Reclaiming Your Body After Weight Loss
May 6, 2019Patients can lose 70-80 percent of their excess body weight with weight loss procedures such as the sleeve gastrectomy or gastric bypass. For some patients, that can mean 100 or more pounds of weight loss. After losing weight, patients have a different body and can focus on reclaiming your body after weight loss.
The simple activities of everyday life that used to cause patients issues – walking, driving, sleeping, even breathing – are no longer a burden.
Losing this excess weight can be liberating. Weight-related medical problems such as high blood pressure, high cholesterol, arthritis, type 2 diabetes, sleep apnea, infertility, and other conditions are often improved or eliminated. Patients report more energy, confidence, enjoy socializing more, and a better quality of life.
Loose, Excess Skin After Extreme Weight Loss
After extreme weight loss, many are left with loose, excess skin. Loose skin is the result of multiple factors including rapid weight loss, age, initial weight, and even genetic components. When weight is reduced more slowly, the skin’s elasticity often allows it to adapt with less stretching. But with rapid weight loss, such as seen commonly after weight loss surgery, the skin does not adjust as quickly resulting in excess. The same result can occur after pregnancy and childbirth.
And while you may see positive results on the scale after your weight loss, you may still not like what you see in the mirror. Your clothes may not fit right, and excess skin can cause irritation or discomfort. In some cases, a rash or even an infection can develop.
Oftentimes, no amount of exercise or toning will fix this sagging skin.
Reclaiming Your Body After Weight Loss
To help patients with this concern, a surgeon can perform an array of plastic surgery procedures. A skin excision (panniculectomy) can remove excess, sagging skin, and an abdominal wall reconstruction (abdominoplasty) can lift and tighten the abdominal muscles. This creates a smoother, firmer abdominal profile. Abdominal surgeons can partner with plastic surgeons who can add on other body contouring/cosmetic procedures including arm lifts, breast lifts, etc.
In addition to the cosmetic benefit of abdominal wall reconstruction, patients experience less bloating, constipation, and improved low back pain. The procedure also helps patients improve their posture, so they stand a little taller and project more confidence.
Notably, research shows that cosmetic abdominal surgery after weight loss surgery greatly increases the probability of long-term weight loss success. Patients keep the weight off longer and are more committed to maintaining their new healthy lifestyle.
A study in Plastic and Reconstructive Surgery, the official medical journal of the American Society of Plastic Surgeons (ASPS), demonstrated this. The researchers compared long-term weight outcomes for two groups of patients who underwent gastric bypass surgery. Approximately half of the patients (98) had gastric bypass followed by body contouring procedures (skin excision and abdominoplasty to remove excess fat and skin with abdominal wall muscle tightening). A matched group of 102 patients with similar characteristics underwent gastric bypass alone, without body contouring.
Weight Regain Results With and Without Plastic Surgery
The research tracked the changes over seven years and found that on average the weight regain was about 14 pounds in patients who had gastric bypass plus body contouring, compared to nearly 50 pounds with gastric bypass only. The study suggested that body contouring should be considered an essential part of bariatric surgery. While most bariatric surgeons don’t think of it as essential, it is a very effective reconstructive surgery for those who have achieved significant weight loss.
Some patients feel like they need this extra procedure to feel “complete” and comfortable in their body.
Nicholson Clinic patient, Trina (not her real name), lost 100 pounds with weight loss surgery. She felt better and was thrilled with the weight loss, but two years post-surgery said, “I didn’t feel like I was complete, even though I had reached my goal weight. With the extra skin that I had and my abdominal muscles not being tight, I never psychologically felt like I was done losing weight.” It was an internal struggle of feeling good but not looking as good as she felt. After the body contouring surgery, she told me “this was the completion to my journey!”
Having said all of this, weight loss surgery and abdominal wall reconstruction is not the easy way out. It still takes hard work and commitment. Patients need to stick to healthy eating habits, get regular exercise, manage stress, and get plenty of sleep. There may be times where one struggles, and that’s ok. Talk about feelings with those you trust and take advantage of any in-person and/or online support groups your clinic may offer.
Before considering body contouring, patients should wait until their weight has stabilized, approximately 12-18 months post-surgery. Body contouring may be appropriate for anyone who has experienced significant weight loss (surgical or non-surgical) and for women post-pregnancy who have lost their baby weight.
Abdominal Hernia and Plastic Surgery
In addition, these procedures can be recommended for those who have been diagnosed with an abdominal hernia. Hernias can cause significant stretching of the skin or muscle and can be quite painful. Many hernia patients experience nausea, constipation, and cannot exercise due to pain or discomfort. This procedure can help improve these symptoms and prevent more serious complications from presenting themselves.
The procedure involves an incision on the pelvis which would be hidden by one’s undergarments. If a hernia repair is needed, the surgeon will replace any herniated organs within the abdominal cavity, then close the hernia. If indicated, a body contouring procedure can be combined and performed during the hernia repair. Excess skin is removed, and the muscles are reconstructed and tightened, improving the shape of the underlying support tissue. This creates the tighter, smoother appearance of the abdomen, pelvis, and core.
Plastic Surgery and Hospital Stays
Most patients will plan to spend at least one night in the hospital. Many people are able to work from home within three to four days after surgery, and patients typically return to work within two weeks. While some insurance plans may cover part of the procedure, the majority of cases are now self-pay. However, this can be better understood by meeting with a surgeon. Patients should not let finances deter them as there are financing options and payment plans that can be explored.
If you are considering “completing the journey” of weight loss with abdominal wall reconstruction or body contouring, please contact an experienced abdominal surgeon today to learn more about your options.
 | ABOUT THE AUTHOR Dr. Thomas Roshek specializes in the treatment of obesity and performs sleeve gastrectomy, gastric bypass, gastric balloon and revisional weight loss surgery. He also specializes in the repair of abdominal and groin hernias/complex abdominal wall reconstruction. Dr. Roshek works at the Nicholson Clinic for Weight Loss Surgery, one of the country’s premier destinations for weight loss. |
