Salvador Ramirez, MD

Hello, if you don’t have co-morbilities like diabetes, dislipidemia or High blood pressure we recommend you a gastric sleeve because your age, the excess of weight will be reduce by 70-80% and you will have the option for gastric bypass if you regain weight for some reason, otherwise the bariatric options after a gastric bypass aré limited!

I can straight up tell you, that it is not a good choice.
The usual timeline of these surgeries should be Gastric Bypass followed by Plastic Surgery Usually waiting around 12 to 18 months for the stabilization of your weight loss. Plastic surgery will have a much better impact on your looks and aesthetics if you are already at your ideal weight.

Dr. Salvador Ramirez

When it comes to the incisions where the ports were placed, it is important to check that everything is healing well.
If what you are experiencing just a little itchiness it is probably related to the normal healing process. I normally don't recommend putting anything on the incisions, because they can heal by themselves.

Hi there,


I do recommend getting the tests done because if you do need a CPAP to ventilate well, it will be very useful in the immediate post-op period. Maybe the 2 weeks period is to know that you are used to the machine.


I did a quick search regarding the leak association to the use of a CPAP and I could not find any positive relation, I will add below the link to a study where they did not find an increased leak % secondary to CPAP use.


I hope this helps,
Dr. Salvador Ramirez Guzman

Hi there.


I think that in this kind of situation, you should visit your physician, a physical examination can tell us a lot of information that a call or an email can't. I do not know specifics about your case, but I would recommend getting that checked out in a hospital to maybe get some studies done as well as some lab studies. A vertical sleeve gastrectomy usually does not interfere a lot with vitamins and nutrients, but vitamin deficiencies could be related to symptoms like that.

Best, Dr. Salvador Ramirez Guzman