Bariatric Surgery
Bariatric Surgery: Patients who have undergone bariatric surgery often find that they have “deflated” skin on many parts of their body, including the face, arms, breasts, abdomen, and thighs, especially in patients who are over 50 lost kilograms of weight.
Effects of bariatric surgery
Surgery that restricts food to the stomach can have several adverse effects. One is loose, sagging skin all over the body. Since the previous weight has stretched the patient’s skin to the maximum, it has lost its elasticity, i.e. the ability to spring back. Instead, the slimmed patient faces layers of hanging skin, including an overhanging panniculus, a large apron of skin that hangs from the abdomen and can cover the pubic and groin areas.
This sagging skin can hang from the upper arms, chest, abdomen, thighs, and buttocks. These rollers and layers of skin can rub against each other, which can lead to irritation and hygiene problems. They can also make movement difficult.
The hardest-hit areas include:
Upper arms may sag and appear loose and full.
The breasts may become flat and drooping with the nipples pointing downwards.
The stomach area can extend around the sides and into the lower back, creating an apron-like overhang.
Buttocks, groin, and thighs can sag and cause sagging skin pockets.
How plastic surgery for body contouring works
Body contouring after massive weight loss are procedures performed by plastic surgeons to eliminate and/or reduce excess post-bariatric surgery. Body contouring improves the shape and tone of underlying tissues and removes excess sagging fat and skin, resulting in smoother body contours and a normal appearance.
While body contouring can be performed in one session, it is typically done in stages under general anesthesia. If the patient has a history of smoking, deep vein thrombosis or coagulation disorders, a high BMI, or other risk factors, additional precautions are needed.
The following are examples of common body contouring procedures:
Arm lift or brachioplasty. The extra skin on the arms of obese patients almost always appears on the underside of the upper arm and is sometimes referred to as “bat wings”. Surgeons make incisions from the armpit to the elbow to remove skin and create a flattering contour. As a result, the surgeons open the underside of the arm so that the resulting scar is well hidden. With brachioplasty, liposuction can be performed after the incision. With the arm open, the surgeon pulls the skin taut and then trims off the excess skin, which can be a pound of skin per arm or more, depending on the patient.
Breast lift or mastopexy. By trimming excess tissue from the upper breast, the surgeon can reshape sagging breasts into a more upright and fuller position. The procedure also often requires an implant to compensate for the loss of fat and tissue in the breast. Scars in women are almost always hidden in the bra area.
Tummy tuck or tummy tuck. Excess skin hanging over the pubic area is unsettling and bothersome to most patients. Gastric pannus retains moisture and causes skin rashes by rubbing against itself, usually resulting in poor hygiene. While the surgical procedure to remove it is called a panniculectomy, more effort is often required in patients who suffer from large amounts of sagging skin. To improve the contours of the waist, back, and flanks, surgeons sometimes perform a belt lipectomy (also called a torsoplasty or circumferential lipectomy).
The incision is made around the center of the patient at the level of the lower waist. The surgeon performs more liposuction on the abdomen and flanks while removing excess skin from the patient’s back and sides. The tummy tuck and girdle lipectomy are placed in such a way that the resulting scars are hidden under the underwear.
The lower body lift removes excess skin on the buttocks and thighs. For an inner thigh lift, the surgeon makes an incision high on the inner leg, starting near the groin and extending to the knee. Some fat can be removed with liposuction. The surgeon then removes excess skin and pulls back the remaining skin before closing the long incision, giving the patient tighter and more attractive thighs. The outer thigh and buttocks can be raised through a hip-to-hip incision across the back, above the buttocks.
Conclusion
Bariatric surgery usually achieves a sustained reduction in body mass index (BMI). However, the remaining sagging skin is reminiscent of the patient’s past obesity. Body contouring after bariatric surgery aims to correct this and restore a sense of normalcy. By reshaping the body to its ideal proportions, the success of weight loss surgery is fully realized.
