POST BARIATRIC (WEIGHT LOSS) SURGERY Procedure Pictures
Major weight loss, whether through surgery or diet/exercise, is highly transformative for patients, leaving them healthier, happier, and more energetic. However, the weight loss is often just the first step in their journey. In many cases, as the body shrinks down to its new, smaller, healthier size, the skin cannot shrink along with it due to a loss of elasticity. The result is excess skin along the face, breast, arms, waist, and thighs that detracts from the new hard-earned physique.
Plastic surgery after weight loss can dramatically reverse these changes. If you are ready to learn more about post bariatric plastic surgery, request a consultation online with Dr. Steele, or call our office at 712-224-8677. We serve patients in Sioux City, IA and surrounding communities and we welcome patients who wish to travel from Sioux Falls, SD and Omaha, NE.
Your Surgical Options
Many patients who have achieve significant weight loss will require more than one body contouring procedure, often in stages. Additional procedures can improve the appearance of the breast, arms, and face. If you have obtained a stable weight and are maintaining a healthy lifestyle, the time may be right to visit Dr. Steele in Sioux City for body contouring surgery. Because weight loss affects each patient differently, Dr. Steele will take the time to answer your questions and help design an individualized surgical plan to optimally and safely achieve your goals. Weight loss patients commonly undergo the following lifting and tightening surgeries:
Upper Arm Lift (Brachioplasty)
This procedure is designed to deal with upper arm skin and fat (often called “bat wings”). Through an incision along the inner arm running from the elbow to the armpit, the skin and fat is excised, often in conjunction with liposuction of the arm. In milder cases, a limited-incision brachioplasty may be an option with the incision limited to the armpit. Click here to see arm lift photos
Lower Body Lift
A lower body lift, also referred to as a circumferential tummy tuck or belt lipectomy, is an extension of a tummy tuck that removes excess skin along the upper hips and buttocks. The result is improved contour and skin tightening around the entire trunk. Click here to see body lift photos.
Inner Thigh Lift
Similar to the upper arm, the inner thigh can be left with residual skin and fat after weight loss. An inner thigh lift, often combined with liposuction, will rejuvenate and tighten the inner thigh. After a body lift, most patients will notice a small improvement in the upper/inner thigh. For that reason, the inner thigh lift is typically performed in a staged fashion after the body lift or tummy tuck procedure.
Like many women who have had children, weight loss patients will often note significant sagging and loss of breast volume. A breast lift or breast lift with implants may be an option to rejuvenate the breast by reshaping the breast, while adding volume to the upper breast. In some weight loss patients, the extent of sagging can be such that it is unsafe to combine a lift with implant at the same operation. In these cases, Dr. Steele recommends proceeding first with a mastopexy (lift) with a delayed breast augmentation 3-6 months later.
Because of the poor skin quality in most weight loss patients, liposuction alone is typically not performed due to worsening of the skin laxity. However, many of the above procedures will be combined liposuction to remove fat in combination with skin excision for tightening.
Unfortunately, significant weight loss can result in loss skin in the face resulting in a turkey neck and jowling. This often makes people look older than their actual age. A facelift can tighten the face/neck skin and reposition the tissues into a more youthful position.
A body lift surgery typically requires an overnight stay due to the length of surgery. Other procedures may be performed on an outpatient bases, however, if multiple procedures are combined together, an overnight stay may also be required.
Recovery time will vary depending on the procedures performed. For a body lift, patients generally need about two weeks off from work. Other procedures such as an arm lift or breast lift have a speedier recovery, often getting back to work within the week. Patients need to avoid cardio activity for 4 weeks and avoid lifting more than 15 pounds for 6 weeks. More vigorous activity like push-ups and planks can be started at 2 months. Depending on the surgery performed, a compression garment or bra may be necessary. Many of these procedures require the use of drain tubes that may stay in place for a few weeks depending on fluid output. You will be given antibiotics, pain pills, anti-nausea pills, muscle relaxants, and for some patients, blood thinning shots to cut down on the risk of deep vein thrombosis (DVT) or blood clots. Although these procedures result in lengthy scars, Dr. Steele will provide optimal scar care instructions to give you the finest scar possible.
