#PlasticSurgery after #BariatricSurgery: Meeting Patients' Needs

Bariatric surgery often results in numerous health benefits, such as resolution or improvement of type 2 diabetes, hypertension, joint pain, and depression. However, the extreme and rapid weight loss after bariatric surgery may also lead to physical and emotional distress resulting from redundant, loose skin. These new skin folds require meticulous care; even so patients may suffer painful rashes and skin infections. The weight of the pendulous skin can prohibit exercise and normal daily activities. Excess skin on the upper arms, thighs, and abdomen can make it difficult to find proper fitting clothes. Patients may feel self-conscious of their atypical body contours and find the hanging skin a deterrent from their commitment to dietary changes, exercise, and continued weight loss maintenance.

“Post bariatric body contouring” is the term used for the multiple surgical procedures typically required to remove excess skin and reshape the contours of the breasts, abdomen, arms, and lower body. These procedures include the breast lift, tummy tuck, lower body and medial thigh lifts, and arm lift. Despite the medical and psychological indications for these procedures, they are largely uncovered by insurance companies. A recent study showed that after bariatric surgery, 75 percent of women and 68 percent of men were interested in plastic surgery, yet less than 6% of patients underwent any plastic surgery procedure. The failure of insurance companies to cover these medically indicated procedures results in patients either paying out of pocket or suffering the negative health and psychological consequences of the excess skin. 

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For patients undergoing bariatric surgery, the surgery itself is only the beginning of their weight loss journey. Achieving optimal health after surgery requires a dedicated team that often includes surgeons, primary care physicians, nutritionists, psychologists, and plastic surgeons.

Our next #obsm chat will feature #obsm co-founder, Dr. Babak Moeinolmolki, a bariatric surgeon Our next #obsm chat will feature three surgeons with expertise in post-bariatric body contouring: Dr. Babak Moeinolmolki, Dr. Samuel Lin, and Dr. Jeffrey Gusenoff. Dr. Moeinolmolki, one of the co-founders of #obsm, is a bariatric surgeon with a unique background including training in both minimally invasive surgery and cosmetic surgery. Dr. Lin, Associate Professor of Surgery at Harvard Medical School and co-author of Atlas of Body Contouring After Weight Loss. Dr. Gusenoff, Associate Professor of Plastic Surgery at the University of Pittsburgh Physicians is the co-director of the “Life After Weight Loss Program” and director of the country’s only post-bariatric body contouring fellowship.

1. What are the pros and cons of undergoing #plasticsurgery after #bariatricsurgery?
2. How does body image after #bariatricsurgery affect patients’ desire for #plasticsurgery?
3. What are the unique medical and psychological needs of post-#bariatricsurgery #plasticsurgery patients?
4. What are the challenges to insurance coverage of #plasticsurgery after #bariatricsurgery? Is advocacy indicated?
5. How can we effectively integrate #plasticsurgery into post-#bariatricsurgery care?
   
   
   ~The #obsm chat leadership: Heather Logghe, MD, Neil Floch, MD, Amir Ghaferi, MD, MS, Babak Moein, MD, and Arghavan Salles, MD, PhD