May - Jun 2013

You've Lost the Weight Now What

By Sarah Wood, RN

 

Is your body shaped the way you thought it would be now that you’ve reached your weight loss goal? If not, consider this: rapid weight loss doesn’t allow your skin to rebound in a fast manner, so it may remain loose. But, there are options available to reshape your body as you envisioned—consider plastic surgery.

 

The thought of having another surgery may be daunting, but removing the extra skin is not only a cosmetic improvement, but can help with your general health. Plastic surgery can help prevent infection, improve movement and enhance body image. The surgeries that may be most helpful are panniculectomy or abdominoplasty (removal of the excess skin and tightening of your abdomen), mastopexy (breast lift), brachioplasty (upper arm lift), and thigh lift. These procedures can help you reach your body shape goal and make you look as healthy as you now feel.

 

When skin hangs down off of the abdomen, it is referred to as your pannus or abdominal apron, and can interfere with daily activities like exercise, cause back pain and possibly cause infection of the underlying skin. Folds in the skin are known to cause dermatitis, maceration, yeast infection, unpleasant odor, and/or chafing. A panniculectomy can help you in many ways. It can allow a better fit in clothing, help you with exercise and movement, as well as help to prevent infection. This surgery is one of the most common body contouring procedures after major weight loss. The surgery usually requires a 1 or 2 day hospital stay, where you will have help to start your recuperation. Because the panniculectomy requires an incision along your entire abdomen, pain is expected with movement. This pain will subside with walking within the next few days following surgery.

 

Mastopexy or a breast lift is most commonly performed on women, but men may require this too. Breast tissue is mainly adipose or fat tissue so as you lose fat it makes sense that the breast will shrink and become flat, causing irritation, chafing, yeast infection or dermatitis. A breast lift is usually completed as an outpatient procedure, but as with any outpatient procedure, a brief hospital stay may be required. A mastopexy will help with exercise and body image as well. Movement after breast surgery of any type can be limiting when reaching up for anything. So, it is discouraged for you to raise your arms after surgery.

 

Brachioplasty or upper arm tuck will help to get rid of some of the excess upper arm skin known as the “bat wing”. This will help with exercise, general movement, and prevention of infections. Movement initially after surgery is limited so ensure that you have someone who can help you with any lifting or reaching. The incision lines with this procedure may be visible. Keep this in mind if you are self-conscious about scars.

 

Thigh lifts remove excess skin in the upper portion of the leg. This helps relieve discomfort from skin friction or chaffing as well as skin infections. After this procedure, walking and movement will be more enjoyable as you no longer experience the pain and discomfort associated with excess skin.

 

Surgery is never an easy decision to make. So, you should speak with nurses and surgeons in your bariatric program to make an educated decision about contouring surgery. They can provide you with support and advise to address your concerns. Don’t be afraid to speak with them about how plastic surgery can increase your quality of life. You may also want to speak with fellow patients who have had the procedures. Remember, your bariatric program’s doctors and staff are all there for you during these life-changing decisions.



References

Twedell, D. (2007) Body contouring following major weight loss. The Journal of Continuing Education in Nursing. 38 (3). P. 103-104.

Gallagher, S. (2004) After massive weight loss, a patient may be left with a potentially serious new problem; excess abdominal pannus.  Here’s the latest on corrective surgery and what to teach about it. Nursing 2004. 34 (12). P. 48-50.