POST BARIATRIC (WEIGHT LOSS) SURGERY FAQS
What body parts are involved?
Common body parts addressed include the abdomen, buttocks, thighs, breasts, arms, and neck. The breasts and abdomen are the most common. In patients with very significant weight loss will require an extended or circumferential tummy tuck to deal with skin laxity all the way around the body. I recommend proceeding with this procedure first as it gives the most “bang for the buck.”
How do you stage these surgeries?
As noted above, the first procedure is typically a body lift (all the way around tummy tuck). After this, the patient can decide what area bothers them most. Typical patients will have 2-3 surgeries. The second procedure is often the arms and breasts or arms and thighs, or some similar combination. Ideally, the patient should have a stable weight for 3-6 months and be very close to their ideal body weight. Significant weight loss or weight gain after the procedures will compromise the result.
Will insurance cover these procedures?
Generally no, because they are considered cosmetic. In some cases, your insurance may pay for the lower 1/3 of the tummy tuck, known as a panniculectomy. This varies widely between insurance companies.
Am I candidate for post weight loss surgery?
If your weight is stable and close to your ideal weight and you have no significant medical issues, then you should be a candidate. Patients who have had a gastric bypass often need some preoperative lab work to check their protein and calcium levels. They also need to makes sure they are getting their B12 injections to avoid anemia.
How bad are the scars?
Because of the significant amount of loose skin, the scars can be lengthy. However, patients are so pleased with their new contour and new look, that they are willing to trade the scars for their wonderful results. Dr. Steele is a meticulous perfectionist and will take the time necessary to give you finest scar possible. He will also instruct you on post surgical scar care.
What about stretch marks?
Generally a body lift will remove all stretch marks below the belly button and lower waist/upper buttock area. Patients with upper abdominal stretch marks will get some improvement- they will be moved lower down on the abdomen and will be tighter, which helps diminish the appearance. Stretch marks in the upper breast cannot be excised, however, the placement of an implant makes them less noticeable by placing tension and stretch on the skin. Some stretch marks in the inner arms and thighs can be removed and those on the outer aspect may be improved by tightening the skin.
Can I expect to lose weight and go down a dress size?
A body lift is not a weight loss procedure, but I typically will remove at least a pound of fat from each hip/waist area with liposuction and 4-8 pounds of skin and fat from the abdomen, hips, and low back. This varies widely from patient to patient depending on how much fat is underneath the excised skin. Patients may notice an immediate weight gain after surgery due to the fluids received from anesthesia, but this is only temporary. Most of my patients will notice a drop in at least two dress sizes, and in some cases up to four.
How soon can I return to normal activity?
You will have a graduated return over several weeks to 2 months. It is important to return to light activity right after surgery to minimize the risk of DVT (blood clots). Most patients are back at work by 10-14 days. Cardio activity can be resumed at 4 weeks and heavy lifting (>15lbs) at 6 weeks. Core activity can start at 2 months.
What if I am still overweight?
A body lift is not weight loss surgery. It is designed to improve contour and remove excess skin and some fat the results in patients who still have large amounts of fat are not very good. Similarly arms and thighs that are still full of fat are very difficult to improve compared to arms/thighs that are full of loose skin. Dr. Steele advises patients to be as close to their ideal body weight as possible, with a body mass index (BMI) between 25-30. Patients who lose significant weight after their surgery can be left with recurrent loose skin due poor skin tone. Also, patients who are obese (BMI > 30) do not get as good a result compared to patients of normal weight and are at higher risk for complications including delayed healing, fluid pockets (seroma), and deep vein thrombosis (DVT).
Is it safe to combine these procedures?
There are always risks involved with surgery, however, with today’s modern anesthesia, the risk is very minimal in healthy patients. Medical problems such as asthma, high blood pressure, and diabetes may increase your surgical risk and may require a preoperative medical evaluation to gauge suitability for this longer procedure.