Patients who have recently undergone bariatric surgery may experience sagging, loose skin following weight loss. Post-bariatric body contouring combines multiple procedures for a comprehensive approach. It typically addresses the arms, breasts, trunk, thighs, and to a lesser extent, the face.
Post-bariatric body contouring, also known as post-massive weight loss body contouring, because some people do lose a massive amount of weight without the bariatric surgery, just by exercise and diet, is a new specialty in plastic surgery. Probably has been going for about 20 years, since the advent of bariatric surgery, which had really led to a mass of patients coming in with excess skin following their weight loss. It is highly specialized. It involves multiple procedures and can take multiple surgeries to get all the procedures performed, in usually six months to a year, in my hands. Typically, the areas that are operated on are the arms, the breasts, the trunk, and the thighs. To a lesser extent, the face also needs volume replacement following their weight loss.
The longevity of post-massive weight loss body contouring is dependent, to a large extent, on the patient. The patients who continue with their journey, keep their weight down, are much more health conscious, do well. They rarely need any further surgeries. They certainly age like anyone else, and their results are not as good after many years, but they never get anywhere back to where they were before. So I think that these procedures are a big help in their journey to complete...to complete their journey that they started with their original either weight loss from dieting or their bariatric surgery.
Generally, these are elective procedures. If you have a pannus, which is excess abdominal skin that hangs way down over your pubis towards the knees, there are insurance companies that will cover what is called a panniculectomy, which is just cutting out the skin. It's not body contouring. Certainly helps patients, but it's not the same body contouring procedure that I'm talking about, that I do for these patients. I do do many panniculectomies. The patients are very satisfied with us. It helps hygienically. It takes away the problems that they had within the crease, when the excess skin falls over, and they certainly feel better about having that excess skin removed. We will often incorporate that with an elective procedure to try to reduce the costs.
I tell patients that I want them to be at a stable weight for at least three months after their massive weight loss. Whether that's a year, whether that's three years, whether that's six months after they initiated their journey doesn't matter. I will sometimes, however, even when they're stable, ask them to try to lose more weight. Definitely getting down to a weight that I'm more comfortable with will give them better results. So that's fairly critical as far as when we start the process of these body contouring procedures.