Over the past few weeks (with the exception of Butts last week) we have been talking about weight loss and surgical options. This week I would like to start the discussion on what to do AFTER losing all the weight. I guess the first question is....who qualifies to have post bariatric body contouring?? Well, first of all, you must be healthy enough for elective surgery. This means that your medical conditions, if you have any, should be well controlled. I think it is a fairly well known fact that most insurances will not pay for this type of surgery so I wouldn't expect it.
Hypertension, diabetes, heart disease, renal and others should be stable. Fortunately, after massive weight loss, many of these problems are cured as the weight falls off. The second thing that cosmetic surgeons consider is the stability of the patients weight. My rule of thumb is a stable weight for a minimum of 12 months. In other words, after weight loss surgery, we usually don't perform any body contouring until the weight loss has stopped and a stable weight has been maintained for a year. This helps us avoid performing surgery more than once or getting results that are less than expected. Since most patients are spending their hard earned money for these procedures, this precaution is usually appreciated. One problem that weight loss patients struggle with is their new body image. Once the weight starts to fall, the skin, which has been hopelessly stretched, does not return to its normal position and begins to hang. As this occurs, patients have a tendency to become impatient with the process and want it removed. It is my job to encourage patience with the process and wait until the weight has stabilized.
The next step is planning. I like to start with a wish list....what bothers you about your new body sort of thing. Depending on the amount of weight lost, this can be a very long list. It also depends on how an individual loses weight. This can be different for each person. This is why there is no cook book remedy for everyone and procedures are personalized.
The procedures that are requested are numerous and will be discussed in coming weeks. Next week we will start with the most common procedure, the tummy tuck or abdominoplasty.