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Post-Bariatric Surgery

Post-Bariatric Body ContouringSurgery McAllen

Bariatric patients made the conscious decision to embrace a new life, with a lifestyle change to end obesity and begin a healthy journey.

Most Bariatric patients often carry a reminder of their obesity in the form of stretched skin. The fat is gone yet the stretched skin that once held the fat in place remains. The feelings of unsettling emotions due to folds of sagging skin covering the body can override the success of having lostso much weight, making many patients extremely self-conscience about their bodies.

As part of their post-bariatric recovery process, patients should consider cosmetic surgery as a fundamental component. A study published in the Plastic and Reconstructive Surgery®, the official medical journal of the American Society of Plastic Surgeons(ASPS) published in September 2013, found that patients who underwent cosmetic body contouring surgery to remove sagging skin are less likely to regain weight and have better long-term results. Achieving better long-termresults, eliminating sagging skin, and building confidence in the way you look are why post-bariatric body contouring surgery from RGV Cosmetic Surgery & Vein Care should be a vital part of your journey. The next step is setting up a consultation with Dr. Rodriguez at RGV Cosmetic Surgery & Vein Care with offices in McAllen and Brownsville.

Dr. Filiberto Rodriguez is a double board certified cosmetic surgeon, specializing in breast and body cosmetic surgery. In particular, Dr. Rodriguez has mastered the challenging subspecialty that is post-bariatric body contouring surgery, and he is one of the few cosmetic or plastic surgeons in South Texas performing these complex procedures. Often, post-bariatric patients require multiple procedures that must be properly staged. Although some procedures can be combined, such as an arm lift and a breast lift with implants, many procedures must be performed separately in the correct sequence to obtain to best result. During your consultation, Dr. Rodriguez will explain body contouring and review your options for post weight loss cosmetic surgery. Dr. Rodriguez will determine which procedure or combination of procedures will best achieve the results you desire.

Post-bariatric contouring surgery is NOT a replacement for weight loss. Patients must first have lost weight, either through diet and exercise or after gastric sleeve or by-pass surgery, and maintained a stable, healthy weight (BMI less than 35) for a minimum of 6 months to be candidates for these complex body-contouring surgeries. We will test to ensure healthy blood levels and confirm medical clearance as indicated. To learn more about post-bariatric body contouring surgery, click here to request your private consultation with Dr. Filiberto Rodriguez. Or, call to schedule anappointment: 956-687-8346 in Edinburg or 956-350-6561 in Brownsville.

Post-Bariatric Body Contouring surgery details:

Almost every post-bariatric patient will need some type of abdominoplasty, whether it is an extended abdominoplasty, a Fleur-de-Lys pattern abdominoplasty, or an Around-the-World abdominoplasty. Sometimes called a Circumferential Abdominoplasty, or Belt Lipectomy, the Around-the-World abdominoplasty refers to the combination of a tummy tuck, lateral thigh lift, and buttock lift (posterior body lift) to improve the appearance of the entire lower torso by addressing the loose skin on the abdomen, thighs, and buttocks in patients who have undergone massive weight loss (i.e. a Lower Body Lift).

The Lower Body Lift Procedure
 is performed under general anesthesia and usually requires an overnight stay in observation. The procedure takes approximately 6 hours to perform, and starts in the prone position (lying on the stomach) to address the flanks and buttocks. The excess skin and

underlying fat is removed, the buttocks and posterior-lateral thighs are lifted, and this smoothes the back and buttock region. I typically perform VASER liposuction as part of my Body Lift procedures to further enhance the results. Recovery and exercise restrictions are similar to that of a tummy tuck. The discomfort after surgery is moderate and well managed with oral medications like Tylenol and Aleve. Walking after surgery is very beneficial and is strongly encouraged. Light cardiovascular exercise may begin four weeks after surgery, and normal activity at 6 weeks.

Gluteal Implants? Due to weight loss and the effects of lifting the sagging skin, some patients opt for gluteal implants to address their deflated gluteal region as a final, staged procedure, once they’ve had a chance to fully heal from all their other procedures.

In contrast, an Upper Body Lift combines an Extended Breast Lift with skin excision to enhance to improve the appearance of the upper body and around the upper back. In some patients, an Upper Abdominal Lift may be necessary as a second staged procedure after their initial abdominoplasty procedures to excise the excess skin and tissue that remains in the upper abdomen and side chest that cannot be removed with even the most extensive Fleur-de-Lys Abdominoplasty. For these patients, the upper abdominal lift can be combined with a Breast Lift to eliminate the excess upper abdominal skin while hiding the scars in the fold beneath the breasts (See patient at top of page for example).

