Post-Bariatric Reconstructive Surgery


Obesity, now considered a disease, has several treatments. When you have tried diets from endocrinologists, magazines, fitness, diet pills, without favorable results, this patient is a candidate for bariatric surgery, if their weight exceeds 100 pounds of their ideal weight.There are several methods of bariatric surgery today performed by endoscopy. Once the patient undergoes this procedure by a bariatric surgeon, a year later is the time to begin reconstruction plastic surgery. These patients have a very special skin with hyperelasticity, permanent loss of muscle mass, as well as a malabsorption syndrome that has to be treated for life.You cannot practice all reconstructive procedures at once, we propose the patient with their priority needs. These patients generally have problems in the arms, breasts, abdomen, back, buttocks and legs, practically the entire body. This is why several procedures must be proposed for its reconstruction. For the arms, brachioplasty is performed (see previous post). In the breasts, as almost all fat has been lost, it should be subjected to a lifting (mastopexy) and increased with silicone gel implants placed behind the muscle to give them more strength, firmness and tone to this organ. The abdomen presents a big query, because depending on the skin condition, the amount of skin epigastric (above the navel) and the amount of skin in the lower abdomen (below the navel), presents a big problem in their treatment and operative technique because if a classic abdominoplasty (tummy tuck) is performed, the resulting excess skin does not leave a good looking aspect, but also fails to fully stretch the abdomen. Many of these patients have to undergo a medial abdominoplasty (tummy tuck) "inverted T" shaped, is the only way to remove excess skin in the upper abdomen. In patients without such extreme sagging, the classic abdominoplasty can be performed with excellent results. Combined surgery is possible, for example, you can combine breast and abdomen, arms and abdomen, circular abdominoplasty, is when there is an extreme sagging skin of the back and sagging buttocks, here you can lift and tighten skin on the buttocks, but you cannot put buttock implants to increase them at this time, as it is linked to the abdomen and these surgeries are not compatible. On the thighs, cruroplasty is performed, where we tighten all the skin in this area by making an incision on the inner thighs from the groin to the knee, (see previous posting cruroplasty.)It should be clear that any surgical procedure involves cuts, and cuts implies scars, and as I've said countless times, this surgery is “for the dress, not the nude”. We need to discuss before surgery all these consequences, hypothetically put it on a scale and see which weighs more, if you want to look well dressed and feel more comfortable even if you have scars or stay with the discomfort of all this skin hanging. Corrections can be made for the scarring results to improve their appearance, hanging skin stays hanging. Reconstructive surgery is a functional solution, most aesthetically possible.
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Dominican Republic Plastic Surgeon