Bariatric (weight loss) surgery is done for the treatment of obesity especially when dietary and lifestyle adjustments have failed to achieve a satisfactory weight loss. They also have an additional benefit of causing resolution or improvement in obesity associated disease conditions due to their significant weight reduction effects.
These surgeries can either be restrictive or malabsorptive or both based on their mechanisms of inducing weight loss. The restrictive operations bring about weight loss by limiting the capacity of the stomach resulting in the sensation of fullness after a small amount of meal. Examples of these include gastric sleeve surgery and gastric banding. The malabsorptive procedures, on the other hand, reduce the absorptive surface of the small intestine resulting in reduced nutrient absorption. Laparoscopic Roux-en-Y gastric bypass and duodenal switch with biliopancreatic diversion (DS-BPD) offer both mechanisms.
The consequence of these surgeries is that the food intake and nutrient absorption reduce and the body will have to mobilize the excess fat for the production of energy. Following bariatric surgery, weight loss is expected. This usually reaches a maximum at about 12-18 months after surgery during which the weight plateau provided the individual continue to adhere to the dietary and exercise plan.
The weight loss is however followed by skin sagging as the fat deposits that stretch it is gradually mobilized for energy production. This commonly occurs in the abdomen, buttocks, thighs, breasts, neck, and face. It also predisposes to fungal skin infections. This becomes the source of worry to many individual necessitating different forms of cosmetic surgeries.
One of the post bariatric surgery procedure commonly sought by the patient due to skin sagging is skin removal. These procedures are named depending on the area of the body affected. They include abdominoplasty (tummy tuck), thigh lift, lower body lift, breast surgery (augmentation), arm lift, facelift, etc. collectively they are known as body contouring procedure.
The weight needs to have stabilized before the surgery is performed. This helps to minimize the operative complications and the need for a revision surgery. Most surgeons will want you to wait for at least 18 months after the bariatric surgery or 6 months of stable weight before attempting body contouring procedure.
The costs of these procedures depend on your location, the quality of the surgeon, and how extensive is the excess skin and whether you want to have the surgeries one after the other or more than one procedure at a time. This surgery is not usually covered by the insurance policy, and most patients end up paying out of their pockets. However, some surgeons offer different packages that make the payment more convenient for their clients.
Abdominoplasty or tummy tuck involves the removal of excess fat and skin from the abdomen and tightening of the muscles of the anterior abdominal wall. For those with hanging skin fold over the pubic area, panniculectomy (a modification of tummy tuck) is carried out to remove this excess skin.
A thigh lift is the removal of excess skin around the thighs to make it proportional to the legs and other parts of the body. The price is around $4,000 in the US.
Lower body lift (belt lipectomy) is the removal of excess fat and skin from the abdomen, buttocks, hips, and thighs. The cost is slightly higher due to the areas of the body involved. The price ranges from $7,000 to $8,500 in the US.
In order to improve the overall shape of the breast, excess skin may be removed with or without the use of implant. In United States, the cost of this procedure ranges from $3,500 to $4,500.
A facelift is the removal of excess skin on the face to achieve a smooth devoid of wrinkles.
These procedures can be done one after the other or combined at once. Your surgeon is in the best position to determine which one is best for you.
Skin removal after bariatric surgery is required in those with excess skin folds due to weight loss. However, it is a major procedure that requires proper evaluation pre-operatively. The weight must be stable before the procedure is done in other to reduce operative risks and to achieve the satisfactory cosmetic outcome. Always seek your doctor’s advice before the procedure.