I often tell my patients that being a plastic surgery patient after massive weight loss is like being a medical resident. Are you wondering how?
When I went to medical school, I naively thought that I would be a doctor when I graduate in four years. That was somewhat true. In order to really be a doctor and treat people the way I wanted to though, it took an extra nine years to complete two residency programs and two fellowships!
Six Weight Loss Myths
1: You’ll look great after your bariatric surgery
For some people (not all), having a bariatric procedure is like finishing medical school and having a plastic surgery procedure to get rid of the extra skin and to contour the body, is like finishing a residency; you may not get to your goal without it- sadly.
Over the years, I have performed numerous cosmetic procedures on patients who had undergone massive weight loss, and I came to have a special affinity to those patients. They are very grateful, wonderful people, with a big heart, and have undergone a difficult and sometimes painful journey.
2: Cosmetic surgery is much more difficult than the gastric bypass
In general, that is not true. A Massive Weight Loss (MWL) operation not only enables a patient to lose weight, but it also improves their blood pressure, diabetes status, heart disease, joint pains, etc. Although cosmetic surgery may have its risks, the person undergoing cosmetic procedures is a much healthier person and can heal better than when they were overweight. That leads me to the next myth.
3: After losing the weight, I’m in optimal condition to have cosmetic surgery
That is not necessarily true. Some people go in the opposite direction after weight loss and become emaciated or at least under-nourished. I wrote a chapter in a plastic surgery textbook entitled “Nutrition Issues after Bariatric Surgery for Weight Loss” to educate patients and healthcare providers on how to prepare a patient for cosmetic surgery after bariatric surgery. The way to prepare is to ensure that the nutrients, vitamins, and overall nutrition are optimized.
4: Protein intake after plastic surgery is somewhat important
No, it is very important. We usually tell our patients to take in 80-120 grams of protein daily the week leading up to their cosmetic surgery and for one month, at least, following their surgery. The reason for this is because around the time of the surgery, the patients may be in pain, anxious, nauseated from all the medications, sleepy, tired, and/or in a depressed mood. Any of these factors can lead to loss of appetite or not paying attention to the quality of food intake. As the body is healing, a large wounded area for example in a tummy tuck, a breast lift, or an arm lift, protein is essential to form the collagen needed to heal those scars and avoid wound breakdown complications.
5: If I stop smoking the day of surgery, I will be fine
Smoking is very bad. We all know that by now. Smokers have a four-fold chance of having surgical complications over non-smokers. Why? Nicotine constricts the small arteries bringing oxygen to heal the tissues that have undergone the trauma of surgery, and carbon monoxide replaces oxygen in the arteries – a “double whammy.”
It is reported in the literature that if someone stops smoking for 10-15 years, their body will go back to the “non-smoking” state of normalcy. It is agreed that stopping smoking for at least two weeks before surgery and two weeks after surgery improves the surgical outcome. Of course, the longer someone quits smoking the better. Early studies are showing that vaping affects wound healing negatively as well.
6: Once I have my cosmetic surgery, I cannot regain the weight
Sadly, that is not true. Removing the excess skin and tightening the muscles will no doubt improve the body contour, but I have seen patients undergo cosmetic surgery and regain some or most of the pre-bariatric weight. The good news is that this unfortunate outcome is the exception, not the rule! We usually perform cosmetic surgery at least 18 months after bariatric surgery has been successful. That time allows the patient to heal from the bariatric surgery and for the weight to stabilize. When a patient is motivated to have their cosmetic surgery to achieve their desired body, they are usually motivated enough to maintain it.
Clearing Up the Misunderstandings
These myths underscore both the difficult journey of undergoing bariatric surgery as well as the satisfaction and joy to regain one’s body back whether the bariatric surgery is by itself enough, or cosmetic surgery for getting rid of the excess skin is needed.
Hopefully, by being cognizant of some of the warning signs and pitfalls discussed here, our readers will be able to make wise choices and achieve the body that they have yearned for all those years!
Learn more about our plastic surgery procedures and treatments after weight loss.
George Bitar, MD, FACS is an award-winning, board-certified cosmetic and reconstructive plastic surgeon, the Founder and Medical Director of Bitar Cosmetic Surgery Institute in Virginia. He specializes in the latest surgical and minimally invasive techniques to scar management and reduction. Dr. Bitar is involved in groundbreaking research and education in plastic surgery and has authored numerous articles, abstracts, and chapters.
