Often times in the field of cosmetic surgery, patients present with an excessive amount of skin from a variety of anatomic areas of the body, literally from head to toe. The classic facelift patient, typically has excess skin that requires tightening, but in addition to that, patients have loose skin of the arms, back, chest, breasts, abdomen, buttock, thighs, and the lower legs. This is true in many patients who simply have a hereditary condition or who may have had some fluctuation of weight over the years. But it is especially true in, what is known as, post bariatric Liposuction surgery.
The average person in western culture is very in tune to health and nutrition and body weight. We’re reminded of one of the reality television shows that is called the Biggest Loser, in which their in actual competition among obese people to lose significant amounts of weight. Once they lose enormous amounts of weight, the result is in an excess amount of skin of various parts of the body. Patients who lose a moderate amount of weight, might have a moderate redundancy of excess skin, but understandably patients who lose 150 or 250 lbs of weight, are going to have an enormous amount of excess skin hanging from different parts of their body. Any and all of these patients are candidates for open body surgery.
The story begins with proper nutrition and diet so that the optimal goal is for patients to stay within a reasonable weight range and not be classified as obese. However, in this country the sad reality is that obesity is a very common phenomenon that is primarily driven by over eating and poor dietary habits. At times, certainly this is exacerbated by a hereditary propensity for deposit of excess fatty tissue. Society is becoming more and more aware that nutrition and good dietary habits and staying in reasonable shape is not only beneficial from an appearance standpoint, but also from a medical standpoint. Patients who have excessive weight are candidates for diabetes, high blood pressure, early heart attacks and a variety of medical diseases.
The concept of open body surgery is relatively in its infancy in the field of cosmetic surgery but is growing by leaps and bounds. It is becoming ever more popular and the patients have a keen desire to lose weight and then follow up with cosmetic body surgery to improve their appearance, improve their self esteem, and improve their interpersonal relationship in their private lives, not only in the work arena, but in their social arena.
Patients who have mild obesity respond very well to a variety of diets and self discipline and are able to obtain significant reduction in their excessive weight. In patients such as this, if the skin shrinks, then the patient is happy. If the skin does not shrink they then become candidates for sometime of skin tightening procedure. Patients who have excessive body weight, which is sometimes referred to as morbid obesity, have to consider undergoing a surgical procedure first, which aids them tremendously in losing body weight. The surgical procedure is predicated on the amount of weight a person wants or needs to lose. We have all seen on television documentaries, patients who weight in excess of 1000 lbs and live their life bed ridden. In patients who want to lose a moderate amount of weight, a surgical procedure known as lap bad surgery is performed through tiny incisions through the abdomen and through endoscopic techniques, a device is placed on the stomach which reduces the stomachs volume and the ability to retain food. As a result, the patient no longer engorges themselves at the dinner table and has a significant reduction in food intake. There are a variety of other more extensive surgical procedures which re-route the food through the gastrointestinal tract so as to minimize the amount of food a person can eat and then bypasses a large portion of the gastrointestinal tract that absorbs the food. If a person diminishes the intake and is not able to absorb as much food, then over a period of time, a significant weight loss can occur. These patients require significant post bariatric Liposuction surgery.
The common denominator in this type of surgery is that external skin incisions are required on different parts of the body that include the arms, back, chest, breasts, abdomen, buttock, and legs. The patient must realize that extensive incisions are required and at times enormous amount of excess skin is removed. Theses procedures are not to be taken lightly and have inherent risks to them, proportionate to the amount of redundant skin that is being removed. Often times these procedures have to be performed by the cosmetic surgeon, in what is called a staged procedure, where, for example, the face, arms, and breasts are operated on a given day and in future time, perhaps the back and abdomen is performed, and still again in the future perhaps redundant skin of the buttocks, thighs, and legs are removed. So it must be realized by the obese post bariatric patient that not all of the excess skin can be removed in one surgical setting. A series of examples of patients who have excess skin of various parts of the body follows with explanations of the placement of the incision. The patient must make a conscious decision that they are going to be trading the excess skin for a potential scar. But as we can see from the photographs, this invariably is a very good trade, not only for the appearance of the patient, but also to change their self perception to increase their self esteem and to improve their social interaction. In addition, these patients enjoy a much healthier life and are no longer a burden to themselves, family, and to society in general.
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