Cosmetic Bariatric Surgery
Body > Cosmetic Bariatric Surgery
- Cosmetic surgery after massive weight loss
- Cosmetic Surgery after Gastric Bypass
Bariatric or gastric bypass surgery has become a common treatment for morbid obesity. The resulting weight loss can cause excessive skin folds and many patients select body contouring cosmetic surgery procedures to improve their looks.
Dr. Shureih can help you achieve your
optimum body image hidden beneath all the excess skin folds that come
as a result of massive weight loss. He uses the latest techniques in
body sculpting individualized to each patient's specific needs and
priorities.
Patients experience significant weight loss over a relatively short period of time (usually 12-18 months) after gastric bypass surgery. The stretched skin has lost the elastic qualities necessary to "shrink back" to your new body size. This often leaves patients with excessive amounts of hanging skin that creates a multitude of problems, most important of which the complaint that the patient still feel fat, because of the excess skin and the deformity it leaves behind.
A comprehensive approach to the bariatric patient is necessary to achieve the best results, and the body image they can have.
One of the most important considerations for both plastic surgeon and patient to realize is that a bariatric patient must be treated differently from non-bariatric body contouring patients. What has worked well for many years on other patients simply may not provide adequate shaping and contouring for the bariatric patient. The stretching forces resulting in excess skin are different from what is usually seen in the non bariatric patient.
Patients who have undergone gastric bypass surgery have numerous areas of concern which may differ from patient to another.
These areas include a combination of the following:
- Breast ptosis, or droopiness, with or without loss of breast volume
- Sagging of the facial skin
- Abdominal skin laxity with laxity of the muscles of the abdominal wall.
- Circumferential Lift or lower body lift
- Hanging skin of the arms (Brachioplasty, Arm Lift)
- Wrinkling and excessive skin folds of the thighs
(Mastopexy is a procedure to lift the breasts and may be performed with or without the addition of breast implants to improve shape, fullness and cleavage.) Breast implants assure fullness in the empty upper pole of the breast.
Face lifting, forehead lifting and eyelid surgery, along with neck contouring and neck definition, may be necessary to achieve complete facial rejuvenation. The face lift should be customized to the needs of the individual.
Abdominoplasty or a lower body lift procedure can contour the abdomen, hips, thighs and buttock. After massive weight loss, laxity can be horizontal and vertical, as well as circumferential. Abdominal laxity has to be studied very well so a plan of repair can be formulated. Liposuction may still be needed for resistant areas. These include hips, lateral thighs, flanks or arms.
The laxity of skin may extend laterally and posteriorly to the buttocks.
Involves lifting the Medial Thighs, the lateral Thighs, the abdomen and the buttocks.
Such a procedure can be done in one surgery or divided into two surgeries for your safety and comfort.
Liposuction may be needed along with the removal of excess skin. Different designs for arm lifts are available to meet the needs of the individual.
A medial thigh lift can lift the inner thighs, with or without liposuction. The incision is well hidden in the crease of the groin.
The lateral thigh and the buttock, posterior thigh is lifted through a circumferential abdominal lift, or lower body lift.
Obviously all of these concerns cannot be addressed simultaneously during one operation. However, two procedures usually can be safely combined. During your consultation, Dr. Shureih will assess your needs and your priorities as well as your concerns to help you develop a comprehensive plan for your body contouring.
The cornerstone of a successful approach to body contouring is to individualize the treatment to your specific needs and goals and to ensure that you have a full understanding of the issues involved so that you are able to make an informed decision.
If you think you might be a good candidate for body contouring following significant weight loss, call us for your personalized consultation.
The Consultation
During your initial consultation, Dr. Shureih will inquire about your medical history, prior procedures, medications, allergies, and your motivations for seeking cosmetic surgery. It is very important that you be thorough when providing your medical history, as this information helps to prevent complications during your care. When asked about medications, be sure to include any vitamin or herbal preparations, health food supplements, as these can affect your blood pressure and blood clotting ability which might cause complications.
Smoking and drinking alcohol can have a profound impact on your recovery and your ability to heal following your surgery. Remember that second hand smoke is just as harmful.
Dr. Shureih will discuss your concerns and priorities. After examining you, he will be able to offer advice and options to help you achieve the body you desire. He will explain the advantages and disadvantages of the different options you have before you.
At the completion of your consultation, you will be given a written estimate of the cost of your procedure. At this time, you will also have the option to schedule your procedure if you so choose. The decision to undergo surgery is a very important one, and the final decision should be given very careful consideration. You are also encouraged to bring your spouse, family member, or a friend to your consultation. Any body that has or will have an opinion regarding the surgery or the results should be involved in the consultation process.
WHERE WILL YOUR PROCEDURE BE PERFORMED?
Most patients undergoing body contouring following significant weight loss choose to have their surgery performed in our surgical facility. Sometimes an overnight stay is required, depending on the procedure you choose, or combination of procedures and your overall health status. The procedure is then performed at a full service hospital. Alternatively dividing your surgeries into multiple smaller procedures allows us to perform the procedure in our surgical facility. A private duty nurse can care for you in the comfort and privacy of your own home, or your family or friends may care for you during the early postoperative period. You will need help in the first few days after surgery.
