Marina del Rey
Dr. David Stoker
4640 Admiralty Way #1000
Marina del Rey, CA 90292
After major weight loss through bariatric surgery in Los Angeles, you may be ready to take the next step and remove the loose skin with plastic surgery. Here are some of the common questions Dr. David Stoker answers about plastic surgery in Los Angeles after bariatric surgery or major weight loss.
The best candidates for surgery after weight loss are healthy non-smokers who have large amounts of excess skin.
Patients with a history of obesity have a higher rate of complications than patients who have never been overweight. However, they also tend to benefit even more from plastic surgery because of their large amounts of extra skin.
To prepare for surgery, patients should exercise and avoid smoking. Patients tend to recover more quickly when they are in good physical shape before surgery. Patients should also make sure they are nutritionally balanced. It's common for bariatric patients to have vitamin or iron deficiencies, and dietary supplements are usually appropriate for them to take.
It's never a good idea to gain the weight back. Usually patients will still look better than they would have without the surgery, but obviously they're not making the most of their opportunity.
Most of my weight loss patients have more than one procedure with each trip to the operating room. I have published multiple clinical studies on the safety and efficacy of my techniques for these combined surgeries. Breast and abdominal surgery, or multiple facial procedures would be common examples of procedures to perform at the same time.
Planning the stages of plastic surgery for weight loss patients is highly individualized in my practice. It's common for my patients to have 2 or 3 different days of surgery, with multiple procedures done at each stage. The age and health of the patient, as well as the scope of the procedures, are key considerations for planning the stages of surgery.
Medical insurance frequently covers lower abdominal skin removal (panniculectomy or abdominoplasty) when the patient's excessive skin is so severe that it creates medical problems requiring treatment. Examples include rashes, sores, or infections in the folds of skin. However, patient eligibility and benefits vary greatly between policies.
In a perfect world, it would be nice for all patients to be at their ideal weight and to remain at their ideal weight. That's not realistic for many patients. Carefully chosen procedures may improve a patient's ability to continue to lose weight and enjoy their lives even before they reach their goal weight. Examples include removing large amounts of hanging skin from the abdomen or fat from the inner thighs if it inhibits the patient's ability to exercise. Plastic surgery is definitely not a substitute for weight loss, but it may be a powerful tool to help patients achieve their goals.
For patients following bariatric surgery, I typically allow for their weight loss to plateau for several months before scheduling plastic surgery. For patients who are losing weight through diet and exercise, I will sometimes operate earlier if the patient's need and desire for surgery is great. Selected plastic surgery procedures may act as a powerful catalyst for the patient to continue to work hard to achieve their weight goals.
The female body changes quite a bit following pregnancy. It's reasonable for most weight loss patients to wait until after pregnancy for procedures such as a tummy tuck or breast lift. If the weight loss is substantial, however, the loose skin may be a much bigger problem for the patient. In these cases plastic surgery may help a patient's self-esteem in a way that is beneficial to them before having children. In abdominoplasty cases before pregnancy, the abdominal muscles are usually flat enough that they do not require tightening. This speeds the recovery from the surgery.
Some of the more common risks of plastic surgery following weight loss include bleeding, seromas (fluid collections) and delayed wound healing. Patients with complications require more care and recovery time, but they still benefit tremendously from the surgery. Venous blood clots in the legs are also possible. They are reduced in frequency with early ambulation following surgery.