Massive weight loss patients should be aware that body contouring may require surgeons to address the entire body circumferentially

Many post-bariatric surgery patients experience an extreme loss in skin elasticity that leads them to have body contouring procedures, which greatly differ from contouring procedures performed on normal weight patients.

After contouring, these patients' skin will still loosen and sag much faster with age, according to Jeffrey M. Kenkel, MD, chair of the American Society of Plastic Surgeons (ASPS) Post-Bariatric Task Force. Dr. Kenkel will moderate a panel today discussing how post-bariatric plastic surgery differs from standard body contouring techniques at the ASPS Plastic Surgery 2004 conference in Philadelphia.

"When a person loses a large amount of weight in a short period of time, particularly after bariatric surgery, the person has large amounts of extra skin," said Dr. Kenkel. "Bariatric surgery isn't just a commitment to weight loss. It often requires an additional two years of body contouring surgeries to help the patient's skin fit his or her new body."

"The skin and tissue from a gastric bypass patient is different from healthy normal weight patients," continued Dr. Kenkel. "With post-bariatric patients, their tissue is permanently damaged from being stretched to such an extreme. It has lost its ability to maintain tightness or tone to some degree. Even though we can make the skin fit the body again through plastic surgery, these patients' skin will loosen much faster than patients with normal skin."

Massive weight loss patients should be aware that body contouring may require surgeons to address the entire body circumferentially and not just one or two specific areas, as is the case with body contouring in more normal weight patients. Plastic surgeons must re-contour both the entire upper and lower body trunks after a patient has lost massive amounts of weight, according to Dr. Kenkel, who recommends patients carefully choose a plastic surgeon who has the training and experience in working with post-bariatric patients to ensure a successful outcome.

"Gastric bypass patients need to be realistic about their expectations," said Dr. Kenkel. "As board-certified plastic surgeons, even though we can improve the shape of their skin, we can never eradicate the problem of the extra skin completely. The laxity in the skin will still be there, and the tissue will give over time, but not to the same degree as experienced previously."

The popularity of gastric bypass surgery has skyrocketed to treat morbid obesity, leading to an influx of post-bariatric patients looking for body contouring plastic surgery. In fact, more than 52,000 body contouring procedures were performed for massive weight loss patients in 2003, according to ASPS, which expects body contouring procedures for post-bariatric patients to increase at least 36 percent in 2004.