Body Contouring After Massive Weight Loss: Challenges

By Jerome Edelstein, MD

As more and more people experience massive weight loss (MWL) due to procedures like bariatric surgery (for example, the lap-band or gastric bypass), plastic surgeons have had to refine the techniques they use to treat the side effects of this process.Bariatric surgery, while successful in treating obesity, takes a large toll on a patient’s body. To compensate for this, it’s essential to prepare the patient for the procedure by ensuring optimal health prior to any body contouring surgery, such as Circumferential Body Lift. This ties into the pre-operative evaluation, a crucial step toward ensuring a safe and efficacious treatment.

During the consultation stage, patients must be prepared to share their weight loss history in full detail. Prior surgeries can have an impact on contouring treatment and their timeline may also help surgeons to understand whether or not weight loss has stabilized. Surgery should only be performed once the patient has finished shedding body mass and begun following a proper exercise and diet regimen. Without a normal body mass index (BMI) that has remained stable for at least three months, body contouring results may not be long lasting or effective.

This information also allows plastic surgeons to determine whether or not the patient has been receiving proper nutrition. MWL is often accompanied by a substantial reduction in calorie intake and, because of this, can lead to deficient protein, mineral and vitamin levels. These deficiencies can adversely affect results or, worse, increase the risk of surgical complications.

By the time most MWL patients have come to a plastic surgeon for body contouring treatment, they’re no longer within the care of their bariatric surgery team. This means that they may not be actively monitored for the development of MWL related medical conditions. Lab tests work to safeguard against this by checking patients for vitamin, folic acid, iron, potassium and copper deficiencies. Without sufficient amounts of these elements, patients may experience or develop irregular metabolisms, trouble forming blood clots and other significant problems that can lead to improper healing and serious complications.PATIENT PSYCHOLOGYOnce a patient’s physical health has been established it’s important to evaluate their mental well being, too. Body contouring procedures can greatly improve an individual’s self-esteem, but, as with all aesthetic surgery, realistic expectations have to be set in order to provide these benefits. To complicate matters, many MWL patients have poor self-image, often experience weight loss alongside a stressful life event (like divorce) or suffer from body dysmorphic disorder.

Anyone who is currently troubled by psychological issues such as those listed above may not be a suitable candidate for body contouring surgery. With reasonable expectations and an optimistic outlook, however, the procedure can lead to complete satisfaction.

Providing MWL patients with body contouring treatment with a Circumferential Body Lift involves substantial challenges. Surgeons must begin the procedure by following a number of standard precautions related to pain management, antibiotic use and more. Follow-up appointments should be set in order to monitor body changes, wound healing and the patient’s general health. Instructions should also be provided that outline the details of a proper exercise and diet plan. If patients plan to travel a significant distance to or from their surgical facility, they should also be given instructions on how to avoid developing deep vein thrombosis during long stretches of inactivity.