients, however, are sometimes disappointed in their appearance due to excessive sagging skin. This is a natural feeling and we understand that many patients would like to get rid of the excess skin to look and feel better and avoid skin rashes that may develop.

Insurance Coverage For Body Contouring:

Every patient is different and will have different post Weight Loss Surgical needs.  We will happily refer patients to respected Plastic Surgeons, however, many patients cannot afford the expense because most Plastic Surgeons do not accept insurance.

Our team at New Life Center is happy to evaluate and treat patients for these needs. There are insurance codes that cover skin reduction surgery after massive weight loss to remove the hanging skin of the upper and lower abdomen (abdominoplasty).  Dr. Williams is experienced in helping patients with their skin reduction surgery after massive weight loss and with getting it approved by insurance when it is a covered benefit. When skin reduction surgery is not a covered benefit, the New Life Center has arranged for affordable rates with the hospital and anesthesia.  The self-pay cost is about 1/3rd that of comparable surgery with area Plastic Surgeons.

Surgical Procedures:

When a patient has sagging skin of the lower abdomen it is called a pannus and removal is a “panniculectomy.”  The skin fold (intertrigenous folds) predisposes patients to rashes that are uncomfortable and difficult to eradicate.  The procedure involves making a low transverse incision above the pubic area that extends to the hip bones.  The skin and fat of the lower abdomen is elevated and removed.  The umbilicus is not repositioned in this operation, however, for an extremely large pannus it may be removed.

For patients that have an upper abdominal pannus as well as a lower one and laxity to the abdominal wall an abdominoplasty is indicated.  The most common operation is called a Fleur-de-Lis Abdominoplasty.  This procedure starts as a panniculectomy but has the addition of plication of the abdominal musculature to repair the abdominal wall laxity and protrusion.  The upper pannus is removed through a vertical incision from the breast bone to the pubis.  These two parts of the procedure have the effect of narrowing the waistline.  Finally, the umbilicus is re-implanted at the appropriate level.

All of the operations involve elevating skin flaps and sewing the skin back together.  When doing so, there is a large space under the skin that tends to collect fluid (wound seroma).  In order to evacuate the fluid as it develops a drain is usually placed in this subcutaneous (beneath the skin) space during surgery.  The drain will be left in place until the output decreases to less than an ounce/day.  The larger the space is the longer this may take.  Typical duration of drainage is two to four weeks but may be longer.

Post-operative bleeding is possible as with any other operation, however, because of the large subcutaneous spaces created with the abdominal procedures there can be significant blood loss possibly requiring transfusion if this occurs.  Finally, infection is also a concern because of the very long incisions required for these procedures.  Prophylactic antibiotics are given but do not eliminate this risk.