Obesity is fast becoming one of the major health concerns in the western world. High blood pressure, Diabetes, joint problems and many more issues frequently affect the obese. Significant weight loss will do wonders for your health, but can leave an embarrassing legacy of unwanted skin folds. Regaining your figure will require professional help.
Following significant weight loss after dieting or Bariatric Surgery the body’s subcutaneous fat and surrounding skin hangs in folds. This is uncomfortable and interferes with normal activity. It can also be embarrassing. The areas affected are similar in each patient – the abdomen hangs forming an apron, breasts become droopy and empty, and buttocks flatten and hang. The inner thigh and inner arm are also problems with pendulous skin excess. Occasionally back folds in the upper back are a problem too.
Exercise can help tighten the muscles, but is of little assistance in correcting the folds of skin/fat that cause such embarrassment. The correction of these unwanted skin/fat folds involves staged operations. Four or more procedures are sometimes needed to optimise body shape. The operations remove excess skin, unwanted scars, stretch marks, fat and can tighten the stomach muscles.
Most patients wish to have the excess abdominal tissue removed first. These patients usually require a belt lipectomy which involves removal of tissue from all around the lower trunk. A belt lipectomy operation is performed under general anaesthesia and usually requires a hospital stay of 3- 4 days. Although this operation leaves a long scar, it does provide the greatest degree of improvement in shape. Subsequent operations involve lifting and filling empty breasts, arm and thigh tucks, and adjunctive liposuction.
At the initial consultation, patients are carefully assessed for skin quality, the quantity of fat and muscle tone. General fitness for the procedure will be evaluated and potential for problems considered. Reasons for wanting the procedure will also be discussed. It is important that expectations concerning the outcome of the procedure are realistic.
Photos show patient before and after abdominoplasty (tummy tuck) and mastopexy/augment (breast lift)
Healing is a variable process and it may take a month to six weeks to feel like your old self again. People vary enormously in their recovery period. Immediately following surgery there is both bruising and swelling. The scars are healed by the end of the first week, but continue to mature for up to a year, by which stage they should be thin, fine, inconspicuous lines. Once home, patients are advised to mobilize gently around the house and rest frequently. After a week this can be extended to walks in the park and to the local shops. Gentle exercises can be begun about one month after surgery; vigorous exercise should be avoided for around six weeks. Return to work is usually possible after one month to six weeks depending on occupation, and the type of procedure.
When performed by a qualified plastic surgeon, surgery after massive weight loss is normally safe and the results predictable. Nevertheless, as with any surgery, there is always a possibility of complications and these have to be fully discussed before any decision is taken on surgery.
Belt lipectomy produces excellent results for patients following massive weight loss. In most cases the results are long lasting, especially if after the operation you avoid weight gain, follow a balanced diet and exercise regularly. Remember that realistic expectations are important. Patients are similarly satisfied with breast, thigh and arm rejuvenation which is also long lasting. The scars are permanent, but fade with time.
These can be long procedures and choice of hospital and surgeon is important.
With thanks to Mr. Mark Soldin, Consultant Plastic Surgeon, and national Chair for BAPRAS 'Body Contouring after Massive Weight Loss Group'.
St Anthony's Hospital. Tel. 020 8337 6691