Post Bariatric Surgery

Significant sagging and deformations occur on the body after bariatric surgery procedures or weight loss by the effort of the person. This is caused by the skin changes which have become irreversible with the loss of tissue elasticity. Post-bariatric surgery meets the aesthetic expectations of patients who have relieved from their excess weight but have another problem with their new body shape. Aesthetic surgery is to get an almost normal or much better appearance. It includes body shaping surgeries and deformities that develop in the face, breast, back, abdomen, butt, arms and legs. Removal of excess tissue from all these areas and tightening the body are included in this scope.

Patients who have completed a period of 12-18 months after bariatric surgery, who have a constant weight in the last 6 months and whose body mass index is less than 30 kg/m2 (ideal group) • Non-smokers (should not smoke for at least 2 months before surgery) • Patients who have not an additional disease which might cause wound healing problem • Patients with reasonable expectations about the results to be achieved with the aesthetic surgery to be performed. • Patients who take care of their nutrition and do sports

Body Lift Surgery is the process of pushing the skin upwards on the sagged parts of the abdominal wall of abdomen and buttocks after weight loss as if pushing the pants from the bottom to the top and achieving the body form by removing the excess tissue. Thus, the wide area between breast and knee is shaped both from the front and back. Body lift surgeries include abdominoplasty, side leg stretching, genital stretching, inguinal stretching, buttock stretching, providing the desired buttock volume by forming buttock prosthesis from the tissues to be removed and shaping the local lipoidosis areas by liposuction as if shaping a dough. These procedures can be applied in one step.

The patients are dressed in body corsets by placing tissue adhesive tapes over the surgical area of application. For the first few days after surgery, drains can be placed to prevent blood and fluid collection under the skin. Points that must be followed after surgery are given to the patient, medicines to be used are explained and the patient is monitored in the early period under the physician supervision in terms of infection and wound healing problems that may occur on the surgical area. It should be taken care not to force the surgical area for a few days or a week. Patients should prevent from leaning backwards while they are generally in a straight position and should walk by slightly bending forward. It will be useful have support with a pillow under their knees while sleeping. Starting to move and walking in the postoperative early period and drinking adequate amount of water significantly reduce the risk of developing DVT (blood clots formation in the legs). Staying in the hospital for the first night will be convenient for patient comfort and follow-up. The process does not require any dressing.

In some cases, it may be possible to achieve the desired result at one time but additional procedures may be needed sometimes. Patients who do sports with stable weight loss and  whose skin elasticity is preserved usually have permanent results in the long run. It is necessary to remove the excess tissue in order to achieve the desired result and the patient should not have any concern about scars even the scars are tried to be hidden in invisible areas. It might take 1 year to obtain the clear aesthetic result after body shaping surgeries performed after excess weight loss. Following your doctor’s instructions will bring you the success.

Surgery time should be scheduled in advance and if possible, deformities should be partly approached in terms of patient comfort. Attempting to shape all areas in the same session may force the patient due to the extent of surgical site and may pose a risk to the patient because of the extended surgery period. Based on the following sequence, patient-based evaluation is carried out and surgical planning is performed. The sequence can be like this: 1. Abdominal, buttock and outer leg area 2. Breast uplift, Arm lift, Back lift 3. Inner leg lift 4. Facial lift

The incisions to be made on the body are determined by your surgeon, taking care of the benefit-damage relationship. However, as with any surgical procedure, there are some risks involved in these procedures. Risk factors for Post-Bariatric Surgeries are made to be read and signed by the patient before surgery (specified for the patient even the probability is rare); • Bleeding and infection • Discharge from the wound area • Wound healing impairment • Skin loss • Deep venous thrombosis and pulmonary embolism due to blood clotting • Expanded and swollen scars • Sensory loss in skin • Risk of anaesthesia •Excess skin and irregularities. These risks should be discussed with the doctor before surgery and you should be fully informed.

• Your expectations from the aesthetic surgery • Drugs that you are doing and your allergies • Drugs used in recent days; medicines, herbal medicines, alcohol, smoking • Previous surgeries. Your doctor will evaluate your general health condition and the risk factors. He will make measurements and calculations on your body. He will take photos of your body and then evaluate them. He will talk to you about treatment options and provide information. He will give general information about the results and evaluate risks and complications. Please take a note what you want to ask before going to your doctor. It is very important to fully understand the surgical procedure to be performed. It is quite normal that you have concerns before the surgery, but you should rely on your doctor, get information and get rid of these concerns.

Before surgery; smoking should be stopped at least 2 months in advance, aspirin, painkillers and herbal remedies should be avoided since they might increase bleeding, surgery should be done in a suitable hospital with appropriate intensive care conditions, a person to accompany you should be ready for the first night.

It depends on the combination of operations to be performed. It can be determined after the detailed examination.