How risky is the tummy tuck after bariatric surgery?

Introduction
There is no doubt about the fact that bariatric surgery can be highly beneficial for patients suffering from morbid obesity or are just severely overweight. Bariatric surgery is recommended for patients with an IMC of 40kg/sqm or larger, a history of obesity of over five years, ages 18 and 60 years old. However, just like any other surgical procedure, there are risks and potential complications associated with undergoing bariatric surgery.
After undergoing bariatric surgery and losing weight, most patients notice that the appearance of their body is still not a desirable one, and this is the time when plastic surgery comes into discussion. However, undergoing plastic surgery entails risks once again. So, how risky is the tummy tuck after bariatric surgery? In this article, we will discuss issues associated with undergoing bariatric surgery followed by plastic surgery.

More about bariatric surgery
The surgical procedure performed to help patients lose weight by limiting food intake done in different ways is called bariatric surgery. Obesity is a condition that affects both children, teenagers, and adults, and more and more people are confronted with it and the issues associated with being obese every day.
Bariatric surgery doesn’t just lead to a sudden weight loss, but also to a change in hormones. If obesity is known to increase estrogen production both in men and women, sudden weight loss automatically reduces estrogen in the body. This is why after undergoing bariatric surgery, it can happen for patients to find it difficult to manage their emotions, and it is not uncommon for a new, heavily restricted eating regimen combined with the changes in hormonal balance to trigger irritability. Some patients go through this process barely noticing their emotional condition while for others it can be a real struggle. Combined with the new perception of the self and the difficulties that can occur during the recovery period, it can be rather difficult for some patients. Patients might also find it disappointing to notice that despite the sudden and massive weight loss, the appearance of their bodies is still not what they hoped for.
One of the factors that can significantly alter the appearance of the body is weight fluctuations, especially sudden weight loss.

What happens after bariatric surgery?
The expected result after bariatric surgery is weight loss. The weight loss occurs suddenly, but it can take up to twelve months or more for patients to get back to a normal weight, especially if they were severely obese before the procedure. In the following months after the surgery, the patient will start losing weight as a result of the effects of the surgery. The patient will also need to adjust to a new, restrictive eating regimen that is very different from what they did before. The quantities of food that can be ingested in one meal are maybe a tenth of what they used to eat before, and this can be disconcerting for the patient.
With weight loss, skin sagginess will occur. What happens when we gain weight is that the skin is stretched to accommodate the excess kilograms. When we lose weight, the kilograms will go away, but not the overstretched skin that will be left behind. It is not possible for the skin that was stretched for so long to shrink back and retract on the new contours of the body, especially when we are talking about severely overweight or obese patients. In areas where there is a more considerable fat accumulation, the skin sagginess will be more extreme, creating other problems for patients.
Among the complaints that we often hear from patients who had bariatric surgery is having a belly apron. After weight loss, there will be skin folds hanging on the abdominal wall that will cover the pubic area partially or entirely. This skin fold will take the appearance of a belly apron, hence the name. The belly apron doesn’t come associated with health complications; it is just an aesthetic issue, but it can be difficult for the patient to live with it, not to mention its unsightly appearance.

How risky is the tummy tuck after bariatric surgery?
Due to the unsightly appearance of the body that patients undergoing bariatric surgery are confronted with, most of them consider plastic surgery to correct the aesthetic imperfections. The reality is that no matter how active you are and committed to your daily physical exercise routine and eating healthy and balanced meals, there is little one can do about skin sagginess. The only optimal solution that can efficiently correct the problem is plastic surgery.

The tummy tuck is often the procedure recommended for patients who had bariatric surgery and lost a considerable amount of weight. The procedure can be performed as a stand-alone or with liposuction if the patient still has unwanted adipose tissue on the flanks or the abdominal wall.
The tummy tuck entails the removal of the excess skin on the tummy, but can also correct the loose and weak abdominal muscles and umbilical hernia, if present. The tummy tuck is a major and complex plastic surgery procedure that is also associated with risks and complications, just like bariatric surgery. Let’s have a look at what the procedure entails.

When undergoing abdominoplasty, patients are often administered a general anesthetic. Once the anesthetic takes effect and the patient is asleep, the plastic surgeon will make an incision on the lower part of the tummy in the suprapubic area. The length of the incision is dependent on the amount of tissue that is estimated to be removed from the abdominal area. If the patient has skin folds on the flanks as well, the procedure is called an extended tummy tuck and it entails incisions on the flanks as well.

After the incisions are done, the skin tissue is lifted from the muscles and elevated up to the level of the rib cage. This will allow the surgeon access to the abdominal muscles so he can bring them together on the median line and strengthen them with sutures. This ensures a flat and firm appearance of the tummy post-op. If umbilical hernia is present, it will be corrected at this stage of the procedure. After strengthening the weak abdominal muscles, the surgeon will re-drape the skin on the tummy. Usually, there will be a need for a second incision to be performed around the belly button that will allow its repositioning. If the sagginess is severe and present on the upper part of the tummy, an incision around the navel is mandatory.

After ensuring good tension on the abdomen, the excess of skin is removed. For some patients, it can be a few kilograms of skin and underlying fat tissue that are removed. After the incisions are sutured, the patient can go to the recovery room where he will spend the next few hours under medical supervision. Usually, there is no need for patients getting a tummy tuck to stay for longer than a few hours in the hospital.

Is it risky to get a tummy tuck after bariatric surgery? There are risks associated with both procedures, but the tummy tuck can help patients regain a beautiful appearance of the body and erase the signs of obesity from their bodies completely. This is why many patients choose to undergo the procedure despite the inherent risks. Keep in mind that most of the risks associated with the tummy tuck are specific to any other surgical procedure such as infection, delayed wound healing, seroma and hematoma, excessive bleeding, deep vein thrombosis, and so on. The incidence rate of developing a complication is small if the patient takes time to recover after bariatric surgery completely and has no other pre-existing health conditions that are contraindications to the tummy tuck.

Conclusion
Undergoing plastic surgery after bariatric surgery has become quite a common practice nowadays as patients are not happy with the appearance of their bodies after sudden weight loss. After the excess weight is shed off, most patients are left with significant amounts of saggy skin in different areas of the body, including the tummy. To get rid of this skin and to correct other imperfections of the abdominal wall and the flanks, the tummy tuck procedure is recommended. The tummy tuck as well as bariatric surgery, and in general any surgical procedure, is associated with risks and complications. It is important for patients to be fully restored and in good physical and emotional condition after bariatric surgery before getting a tummy tuck.