Completing Your Journey - Plastic Surgery by Dr. Edward Jonas Domanskis, MD, FACS - May 2007 The pounds are off, but the skin is still there; you feel thin, but your mirror tells you otherwise. You had ruled out plastic surgery before your bypass, but you are anxious to complete the journey. Unfortunately, your insurance company will not pay for what they consider cosmetic surgery. Finally, when you can?t stand looking at all that loose skin anymore, you make an appointment with a plastic surgeon. In this scenario, it may be difficult to decide what part of the body to fix first. I suggest that the patient address the area that they are most unhappy with first. For many people it is the abdomen, where the loose skin may hang down over the belly button and pubic area, but your arms, thighs, breasts, or even face may present more of a problem for you. Fortunately, several areas can be addressed safely in a single operation; in my practice, combining procedures is the norm. Your goal is to finish your process as quickly as possible, and mine is to accomplish this safely. To determine whether a patient is a candidate for any body-contouring procedure, I use these criteria: the patient?s weight must have stabilized for about six months; he or she must be healthy; and diabetes, high blood pressure or other medical problems must be under control. Smoking is contraindicated for a complication-free recovery. I set a maximum operation time of six hours, and we decide what areas can be altered in that timeframe. This may include abdominoplasty (tummy tuck), brachioplasty (arm lift), breast surgery or liposuction. When combining procedures, I often require the patient to donate blood beforehand that can be used during the operation. Some operations can be done in an outpatient or same-day surgery center, while others, especially combined procedures, may require an overnight hospital stay. Since most of these surgeries involve removing excess skin and underlying fat, pain is mild and easily controlled with oral medications. The recovery from these procedures is also relatively quick, with most patients up and walking by the next day and resuming normal activities within a week or two. Combining procedures may require a longer recovery in some cases, but it lets you save on costs and gets you closer to your goal of feeling better about your body. ![]() |