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Post Bariatric Surgery
Despite losing up to hundreds of pounds, patients who have undergone bariatric surgery can still be plagued with problems. Clothes that don’t fit right, inability to exercise, skin rashes and infections from excess skin folds can be debilitating issues to patients on a daily basis. Body contouring and breast procedures after massive weight loss can help complete the transformation, helping patients realize the full potential that their weight loss has provided. Common procedures for these patients include lower body lift (circumferential abdomnioplasty or belt lipectomy), brachioplasty (upper arm lift), thigh lift, mastopexy (breast lift), and liposuction.
Lower Body Lift (Circumferential Abdominoplasty)
A lower body lift or circumferential abdominoplasty involves a circumferential excision of excess skin and fat around the lower trunk. Of all post bariatric surgery procedures, the lower body lift has the potential to give massive weight loss patients the most dramatic results. The procedure involves removing extra skin and fat from the abdomen and tightening of the vertical abdominal muscles, producing a flat and firm tummy. The excision continues around the lower back, trunk and upper thigh, and reshapes the buttock and tightens the outer thigh and flank. After completion of this procedure, patients regain their mobility and find that clothes fit and look the way they have always wanted.
The recovery process usually involves a one to two night stay in the hospital, followed by a period of rest for one to two weeks. Swelling, mild pain and discomfort can be expected, but patients will be given pain medication and anti-inflammatories, which are immensely helpful during recovery. A compressive garment around the abdomen and lower back is worn to help reinforce the new body shape and provide support and comfort during the healing process. Most patients will have drains under the skin for a few days, and any non-absorbable sutures that are placed are removed after one week. However, the vast majority of stitches are absorbable and do not require removal. Most normal activities can be resumed after two weeks.
Arm Lift (Brachioplasty)
Brachioplasty is a great procedure for massive weight loss patients who feel uncomfortable wearing short sleeve shirts due to excess skin hanging below the arm from the axilla (armpit) to the elbow. The problematic excess skin is excised in an elliptical shape, which results in an incision discreetly placed on the inside/back of the arm. When necessary, the procedure can be combined with liposuction to remove any residual excess fat. The end result will give patients the confidence and freedom to wear short sleeve and sleeveless garments without the insecurity of flabby arms anymore.
Drains may be placed under the skin and are removed after a few days, and drains are generally necessary when the arm lift is combined with liposuction. Compression garments are worn to help with swelling and to keep the patient more comfortable during recovery. Stitches used in the skin closure are placed under the skin and are self-dissolving, not needing to be removed. Temporary numbness can occur on the inside of the arm above the elbow. Most patients can return to normal activity within a week.
Even after losing up to hundreds of pounds, post-bariatric patients can still be plagued with difficulty exerting themselves or exercising because of extra folds of skin on the inside of the legs. The excess skin can be severe enough to make it difficult even to walk. A thigh lift excises an ellipse of skin oriented along the long axis of the upper, inner leg. The incision, which results in the excision of excess skin and fat, starts on the inner thigh and continues upward along the groin crease. After the procedure, patients will gain freedom of movement and can exercise and walk more comfortably. Additionally, the procedure enables them to wear shorts, skirts and pants with confidence.
Compression garments will be worn for the first two weeks after the procedure for the patient’s comfort and to assist in keeping the swelling down. Drains placed under the skin are usually removed within the first week. Stitches used in the surgery are placed under the skin and are self-dissolving, and do not need to be removed. Patients usually can return to normal activity within one to two weeks and may exercise fully within three to four weeks.
Call us for an appointment to discuss your options for post bariatric surgery.