Breast Lift surgery after massive weight loss is much more challenging that typical breast lift surgery. This is due to the severity of the excess skin that exists. Typically implants are required in addition to the lift in order to restore a firmer, more pleasing shape to the breasts.

For men with severe breast enlargement with drooping excess skin (Grade III or IV gynecomastia) VASER Liposuctions is combined with formal excisional procedures to remove the excess skin and reshape the chest. I avoid the vertical breast lift scar, and I carefully concealing the scars to create a more masculine appearance. Some men choose to add pectoral implants to further improve the appearance of their chest.

Arm Lift, or Brachioplasty, eliminates redundant skin and fat hanging off the upper arm. Through an incision which runs along the inside of the arm (hidden in the biceps groove) from the elbow to the armpit, an arm lift eliminates the extra skin that many patients hate (I’ve heard patients call their arms “batwings”!!). Even though the arm lift scar is one of the hardest to hide, post-bariatric patients love their arm lift surgery, because it leavestheir arms with a more desirable contour. Patients are finally happy to fit into nicer shirts!

There are two main types of Brachioplasty procedures: the Full ScarArm Lift and the Short Scar Arm Lift.

  • Full Scar Arm Lift: The Full Scar Arm lift allows all the excess skin to be removed along the full length of the upper arm and createsa dramatic result. The scar runs from the elbow across the armpit and is hidden in the biceps groove of the inner upper arm. This approach also addresses some of the excess skin from the side chest, and I can combine this with an extended breast lift to create a beautiful S-shaped Upper Body Lift. The downside of this traditional arm lift is that it leaves a visible scar on the upper arm and is therefore only suited for patients who are willing to trade the excess skin for a scar. Although placing the scar in the biceps groove of the inner upper arm hides it nicely, the scar will be visible if you’re looking for it. Fortunately, with most clothing it can be well hidden. The surgery takes approximately 4 – 5 hours to perform in conjunction with VASER Liposuction to the arms. This canbe done asan outpatient procedure, unless combined with additional procedures, such as a breast lift or abdominoplasty. ACE wraps are worn immediately after surgery, and are later exchanged for a compression garment to assist with swelling and support the incision during the first 6 weeks. The surgery is not particularly painful, and exercise is limited for 3 to 4 weeks.
  • Short Scar Arm Lift: The scar from a Short Scar Arm Lift is confined to the armpit and there is much less tightening force. The attraction of this procedure isthe short scar and it’s hidden location, but the downside is that the results are not as effective as with the Full Scar Arm Lift. I seldom perform this procedure. However, for select patients, the Short Scar Arm lift can provide an acceptable result, especially when combined with VASER Liposuction of the upper arm.

Thigh Lift surgery reshapes the inner thighs by reducing excess skin, and in some cases fat, resulting in smoother skin and better-proportioned contours of the thighs and lower body. An Outer Thigh Lift is performed as part ofthe Around-the-World abdominoplasty (Lower Body Lift) surgery detailed above. Inner thigh lift surgery is usually the final stage in the post-bariatric body contouring process. An important concept for patients to understand is that the abdominoplasty must be performed before the inner thigh lift, because the abdominoplasty anchors the thigh lift. Every attempt is made to conceal the scars of the thigh lift within the inguinal crease, although thigh lift scars, like arm lift scars, are at risk for widening – even despite proper deep fixation and meticulous surgical technique. Fortunately, we can avoid long scars along the inside of the inner thighs for most patients. The recovery is remarkably fast, and patients do very well. I employ VASER liposuction as part of my thigh lift procedures, in fact as part of all my body contouring surgeries, to further enhance the long-term results.

Liposuction can help shape and contour remaining deposits of fat in areas such as the arms, neck, chin, waist, hips and thighs. VASER liposuction to the chin can help tighten the skin in this area if a face and neck lift is not indicated.

At your initial consultation, I will take the time to go over all of your options for post weight loss cosmetic surgery in McAllen and Brownsville. I will work with you to determine which procedure or combination of procedures will best achieve the results you desire. Typically, post-bariatric patients must undergo a series of procedures, over the course of several months or years. Occasionally, surgeries can be combined, but since many of the procedures require extensive incisions, this is something that I must evaluate on a case-by-case basis. To learn more about post-bariatric body contouring surgery, click here to request your private consultation with Dr. Filiberto Rodriguez, a double board certified cosmetic surgeon specializing in breast and body surgery with an expertise in complex post-bariatric body contouring procedures. Or, call to schedule anappointment: 956-687-8346 in Edinburg, or 956-350-6561 in Brownsville.

Submitting your information to be contacted by RGV Cosmetic Surgery & Vein Care, does not constitute or establishes a physician-patient relationship with the physicians or nurse practitioner of RGV Cosmetic Surgery & Vein Care.

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