The Surgeon Minute

Post Bariatric Surgery: What to Expect

Post Bariatric Surgery: What to Expect

Losing weight with bariatric surgery is a fantastic way to take charge of your health. Lowering your body mass index is good for your heart, your joints and helps to prevent disease such as diabetes. However, many patients are surprised to find that they still aren’t happy with the way that they look even though they’ve lost the weight. This is due to the fact that losing that extra 40, 50 or 100 pounds is very often only the first step towards a new you.

Excess fat not only takes its toll on your organs, but it also stretches out your skin past its ability to “bounce back.” The end result may be pounds of extra skin that hangs off the body. Even if the patient achieves weight loss and begins to ripple with muscles, that skin isn’t going anywhere. Dr. Bill Kortesis and his colleagues at HKB Cosmetic Surgery in Charlotte, NC help their post bariatric surgery patients achieve the body of their dreams by laying out the stages of surgery and then being totally upfront about the fact that the whole process will take a year. However, the end result is a very happy patient. Here are some things to consider if you’ve recently undergone bariatric surgery and are looking to lose that extra skin to complete the process.

Getting Body of Your Dreams is a Process

Many bariatric surgery patients are not aware of the fact that losing the weight is typically just the first step in their journey towards a better body contour. Most of the post bariatric surgery patients that Dr. Kortesis sees in his office don’t like the way that they look even though they’re thinner. “They thought that they were going to be happy when they lost the weight,” he shares, but the weight came off and these patients are still left with: 

  • loose, draping skin
  • pockets or bulges of excess fat
  • uneven body contour 

“They look to us as plastic surgeons to really help them,” he explains. “My analogy is that they’ve already run 20 miles of the 26 miles of a marathon, and it’s great for us because we really get to carry them that last little bit over the finish line.”

Staging Your Post Bariatric Surgeries

It is very common for a post bariatric weight loss patient to come in for a consultation and want to tackle the whole body at once in a single surgery. Dr. Kortesis understands. You’ve put in the hard work, lost the pounds and, now, you just want the body contour that you’ve always dreamed about. But he and his colleagues make it a point to always be honest with patients as to what, exactly, they can expect. “If you want everything done, this whole process will take about a year, but we’ll be with you every step of the way,” says Kortesis.

Working with Post Bariatric Patients

The reason that the whole process takes so long is that it is not safe to perform surgery on every area of the body in one sitting. In general, Dr. Kortesis and his team will spend the consultation discussing everything that the patient may want done. Then, together, they will break down the body into areas of need, starting with what bothers them most. For most people, this is the trunk. 

Breakdown of Post Bariatric Surgery

In general, Dr. Kortesis will combine 1 to 2 procedures in each surgical sessions. These procedures may include: 

  • arm lift
  • thigh lift
  • tummy tuck
  • liposuction
  • buttock augmentation with fat grafting
  • facelift
  • breast lift
  • breast augmentation
  • breast reduction

Dr. Kortesis and his colleagues work to accomplish as much as possible in each session. However, they always try to limit the overall operating time to 5 to 7 hours in order to ensure your safety. This is why it will typically take 2 to 3 sessions in total in order to complete your entire post bariatric “wish list.”

Trunk First

“Most patients like to go with their truck area first,” explains Dr. Kortesis. This is usually where the largest amount of loose, drooping skin resides in both men and women. A session addressing the trunk might include a body lift with fat grafting to the buttocks, or a reconstruction of the buttocks region. It may also include some form of beast surgery. The second surgery session will often entail addressing the arms and legs with an arm lift and thigh lift. And the last session may include a facelift and/or neck lift as well as any tweaks that need to be performed in order to deliver your optimum results.

The great thing about post bariatric surgery is that while it is a journey, the end result is a seriously happy patient. “Some of the happiest patients in our practice are our post bariatric surgery patients,” explains Dr. Kortesis. “Honestly, it is amazing. They’re the ones that cry the most post operatively.” These are tears of joy, not sorrow. It’s incredibly gratifying for both the surgeon and the patient to complete the marathon and begin a new journey in life.

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