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.

Plastic Surgery:

The goal of plastic surgery after massive weight loss is to tighten loose skin left behind. Removing the excess skin can result in more proportionate body contours and can improve hygiene issues caused by overhanging skin. Every patient is different and  will have different post Weight Loss Surgical needs.

Our office will happily refer patients to respected Plastic Surgeons in the area. Please note: most procedures are considered cosmetic and are not covered by most insurance plans. Plastic Surgeons usually offer a variety of payment plans and financing options for clients.

Surgical Procedures:

Here are some examples of popular post-weight loss 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.

Abdominoplasty (Tummy Tuck):
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.

Breast Lift with Optional Augmentation

Lower Body Lift

Arm Lift

Medial Thigh Lift

Facelif and/or Neck Lift

Minimally Invasive Radiofrequency Skin Tightening

Some 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.