Tummy tuck after bariatric surgery
Tummy tuck after bariatric surgery
Bariatric surgery is used to reduce the weight of the patient and as a treatment for obesity. Plastic surgery is used to remodel the body and improve certain features or make the features more harmonious, but no plastic surgery procedures can be used to lose weight, even if they might provide slimming effects. In other words, liposuction and tummy tuck are not substitutes for bariatric surgery. If weight loss is necessary, then you need to see a surgeon who does bariatric surgery. If you had bariatric surgery and are unhappy with the appearance of your body, then you need to see a plastic surgeon.
Because all these can be confusing for the patient, we will discuss what the role of bariatric surgery is, what the role of plastic surgery is, and why the tummy tuck surgery is so in demand for patients undergoing bariatric surgery.
What is bariatric surgery?
The recommendation for bariatric surgery is given by the surgeon and according to international protocols that have been developed over decades of studies and research. The surgeon will take into consideration the mass body index (calculated by dividing the weight (kg) to the square height (m) and the health conditions that might be present and affecting the everyday life of the obese patient. Generally speaking, all patients with a mass body index over 40 have a recommendation for a bariatric procedure as numerous studies show that it is nearly impossible for a patient with such a mass body index to reach a normal weight and sustain it for a long period of time without the help of bariatric surgery.
There are different types of bariatric procedures that can be performed depending on the characteristics of the patient and the amount of weight that is in excess. There are three main types of procedures: restrictive procedures, malabsorptive procedures, and mixed ones. Restrictive ones reduce the volume of the stomach, and malabsorptive ones shortcut a portion of the intestine so the food doesn’t go through the whole intestine.
Despite what most people think, bariatric procedures are not meant to help the patient improve his appearance, and they are never performed for aesthetic purposes. Bariatric surgery is performed to improve the quality of life of patients suffering from obesity and restore functionality. A good result after bariatric surgery is weight loss, getting to a normal weight, and sustaining it permanently.
What is plastic surgery?
The recommendation for plastic surgery comes from the plastic surgeon after a consultation. During this consultation, the plastic surgeon will perform measurements and a medical examination on the patient with the emphasis on areas with imperfections. Moreover, the aesthetic goals and expectations of the patient will be discussed, as well as the reasons for undergoing the plastic surgery procedure. One of the reasons why the plastic surgeon will make sure to ask about the expectations from the surgery is to make sure the patient doesn’t plan on achieving weight loss with the procedure. Moreover, a responsible plastic surgeon would only perform these procedures on patients who have a normal weight and have sustained it for at least eight months, preferably more. This means you shouldn’t undergo plastic surgery if you are obese or overweight.
The plastic surgery procedures performed with the aim of slimming the body such as liposuction and the tummy tuck have different goals, but the main thing is reshaping the body to make it look more appealing. These procedures have a localized area that they target and won’t affect the overall weight of the body considerably.
It is important to know that plastic surgery procedures are performed with the main aim of reshaping the body, giving it a nicer contour and eliminating certain imperfections that could be present. Plastic surgery procedures are often recommended after bariatric surgery to help the patient who has lost weight to get a nice shape of the body and eliminate fat deposits and saggy skin from areas where they are in excess.
Tummy tuck after bariatric surgery
It is common for patients undergoing bariatric surgery to be left with an excess of skin that is saggy on the abdominal wall. This can happen even in very young patients where the skin sagginess can’t be attributed to aging. What happens is that when we gain weight, it will be accumulated all over the body, depending on the predisposition of the patients. However, the tummy seems to be one of these areas for most people, men and women alike. This means that the muscles and tissues of the abdominal wall need to stretch to accommodate the excess weight that is in the form of adipose tissue. What actually happens when we gain weight is our fat cells increase their volume multiple times. After weight loss occurs, the skin doesn’t often retract on the new contours of the body and it will be left saggy.
When bariatric surgery is performed, the weight loss will be sudden. This means that the patient will lose a large amount of weight immediately and the weight loss will continue over the months and even up to a year after the procedure. Due to the sudden weight loss, saggy skin can occur in different areas of the body, especially the lower abdomen. Different patients will have a different level of skin sagginess, but the excess of skin can be so severe that it could end up covering the pubic area entirely and even going lower than this. This means that the patient will be confronted with another issue, but this time we are talking about an aesthetic issue with a slightly dysfunctional appearance. The skin fold that covers the pubic area partly or entirely can lead to dermatological conditions that might be difficult to treat and also might pose problems in terms of finding suitable clothing to mask it.
This “belly apron” as some people call it is the main reason why patients of bariatric surgery resort to undergoing a tummy tuck. Keep in mind that the tummy tuck should only be scheduled after the weight loss process has completed and the patient has had normal weight for at least eight months to a year. Undergoing a tummy tuck when the weight loss process is not complete can result in more sagginess and in need to undergo additional procedures to correct it.
When the tummy tuck is performed, the plastic surgeon will make an incision in the suprapubic area and use it to detach the skin and fat tissues from the abdominal muscles and lift them to the level of the rib cage. If the abdominal muscles are relaxed, the surgeon will use sutures to strengthen them. The tissues are then lowered on the muscles, a new hole is created for the belly button, the surplus of skin and fat tissues are eliminated, and the incisions are sutured. For patients of bariatric surgery, a more complex procedure might be needed. This procedure is known under the name of the extended tummy tuck, where the plastic surgeon will also address and remove the excess of skin that is present on the flanks, not only on the lower part of the abdomen.
The patient might leave the clinic within hours after waking up from the general anesthesia that is often used for this type of procedure but will need to return to see the plastic surgeon a few days after as the drain tubes will have to be removed. It is not uncommon for the plastic surgeon to use drain tubes inserted in each side of the tummy to allow for the drainage of blood and other fluids after the tummy tuck.
The recovery period after the tummy tuck is usually about two weeks, and during this time the patient is advised to avoid sleeping on the tummy. Smoking is strictly contraindicated for three weeks before and after the tummy tuck as the lack of proper oxygen levels in the blood can delay the healing process and trigger unwanted complications.
While plastic surgery is often needed after bariatric surgery to improve the appearance of the patient, it doesn’t mean that one procedure can substitute the other. Bariatric surgery is used to help the patient lose weight while plastic surgery can be used after the weight loss process is completed to eliminate the signs left by extreme weight fluctuations such as skin sagginess on the tummy and the flanks. A good result after a bariatric procedure is weight loss and the patient reaching a normal weight and sustaining it. A good result after plastic surgery entails harmonious features of the body and a firm and flat tummy in the case of abdominoplasty.