For out of town patients my office can help arrange for hotel reservations. If you wish to have a private nurse to be with you, we will help you arrange for that too.
ANESTHESIA
Anesthesia is an essential part of any surgical procedure and must be performed safely. General anesthesia or in some cases Local Anesthesia with Sedation is preferred for most of these procedures. You are asleep, feel no pain, and will not remember the procedure. Intravenous sedation, called "twilight sleep," is a combination of local anesthetic administered at the surgical site by the surgeon and intravenous sedation administered by the anesthesiologist.
We strive to make your experience as pleasant as possible.
Dr. Shureih will discuss all of these options with you more thoroughly at the time of your consultation; we encourage you to ask about anything you do not understand. All your questions should be asked prior to surgery.
THE PROCEDURE
As mentioned previously, it is important to develop a comprehensive approach to your body contouring. This has evolved into several specialized techniques meant to optimize your results. These include:
- Developing a clear overall strategy during the consultation process and reviewing this plan during the preoperative visit. This plan will be reviewed thoroughly so that you have a full understanding of the procedures, incisions, scars and results you can be achieved.
- Precise preoperative skin marking prior to surgery. While you are standing, Dr Shureih will make marks on the skin identifying certain landmarks as well as the intended incision placement. Not only does this provide information necessary during the operation, but it also allows you to review the operative plan one more time with Dr. Shureih before undergoing the procedure.
- Careful but considerable suture techniques to provide support to the incisions during the healing process. By using multiple layers of strong sutures beginning deep in the tissues and finishing superficially, the resulting scar is optimized. Eventual scarring depends on the surgical closure, the quality of the tissue being operated on, the amount of stretch and your genetic factors.
Depending on the combination of procedures you choose, surgery will probably last between four and eight hours. After you are properly anesthetized, Dr. Shureih will make the incisions necessary for removal of excess skin and fat. For a tummy tuck, the muscles of the abdominal wall are usually tightened using strong, permanent internal sutures. Some patients have hernias in the abdominal wall, and these may also be repaired during a tummy tuck. Hernia repair with a plastic mesh may be necessary to reinforce the weakened abdominal wall. Some patients may require liposuction of the upper abdomen at the same time.
A circumferential lift may be needed in some patients; this will require extending the incision around the back to the buttock crease. This will lift the abdomen, medial thigh, lateral thigh, and the buttocks. Some times buttock enhancement is needed or desired. Several options are available for buttock enhancement surgery. At the completion of the operation, a sterile dressing is applied to the incisions, and a compression garment is applied to the region of the body being treated. This compression garment helps support your incisions during healing, decreases postoperative swelling, and helps decrease any bruising that may occur.
AFTER THE PROCEDURE
If you are staying overnight in the hospital, you will be transported from the recovery room to your own room. You will have a PCA pump (Patient Controlled Analgesia) available so that you will only need to push a button to self-administer pain medications when needed. You will also be provided with thorough postoperative instructions and a phone number so that you may reach your Dr. Shureih directly at any time with any questions or concerns you might have.
Alternatively, if you decide to go home in the company of a private duty nurse, you will be discharged after spending one to two hours in the recovery room.
The antibiotics that were prescribed should be taken as directed. Continue this medication until it is finished. The pain medication should be taken fairly regularly, every four to six hours, during the first twenty-four hours (when you are not asleep, of course). Most patients find that they are able to transition to Tylenol after four to five days. It is not safe to drive a car within twenty-four hours of surgery, or while taking pain medication, as your reflexes and alertness may be altered.
You should plan to take it easy following your surgery. No strenuous activities, heavy lifting (over 10 pounds), exercises, swimming, contact sports, should be planned for three to four weeks. As Dr. Shureih monitors your recovery, he will advise you when it is safe to resume specific activities. You should plan to wear the compression garment for three weeks following surgery. Dr. Shureih will remove the drainage tubes within several days following surgery as the drainage decreases to an acceptable level.
WHAT YOU SHOULD EXPECT
You will notice an improvement in your body contour immediately. However, your shape will continue to improve in the following weeks as the swelling subsides. You should be up and walking the day following surgery, although you will be sore for several days. You should be able to resume your normal daily activities within several days following surgery, and you should be able to resume all of your physical activities within three to four weeks of surgery.
POTENTIAL RISKS
Surgery carries a certain amount of
risk, those include, infection, bleeding, fluid collection skin loss,
delayed wound healing, scarring, possible wide thick scars, blood clots
and pulmonary emboli.
As a result of your body contouring, you should be able to look as good as you feel inside and enjoy your new body.
Dr. Shureih is a Board Certified Plastic surgeon, with a Certificate of Advanced Education in Cosmetic Surgery. He is also a member of The American Society of Bariatric Plastic Surgery. He has 20 years of experience and thousands of procedures. He was chosen TOP DOC in Baltimore Magazine and The National Guide of TOP DOCS for many years. We offer our patient a private, confidential safe surgical environment.
Our Certified Surgical Facility is a state of the art center. Your safety is the number one priority to our surgical team which consists of Dr. Shureih, an MD. Anesthesiologist, an experienced Registered Nurse, and an experienced surgical tech.
5300 Dorsey Hall Drive, Suite 102, Ellicott City MD 21042
(410) 715-2000