Post-Bariatric Body Contouring Surgery (BCS) reduces the excess skin and fat that is left behind from the expansion of skin, loss of fat and lack of tissue elasticity that often occurs after a major weight loss. This sagging skin commonly develops around the face, neck, upper arms, breast, abdomen, buttocks, and thighs and can make your body contour appear irregular and misshapen.
The skin left after weight loss will not shrink on its own and can pose many problems including hygiene issues, skin irritation and continued negative self-image; BCS offers relief from these symptoms.
Patient symptoms usually dictate the sequence of surgery. Depending on individual patient factors and the extent of surgery needed, some patients require multiple operations, which are typically performed in stages.
Through recent advances in all types of BCS, it is now possible for many patients to have a more proportionate body, better body image, and more self-confidence. The best way to get answers to your specific questions and to see if you are a good candidate for this type of surgery is through a personal consultation with a board-certified plastic surgeon. The success of body contouring, like any cosmetic surgery procedure, is influenced by your age and by the size, shape and skin tone of the area to be treated. Remember that no two patients will have exactly the same results. If you are considering plastic surgery after weight reduction surgery you may be one of many patients who demonstrate skin excess in the abdomen, thighs, breasts and upper arms after such surgery. It is vital in these patients that the weightloss that follows bariatric surgery has stabilized, and that their nutritional status is excellent prior to considering plastic surgery. It is usually recommended to wait at least six months to a year after bariatric surgery.
Abdominoplasty: A standard abdominoplasty removes & tightens excess skin and fat from the middle and lower abdomen. Though similar to a panniculectomy, abdominoplasty is more extensive, involves muscle tightening, and allows one to address any hernia related to bypass surgery. An extended abdominoplasty tightens the abdominal wall and the flanks (sides) improving the upper lateral thighs.
Autologous Fat Transfer: Following massive weight loss, fat is often lost from areas in the face which may result in premature ageing. An autologous fat transfer removes surplus fat cells and re-implants where needed. Common areas include the lips, under eyes, cheeks, chin, temples and jaw line.
Brachioplasty: With excessive weight loss, upper arm skin can become loose and flabby. Brachioplasty (arm lift) removes excess skin and fat deposits from the upper arms. The incision extends from the elbow to the underarm, and sometimes on to the side of the chest.
Breast Reduction & Lift: Reduction mammaplasty (breast reduction) removes fat, glandular tissue, and skin from the breasts, making breasts smaller, lighter, and firmer. Mastopexy (breast lift) raises and reshapes sagging breasts. It is occasionally necessary to utilize a breast implant at the time of mastopexy to augment breast volume.
Face & Neck Lift: After dramatic weight loss, facial skin can become flaccid resulting in the loss of a defined jaw line. In addition, the neck is often loose and, sagging. A facelift raises the cheek pads, corrects the jowls, and removes loose, sagging skin. The incisions are inconspicuously placed in front of and behind the ears, extending into the hair above and behind the ear.
Lower Body Lift: Also referred to as a "Belt Lipectomy," a lower body lift corrects the sagging skin of the abdomen, outer thighs, buttocks, hips, and waist. Incisions extend completely around the body to remove a "belt" of excess skin and fat.
Medial Thigh Lift: Drastic weight loss can result in sagging skin on the inner portion of the thighs. A medial yhigh lift lifts and tightens the sagging skin of the inner thigh. Incisions are usually placed in the groin, making them inconspicuous.
Panniculectomy: A panniculectomy is performed to remove the hanging pannus, or apron of skin, from the lower abdomen below the belly button. The excess skin and fat above the belly button are not removed. A panniculectomy is also often performed on patients who are still significantly overweight but have skin irritation from their hanging skin.
Will my BCS be covered by insurance?
There is no guarantee that a BCS procedure will be covered by insurance. However, because many of the procedures are more reconstructive than cosmetic, there is a chance that at least a portion of the surgery cost will be paid for through insurance. If your insurance provider does not approve the entire fee, financing options are available for the outstanding amount.
What are the risks associated with BCS?
The general risks associated with BCS are similar to those related with any surgery performed under general anesthesia. Patients can expect a safe procedure and, with proper follow up, a comfortable recovery.
Will there be scarring?
Scarring from BCS can range from small and inconspicuous to larger and more noticeable depending on the extent of the procedure. Most patients find scarring acceptable and enjoy greater self-confidence when wearing a bathing suit or form-fitting clothes. While the results of body contouring are visible immediately, if you have poor skin elasticity or gain weight, you will have some relapse of the sagging skin.
I just finished recovering from my Bariatric Surgery. How long must I wait before getting BCS?
After bariatric surgery, patients may be nutritionally deficient, and this can have consequences for surgery and recovery. Patients may be referred for nutritional counseling and advised to wait a year or longer following their weight loss before undergoing plastic surgery. It is also important for the patient's weight to stabilize to a level approaching normal BMI before BCS.
How extensive is BCS?
Some patients prefer to have BCS only in one or two specific areas. Many massive weight loss patients, however, choose to address the entire upper and lower body trunks, resulting in a more satisfying, complete transformation.
After BCS, how long can I expect my new "look" to last?
Results for post-bariatric BCS are considered permanent. Often, however, the skin tissue of a massive weight loss patient is permanently damaged from being stretched and has lost its tightness and tone. This can cause some skin loosening as the patient ages.
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