Why Would A Surgeon Say 'No' To A Body Lift?

VVartanian on 13 Aug 2013 at 9:00am

Dr. Stoker maps out why body lift surgery may not be the solution, even after extreme weight loss.

On last week's episode of ABC's Extreme Weight Loss, we had the pleasure of meeting Alyssa Stommen, a 23-year-old from Kalamazoo, Michigan. After witnessing her mother's death in a car accident at age 10, Alyssa buried her grief in food -- clocking in at 414 pounds at her very first weigh-in with trainer, Chris Powell. Determined to change her forward trajectory, Alyssa signs on with Chris for an incredible year-long journey, and loses a remarkable 204 pounds.

Although, she does encounter disappointment when she flies to Los Angeles for a body lift consult with plastic surgeon, Dr. David Stoker. Despite her incredible accomplishment, it was deemed that Alyssa had to lose a bit more weight to qualify for skin removal surgery. Which got us asking... why would your doc say you're not "OR ready"? We sat down with Dr. Stoker to find out.

RealSelf: What are major things you're looking for when someone wants a body lift?

Dr. Stoker: Patients who lose large amounts of weight have a wide variety of body shapes and needs. When I’m deciding if a patient is a candidate for surgery, I consider things including the distribution of the remaining fat under their skin. 

For a tummy tuck procedure, it’s important that the upper abdominal [fat under their] skin not be substantially thicker than the lower abdominal and pubic region.

RealSelf: How can this surgical "mismatch" affect the surgery?

Dr. Stoker: It can increase the risk of delayed healing and would not result in the beautiful outcome that I strive for. Delayed healing can be caused by slow-healing fat being joined with slow-healing fat. [This fat] is more vulnerable to the wound edges separating, infections or fluid collections. We don’t want any of those things if at all possible. 

RealSelf: Why does fat heal so slowly?

Dr. Stoker: Fat is yellow rather than red, because it has a low density of blood vessels. The blood vessels are necessary to bring the healing nutrients and cells to a surgical wound.  And, a lower density of blood vessels, will result in slower healing and increased susceptibility to complications.

RealSelf:  We imagine it's extremely difficult to tell a patient who has worked so hard that they don't qualify for skin removal surgery.

Dr. Stoker: [It is] very tough to tell [patients] "no" to surgery and send them back to the gym to loose more weight -- I do see patients getting discouraged. 

There's always risk in surgery – and that’s especially true following massive weight loss. But, there's also a tremendous medical benefit to treating large amounts of excess fat. I try to guide patients down the right path so they make wise decisions for themselves.  Fortunately, most of them leave inspired even if they are somewhat disappointed.

Do YOU have questions about a body lift or tummy tuck? Ask them on here on RealSelf.