POST-BARIATRIC
Obesity is a disease characterized by excess fat in the body, which in most cases generates a series of comorbidities such as high blood pressure, type 2 diabetes, and sleep apnea, among others. The main causes are excessive food intake, lack of physical activity, genetic tendency, hormonal dysfunctions, and even pregnancy.
WHAT IT IS AND HOW IT IS DONE
The main goal of bariatric surgery is the health of the patient. After weight has been reduced and stabilized, the skin and subcutaneous tissues often lack elasticity and become unsupportive. As a result, the skin on various parts of the body can become unsightly, with a sagging appearance. The breasts may flatten out and be left with drooping nipples.
The skin of the abdomen may extend over the front, sides, and back, resulting in an apron-like bulge. That of the arms, thighs, buttocks, and groin may sag, causing hanging pouches.
Body contouring surgery – also known as Post-Bariatric plastic surgery – after major weight loss, improves the shape and tone of the underlying tissue, which supports fat and skin, and removes excess fat and sagging skin. As a result, an appearance more in line with each patient’s biotype can be achieved. This is, in essence, the final stage of the weight loss process.
It depends on each case, but it can take 2 years, or more, to lose all excess weight and stabilize it. Ideally, Body Mass Index (BMI) should be below 29. It may take the same amount of time for the results of the surgeries to fully appear. One thing is certain: in the end, it is all worth it!
The Post-Bariatric procedures require incisions to remove excess skin and, depending on the amount and location, can be extensive. We use advanced techniques that usually allow the incisions to be made in strategic locations where they can be hidden by most types of clothing. However, this is not always possible.
Normally, we plan with 5 or more surgeries to correct excess skin, which can be done in 2 or 3 operative times. We use surgical techniques for each part of the body (please refer to pages by the respective links), as follows:
Abdomen and region – Typically, Post-Bariatric procedures begin with a body lift that treats abdomen, waist, hips, buttocks, and hips. Incision types can vary, including a circumferential one around the body to remove the “belt” of excess skin and fat. In this surgery it is possible to correct abdominal diastasis. We use the surgical technique of the Abdominoplasty.
Breasts – Incisions for removing sagging breasts are determined based on the amount of excess skin to be removed. From single incision to combination of several, such as circular pattern around the nipple and/or vertical line extending from the areola to the breast crease and horizontally along the breast crease. Implantation of breast prostheses may be recommended to improve breast shape and size. Surgical techniques of the Augmentation Mammaplasty and the Mastopexy.
Arms – Skin laxity on the arms is treated with an incision in the armpit area, extending to the inner or, from the back, upper arm. Additional incisions may be necessary wherever there is excess skin. Surgical technique of the Brachioplasty.
Thighs – Remodeling of thigh contours is achieved through incisions in the groin that may extend down to the knee along the inner thigh. When flaccidity is very important, in order to improve the contour of the external part of the thigh the scar becomes apparent. Surgical technique of the Cruroplasty.
Face – Excessive weight loss causes sagging face and gives it an aged appearance. The main regions affected are the eyelids and jowls. Surgical techniques of the Blepharoplasty and of the Rhytidectomy.
After surgery, dressings or bandages may be applied over the incisions and the patient may be wrapped in an elastic bandage or compression bandage to minimize swelling and support the new contours as they heal.
INDICATION
Losing (a lot) of weight is the effective alternative to improving quality of life and significantly reducing the risk of death. There are two ways to do this. One is drastic dietary re-education accompanied by exercise.
The other is bariatric surgery, known as stomach reduction. The most used surgical techniques in Brazil are vertical gastrectomy (sleeve) and gastroplasty with jejunal shunt (gastric bypass). In both cases, it is essential that the patient be prepared and assisted by a specialized multidisciplinary team.
Post-Bariatric is a reconstructive surgery indicated for women and men of any age who feel uncomfortable with their aesthetics due to excess skin all over the body, the result of significant weight loss.
Not infrequently, this condition limits mobility, causes dermatitis, leaves the abdominal muscles flaccid (diastasis), among other problems. Facing this picture, rescuing self-esteem can also be an incentive for a happier and fuller life.
The procedure is usually indicated when the patient reaches the weight loss stipulated by the surgeon who performed the Bariatric procedure. In addition, the weight should be stable for at least 6 consecutive months. It is very important that the patient is committed to leading a healthy life, including proper diet and good shape.
This is important because, if you continue to lose weight, sagging can reappear. If you gain weight back quickly, it can traumatically stress the skin and cause stretch marks and enlarged scars on the skin.
PRE AND POSTOPERATIVE
It is essential to consult the SCHEDULED THE SURGERY? page which has a series of questions to talk about during the consultations, to help you with your doubts and where you will find recommendations for the day of the procedure.
Likewise, we suggest that you refer to the post-operative items on the respective pages of the surgical techniques indicated for you. Depending on the extent of the Post-Bariatric, we pass on more important information for you to prepare for the surgery such as prior and subsequent lymphatic drainage sessions, use of surgical garments or compressive meshes, among other recommendations.