Shedding 100 or more pounds after gastric bypass surgery is only half the battle for patients who were morbidly obese before having the surgery. Getting rid of the excess skin that can keep these patients from wearing normal clothing and participating in normal activities is another big issue.
Liposuction is often helpful for those who lose 30 to 40 pounds and are near their ideal weight – especially if they have good skin elasticity. But it does not address the sometimes-huge amounts of draping skin left on the once morbidly obese (100 pounds or more over their ideal body weight) as they approach their ideal. Most of the patients in this category come to plastic surgeons looking for answers after having gastric bypass surgery.
If successful, gastric bypass surgery works to diminish the stomach’s size to that of about the size of an adult’s thumb. It also reroutes the small intestine so that it’s directly connecting the stomach and lower small intestine.
Surgeons have removed up to 40 pounds of skin from patients who have lost 200 pounds.
“You tell women or men who are 5’8″ and 350 pounds that they’re going to feel great about themselves when they have their gastric bypass and they only weigh 150 pounds – it’s just not true, [The problem is] when they’re 150 pounds and they have all this sagging skin, they still can’t wear normal clothing. They can’t put on a bathing suit or shorts. They still find it difficult to participate in a lot of activities. So the people who have had massive weight loss need to have skin reduction procedures – thighs, abdomens, arms, facelift.”
The technique for the tummy tuck is fundamentally the same whether the patient is a trim 35-year-old who wants her abdomen tightened after her child-bearing years or a woman of the same age who has had gastric bypass and lost 150 pounds. The goal, he said, is to restore the abdominal musculature and remove excess skin and fat. While the amount of skin removed from the two patients might differ, the procedure is the same.
While the most common area that the plastic surgeon addresses after weight loss is the abdomen, he said that patients also frequently complain about the excess skin on their thighs, breasts, arms, and face.
As people lose weight, the breasts also sag and become ptotic.
Many surgeons will find that there is little breast tissue left after they have reduced the skin envelope so the breast is in a more youthful position. If this is the case, he might recommend a combination breast augmentation and skin reduction for a better-proportioned result.
The natural effects of sagging on the skin around the face and jowls are accentuated with extreme weight loss, We do a lot of facelifts, which is primarily a skin reduction operation. The excess facial skin can make a 35- year-old who has lost a large amount of weight look 10 to 15 years older.
According to WebMD’s December 18, 2000, article, “Bariatric Surgery: It’s not for everyone, but when it works, the results can be dramatic,” the number of bariatric surgeries performed in 2000 was about 40,000, double of that in 1995. This reflects the country’s obesity epidemic.
“In the U. S., 55 percent of adults are overweight. Four million Americans are severally obese. Of that group 80 percent are women of childbearing age.”