Body contouring after bariatric surgery?

Question

Good day! I’m a 31-years-old woman about to undergo gastric sleeve surgery. One of my main aesthetic concerns is the inevitable skin sagging. I’m wondering if it’s possible to undergo Vaser lipo and Embrace RF some months after surgery to improve skin tone and for body contouring. I understand I would have to have a revision once I reach my goal weight and quite possibly body lift. Do you have any insights? Thank you for taking the time to consider my question.

Randal Haworth, MD, FACS · Answer

First of all,  patients with a BMI exceeding 30 may be ineligible for liposuction.

Individuals who are overweight or obese are less likely to observe significant outcomes from liposuction. The primary aim of the treatment is to decrease the appearance of localized fat deposits. Therefore, individuals with a substantial amount of body fat may encounter challenges in achieving their desired results.

The quantity of fat that is eliminated during the procedure may differ, but it is crucial to note that no more than 4%-5% of your body weight can be eliminated.

An ideal candidate for Embrace RF procedures is an individual who experiences slight to moderate levels of discomfort due to excess fat and sagging skin in the neck and facial areas.

The best is to consult with a skilled and experienced board certified plastic surgeon to discuss your goals and needs.

I hope this helps,

Best of luck !

Randal Haworth

J. Timothy Katzen, MD, FACS · Answer

Thank you for your question regarding body contouring after bariatric surgery. Good luck with your gastric sleeve surgery. It is a very successful way to lose weight surgically. Most patients lose the majority of their weight within the first 9 to 12 months, then their weight plateaus. Once your weight has been stable for approximately three months, I would suggest considering reconstructive plastic surgery. Investing your time, money, and recovery in VASER liposuction and Embrace RF may not be the best approach. You will likely need more definitive skin removal surgeries at a later date, which I believe will be inevitable. I believe VASER liposuction and Embrace RF could potentially cause more tissue issues and complicate a definitive 360 circumferential lower body lift.
Sincerely,
Dr. Katzen

Giuseppe Fiore, MD · Answer

Hi,
Thanks for your question. It's understandable that you have concerns about skin sagging after undergoing gastric sleeve surgery.
After this surgical procedure and in similar cases, I always recommend two surgical options. 
The first option is surgical procedure to remove the excess of skin, if required, i.e. body lift (Abdominoplasty, back lift, tight lift, arm lift etc) . This procedure is performed in patients with significant weight loss and involves removing excess of skin. However this procedure involves an extensive scars. 
The second option is a less invasive approach: Vaser liposuction combined with Renuvion/J plasma or Bodytite on the upper and lower abdomen, flanks, and back area. The second option is ideal for patients who want to achieve body contouring and improve the waistline with less extensive scars; however, this procedure does not remove excess skin. The combination of Renuvion with Vaser liposuction can increase the likelihood of skin tightening, and my preferred method involves circumferential body Vaser liposuction (360-degree approach) and Renuvion/J plasma, which is an excellent option for women or men who want to improve their body contour and silhouette with fewer scars and avoid a tummy tuck. Renuvion only requires one session and is typically performed under general anesthesia or sedation in a hospital setting. Bodytite requires one session in combination with Morpheus 8 (three sessions four weeks apart). Before undergoing Vaser liposuction, it's essential to have a preoperative assessment to determine if you are a suitable candidate. Factors such as a BMI less than 30-32, overall health, and medications you are taking will be evaluated. It's important to note that liposuction is not a weight loss procedure and should not be used as a substitute for a healthy diet and regular exercise. Additionally, while Vaser Liposuction can effectively remove unwanted fat, it may not address loose skin or stretch marks. Therefore, it's important to have realistic expectations and understand the limitations of the procedure. I would suggest to make an appointment with a surgeon expert in body contouring and skin tightening who can assess your specific situation and recommend the best course of treatment for you. They can also discuss any potential risks and benefits associated with the procedure. 
Hope this helps, 
All the best, 
Dr Giuseppe Fiore

Anuj Purbey, MBBS · Answer

Hello! Thank you for reaching out with your question. It's great that you're considering your options to address potential skin sagging following gastric sleeve surgery.

Combining gastric sleeve surgery with Vaser liposuction and Embrace RF can be a viable option for improving skin tone and body contouring. However, it's essential to discuss this with your healthcare provider and plastic surgeon to ensure it aligns with your overall treatment plan and goals.

Here are some insights to consider:

Timing of Procedures: Your healthcare team will likely recommend waiting until you've reached a stable weight after gastric sleeve surgery before undergoing additional procedures such as Vaser liposuction and Embrace RF. This allows your body time to heal and adjust to the changes from the initial surgery.
Consultation with Plastic Surgeon: Schedule a consultation with a board-certified plastic surgeon who has experience working with patients who have undergone weight loss surgery. They can assess your specific concerns, discuss your goals, and recommend the most appropriate treatment plan for achieving your desired outcomes.
Combination Treatments: Vaser liposuction can help address stubborn fat deposits, while Embrace RF utilizes radiofrequency technology to tighten and firm the skin. Combining these treatments can provide comprehensive results for improving body contour and skin tone.
Revision Surgery: Depending on your individual response to weight loss and skin elasticity, you may require additional procedures such as body lift surgery to address excess skin and achieve optimal contouring. Your aesthetic surgeon can provide guidance on the timing and necessity of revision surgery based on your progress and goals.
Realistic Expectations: It's important to have realistic expectations about the results of these procedures and understand that they may not completely eliminate all skin sagging. However, they can significantly improve body contour and enhance your overall appearance.
Before proceeding with any additional procedures, be sure to discuss the potential risks, benefits, and timeline with your healthcare team. They can provide personalized recommendations based on your individual needs and help you make informed decisions about your treatment plan.

Best of luck with your gastric sleeve surgery and your journey toward improved health and well-being!

Navjot Singh, MD, FACG · Answer

Following bariatric surgery, a body contouring procedures such as VASER liposuction can effectively help with weight loss efforts. Adding Renuvion skin tightening procedures to the liposuction can be beneficial. However, it's important to remember that excess skin may need to be addressed with a separate surgery down the line. Liposuction can be a useful tool in achieving your ideal weight, but it's important to have realistic expectations and a comprehensive plan for long-term success.

Nanthini Dhevi, MBBS · Answer

After Bariatric fatloss is an ongoing process. Doing any procedure inbetween the procedure and final result would be a waste ,.because we are eitherways going to do a lift. After the lift if there is any need these procedures can help.

Mats Hagstrom, MD (license on probation) · Answer

I think you’re jumping ahead of yourself. The first goal is to recover from the weight loss surgery. The second step should be successful long-term weight loss. There’s no need to have any aesthetic procedure until you have successfully lost the weight and kept it off for six months.
There is no alternative to excision for significant skin laxity. The only appropriate option for massive weight loss. Patient is direct surgical excision, which is going to leave scars. Radio frequency treatment give results that are not even noticeable on before and after pictures.
These type of treatments are not appropriate for patients who have significant weight loss.
Focus on what’s in front of you and that is weight loss surgery.
You’re not a candidate for skin surgery until you’ve successfully lost enough weight to be a candidate.
Best,
Mats Hagstrom, MD

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