Recipients of gastric bypass surgery welcome the weight loss the procedure produces but not the rhinoceros-like folds of lose skin that can also result. But recent scientific studies show that “body contouring” surgery to remove the extra skin not only improves the way they look, but helps them maintain their weight loss.
Skin is like a favorite t-shirt that stretches over time to fit the wearer’s body. When weight is lost gradually through diet and exercise, skin will typically “un-stretch” itself and maintain a tight fit to the body beneath. But gastric bypass surgery produces rapid losses of 100 pounds or more, giving skin no time to adjust to the thinner, trimmer body underneath. The skin hangs loose just like a stretched t-shirt passed down to a younger and much skinnier brother.
Aesthetically, the result may be little better than the obesity that preceded the operation. Some people liken it to wearing a “fat suit.” That extra skin also requires extra hygiene to prevent yeast infections and cysts from developing in the folds.
“Body contouring” is plastic surgery to remove and tighten the extra skin. Along with improving the way patients look, body contouring helps them keep weight off.
In a study reported in the journal Plastic and Reconstructive Surgery, researchers found that gastric bypass patients who also had body contouring to remove excess skin did a better job of maintaining weight loss. When researchers took into account the weight of skin removed, the body contouring group regained just 14 pounds compared to 50 pounds among patients who had gastric bypass only. Patients who had both procedures weighed an average of 176 pounds; patients who had only the gastric bypass averaged 220 pounds.
Before a plastic surgeon performs body contouring, the patient needs to reach a healthy weight and maintain it for at least a year. When the patient is at a stable weight and is healthy enough for surgery, the surgeon and patient will discuss surgical options and goals.
Sex, genetics and individual histories all play a role in determining the kind of body contouring procedures people need. Most people start with a circumferential body lift, a procedure similar to taking in a dress or spot coat. A vertical incision is made in the back, the skin is pulled tight, the extra skin is removed, and the “seam” is sutured together. The procedure pulls skin taught across the chest and abdomen and removes 10 to 15 pounds of loose flesh.
Other body sculpting procedures include tummy tucks, face lifts, breast lifts, lower body lifts (for the abdomen, buttocks, groin and outer thighs), brachioplasty for sagging upper arms, and surgery for to remove loose thigh skin.
“Body contouring” sounds benign, but the skin is the body’s largest organ and maintaining its health is just as important as maintaining weight loss. Patients need to keep in mind that body contouring is major surgery. It can take three months before the aesthetic results are fully apparent and a full year for all the scar to heal. But for many gastric bypass the patients, the improvements in appearance and health are worth it.
By J.W. Huttig