Congratulations on your weight loss! Significant weight loss is hard to achieve, whether through diet and exercise or surgery.
A frustrating part of weight loss is the excess sagging skin that comes with it. I see many patients who still feel large because of loose skin. They tuck the skin into their underwear, wear baggy clothing to hide the folds, and can’t work out because of loose flapping skin.
What surgery to do and when?
You want your weight to be stable. With weight loss you may find you lose weight at a steady pace and then you get stuck. I call this a plateau. You work out, eat well and just can’t move past this point. This can be a good time to use surgery to get you over the hump. While you are actively losing weight take advantage of that momentum. Surgeries such as breast lift or tummy tuck tighten the skin. If you lose weight after, you will loosen the skin.
Stable weight for 6 months is ideal.
I went to Dr. Greenberg after losing 190 pounds and she has done a wonderful job at removing all the wrinkles caused by my weight loss.
– M.B., San Jose
Health & Labs
Many of the gastric bypass procedures result in poor nutrition and absorbtion of nutrients. This can affect your blood levels, resulting in a low level called “anemia.” Blood is vital to make your tissue heal, so you want your levels to be normal. Vitamin B and iron supplements are sometimes needed. Also if you have malabsorbtion, you can have poor healing from lack of nutrients and protein. Before considering surgery, consult with your primary care doctor and have basic labs checked for your blood level and nutrition.
Which surgeries to do?
Major weight loss affects all areas of the body: from the face, to the breasts, to the abdomen, to the buttocks, down to the thighs. You can safely do multiple surgeries at the same time. Which surgeries, and in which order, varies from person to person. The usual course after major weight loss is a series of two or three separate surgeries. I like to operate first on those areas which are most problematic. What is the thing you focus on? Is it your belly? your thighs? your breasts? You can’t do everything safely in one surgery. For this reason, the surgeries are broken up and “staged.” A common course would be extended abdominoplasty and liposuction at one surgery, followed by breast and thigh lift at a second surgery. Again, it is tailored to your body and needs.