Cosmetic surgery following weight loss surgery

Obesity surgery can be very successful in terms of dramatic weight loss. This means improvements in health and overall appearance which leads to en improved quality of life.

There is however, an important aspect of this surgery which some people may fail to take into account: losing vast amounts of weight can leave you with large, drooping folds of skin and pockets of fat which refuse to budge.

What happens is that when you gain weight, your skin stretches to accommodate this increase. But, when you lose weight this skin stays exactly the same: it does not return to its normal elasticity and you are left with these loose folds. This is even more of a problem for older patients as skin loses elasticity as we age.

One answer to this is cosmetic surgery or to be more exact ‘body contouring’. If you are thinking of having obesity surgery whether via the NHS or as a private patient then bear in mind that this adds to the costs. If you are paying for treatment then factor in an extra £6,000 or so for cosmetic surgery. If you are having your surgery via the NHS then they are unlikely to pay for follow up surgery such as this so you will need to pay for this yourself. If you have private health insurance then they are unlikely to cover this as it is seen as a ‘lifestyle choice’ rather than a medical necessity. Check with your insurer to see if they have exceptions to this.

Your aftercare team will be able to advise you about this. They will recommend that you wait for at least a year, up to 18 months before having cosmetic surgery.

Body contouring

This is the collective name given to the range of procedures which are designed to remove excess fat deposits and correct loose folds of skin. As well as being unsightly, loose folds of skin can rub against one another which lead to sores and skin rashes.

The most problematic areas are the stomach, thighs, buttocks, back, neck, face and upper arms.

Whatever you decide you will need to find a good, reputable cosmetic surgeon. Organisations such as BOSPA (British Obesity Patient Association) can help as can your aftercare team. There are various clinics who will offer body contouring but go into this carefully. Most clinics are very good but there can be a few less reputable ones and those are the ones you will want to avoid.
Do as much background reading and research as you can. Obtain plenty of information about cosmetic surgery and clinics in general. It is a good idea to have around 4 to 5 surgeons that you would like to consider. This means ensuring that they are listed on the GMC’s (General Medical Council) register of specialist Plastic Surgery; that they have held an NHS consultancy position or are still in that post and are a member of the FRCS (Fellow of the Royal College of Surgeons). Ideally, they will be a member of BAPS or BAAPS (British Association of Aesthetic Plastic Surgeons). This is a highly respected organisation and it is extremely difficult to become a member. If your surgeon is a member then you know he/she is highly qualified and experienced.

The same rules apply here as to finding an obesity surgeon. You will want to be reassured as to his/her expertise, years of experience and success rates. And, most importantly, you must feel comfortable with him/her as well as a sense of trust and reassurance. Basically, if you do not like your surgeon then this will makes things difficult for you both so ensure that you are happy with your choice.

It is important that you have realistic expectations about this surgery. Your surgeon will impress upon you the need to bear in mind that this will improve your appearance but is not a miracle cure.

Body contouring procedures are as follows:

• Abdominoplasty (tummy tuck)
  This is the name given to the surgical procedure in which excess fat and skin is removed from the abdomen. The muscles of the abdomen are tightened and the loose flap of skin and fat is then stretched downwards. Any excess tissue is removed which results in a toned, flatter looking abdomen.


• Body Lift
  A ‘body lift’ is surgery carried out on more than one part of the body. Excess fat and drooping skin is tightened around the hips, thighs, buttocks and abdomen. Very often this is done as a complete package.


• Breast Lift (Mastopexy)
  This procedure involves the surgeon removing excess skin and then the nipples to a higher position upon the chest. This then lifts and firms the breasts. This procedure can correct drooping breast.


• Buttock Lift
  Excessfat and skin is trimmed away from theside of the thighs and buttocks which leaves a more toned and flatter looking rear.


• Face Lift (Rhytidectomy)
  A very popular procedure for many people. It is designed to remove excess skin around the chin, jaw and neck as a result of weight loss. It involves the removal of any excess fat before the skin is ‘redraped’ to create a more natural appearance.


• Gynaecomastia (male breast reduction)
  Many obese men find that when they have lost a greatdealof weight that they are left withwhat look like sagging ‘breasts’. Another possibility is that they are left with stubborn areas of fat in the chest area which resemble a pair of breasts. This surgery will remove those excess fat deposits which will leave the chest looking flatter and more toned.


• Liposelection (fat removal)
  This is different to liposuction in that it is able to precisely target those stubborn areas of fat. It uses an ultrasound system and involves the insertion of a small tube or cannula through which ultrasound waves of energy will travel. These pulses cause the fat to liquefy. This liquid can then be removed via a gentle suctioning action.


• Liposuction (fat removal)
  This is one of the most popular cosmetic surgery procedures. It involves the insertion of a cannula into the area where fat is to be removed. A vacuum pump or syringe is attached to the other end of the cannula. The cannula breaks up the fat deposits by a series of push/pull movements. These broken down cells are then suctioned up through the pump or syringe.
  


• Neck Lift (Platysmaplasty)
  This can be performed instead of the full face lift. It involves the removal of excess fat and skin around the neck and jaw line. It can also be done in combination with a face lift.


• Panniculectomy
  This is a very similar procedure to abdominoplasty, but the main difference is that it does not tighten the abdominal muscles. It can be performed in conjunction with the tummy tuck or a single procedure. The main difference between this and the tummy tuck is that this only removes the excess fat and skin.


• Thigh Lift
  A very similar procedure to theButtock Lift. It involves the removal of excess fat and skin from both the inner and outer thighs. It can also improve the appearance of cellulite – that orange peel or dimpled effect caused by waste products and toxins.