Do Eating Disorder Histories Discourage Doctors from Removing Excess Skin?

I'm 24 years old, weigh 100 lbs and am 5'2". About 5 years ago I developed an ED that led me to lose more than half of my body weight, going from about 190-200 lbs (after I got that heavy I didn't want to weigh myself, so I don't know the exact weight - I wore a size 18, though) to 86 lbs at my worst. Thanks to the help/encouragement of loved ones I went to a doctor about 2.5 years ago and started making improvements in my life that helped me reach a healthier weight.

Unfortunately, my initial major weight loss happened over the course of 6 months and led to excess skin that serves as a reminder of the person I used to be. Given my history of anorexia and my current weight, would I be disqualified as a candidate for body contouring surgery so that I can get rid of that excess skin? After undergoing several exams, the worst doctors found that resulted from my ED was some loss of bone calcium.

Doctor Answers (15)

Will an eating disorder in my past prevent me from having excess skin removed?

+3

Hi there-

First of all, congratulations on conquering the nasty weight demons! You should be proud of yourself.

Now that you've achieved a more healthy outlook and body, there are several important considerations...

I can certainly understand how the excess skin and undesirable body contour it causes would be an unpleasant reminder for you, and your motivation for having it removed. I don't think your motivations would be perceived as unhealthy.

There are other psychological and physical health considerations, however...

It is very important that you are in a good place mentally before your surgery can proceed. It sounds like you have achieved a healthier perspective, but surgery and its recovery can place significant additional stress on even the strongest of individuals, and post-surgical blues are not uncommon. This is because in the early postoperative period, swelling, bruising, fresh incisions, drain tubes, and discomfort may have you wondering exactly what you got yourself into- with time, as these short term discomforts and inconveniences are relieved and your lovely outcome is visible to you, your outlook will improve.

Visit with your doctor, psychologist, or psychiatrist and discuss your desired body contour surgery with them. They'll be able to write a quick note to your chosen Board Certified Plastic Surgeon letting them know that they support you in this endeavor, and are ready to also assist you with the psychological stresses of the postop period.

It is equally important to see your doctor to be sure that your body's physical functioning is good and you are in optimal condition to undergo the physical stress of the operation. As mentioned by colleagues, good nutrition is essential to good healing and a smooth recovery.

So to summarize, I do not think that the fact you were troubled in the past would limit my personal comfort with taking you on as a patient, but I would want to know that we had done everything possible to make the surgery as healthy and safe an experience for you as possible.

I hope that helps you- I wish you continued good luck!


Orlando Plastic Surgeon
5.0 out of 5 stars 110 reviews

Eating disorder and surgery

+1

Thank you for your question.

Congratulations on getting the support you need to get you through this time.  I believe that as long as the eating disorder is under control (sometimes I ask for a letter from the treating clinician) and there are no body dysmorphic issues, I would not think it would be a problem going forward with surgery.

Best Wishes!

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 781 reviews

Eating disoder and surgery

+1

As long as your eating disorder is udner control and you are cleared by your therapist and medical doctor, I do not see a problem going ahead.

Steven Wallach, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 17 reviews

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Eating Disorders and Plastic Surgery

+1

Thank you for your question. If you are medically cleared both physically and mentally and your eating disorder is under control (because proper nutrition is imperative for healing after surgery) then proceeding with surgery should be just fine. It is important to discuss everything with your surgeon before doing anything. Ask a lot of questions and be sure that your expected results are within reason and attainable. Be sure that you consult with a board certified plastic surgeon that is experienced with weight loss patients and can show you many before and after photos of the procedure or procedures you are interested in. Good Luck

Dr. Bernard Shuster, Miami Florida

Bernard Shuster, MD
Hollywood Plastic Surgeon
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Not necessarily...

+1

Hello,

 

Complex patients require individual evaluation when considering surgery particularly large scale surgery. There are few absolutes.

 

Best Regards,

John Di Saia MD

John P. Di Saia, MD
Orange Plastic Surgeon
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Body lift

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 If you need to improve your self image the surgery do it.  You need to have a good nutritional status and have a clearence form your psycolgist and nutriologyst.  Good look with your reconstruction

Alejandro J. Quiroz, MD, FACS
Mexico Plastic Surgeon
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Eating disorders and plastic surgery

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Congratulations on getting healthy!  We deal with many women who have had eating disorders.  So long as you are truly healthy and have realistic expectations, you may be a great candidate for body contouring.  Prepare yourself, though, for the scars that must replace the loose skin.

Carmen Kavali, MD
Atlanta Plastic Surgeon
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Eating disorders don't disqualify patients from plastic surgery but strongly influence the plastic surgeon.

+1

Cosmetic plastic surgery generates physical changes that make most patients happy.  That's the point.  If there is a psychological condition that prohibits a person from experiencing the psychological benefits of a totally elective operation, why do it?

In the case of massive weight loss, most patients are very please having excess skin removed.  However, for physiological safety, the weight should be stable for 6 months.  This is also an indirect indicator of the patient's emotional health.

Vincent N. Zubowicz, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 10 reviews

Body Contouring

+1

It is really importnat that you will honest and frank with your plastic surgeon.  As long as you have overcome your ED, then there is really no reason for you not to have plastic surgery after weight loss.  However, for these surgeries, it is best to go to someone who specilalizes in these procedures. For many of my patients who are having multiple body contouring procedures, I enhance their diet with a nutritional support supplement.  I believe that you will also benefit from this.

Siamak Agha, MD, PhD, FACS
Orange County Plastic Surgeon
4.5 out of 5 stars 59 reviews

Eating Disorders and Body Contouring Surgery

+1

Congratulations on your success in beating an eating disorder. I'm so glad to hear of your healthy success. Personally, I don't think your history of an eating disorder prevents you from having successful body contouring surgery. Much like a massive weight loss patient, it's important to know that your weight has been stable for about a year. Also, it's important to be sure that your ability to heal your wounds is intact. You should have your nutritional labs checked to make sure your protein levels and mineral levels are normal. Also, it may be reasonable to make sure your heart has not been affected by your disorder, which could complicate anesthesia. Finally, it's important to continue within a support system with healthy eating, exercise and weight monitoring. Good luck!

Karen Vaniver, MD
Seattle Plastic Surgeon
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These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.