Massive weight loss patients face a bitter irony. After expending all that energy, discipline, and expense to improve their lives and lose the weight, they look in the mirror with dismay. Their bodies look deflated. Protruding abdomens now flap as they walk, the thighs may not rub together, but they show pleats. Every part of their bodies shows the signs of massive weight loss.
Facial improvements in the weight loss patient are often limited to the neck and lower face. Sometimes, more needs to be done, but that is usually in the older patient. The nose and eyes are seldom affected.
Breasts and abdomen have the largest need for rehabilitation. The breast loses not only volume but also shape. Standard breast lift techniques often have to be altered to fit the needs of the weight loss patient. Implant use is common as the volume loss is often severe.
Unless the patient was previously pregnant, the body wall is often surprisingly tight. Much of the focus in abdominoplasty is geared to skin resection, and sometimes novel techniques are necessary to achieve good results. There is a real trade-off of scarring versus shape. On the patient’s backside, body lifts are often needed.
Thigh lifts are most common in weight loss patients. This is an area where the trade-offs have to be carefully weighed. Though many patients want all of their scars in the groin, this approach has many problems. Skin resections that pass along the length of the leg are often preferable as they tighten the skin and have the most powerful effect on thigh shape.
Not all massive weight loss patients want or need extensive procedures to improve their bodies, but many do. The differences are not purely esthetic. There are often quality of life issues at stake, both physical and emotional. Insurance seldom considers body contouring as a covered expense. The costs involved in post-weight loss rehabilitation are large. There is also the time needed to recover and return to full normal activities.
The biochemistry of the weight loss patient is not the same as a heavy patient. Special care has to go into planning the procedures to minimize the physical stress of the operations. Anemia is a common problem, particularly after gastric bypass operations. Vitamin deficiency conditions have to be corrected. The patient has to be in a good physiologic state so they can manufacture all of the proteins needed to heal. We use the patient’s primary care doctors to assess the patient’s status in light of the massive weight loss.
Massive weight loss patients are a category of patients that require a high level of coordinated care and detailed planning. With Dr. Geldner’s superior surgical skills, 25 years of experience, and his experienced and compassionate staff, we exceed our patients’ expectations.
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“How can I thank you for understanding what I needed and for you being willing to do it for me. Thank you will never be enough.”