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Paralleling the increasing use of bariatric surgery, there is a high demand for body contouring through plastic surgery. If you’re just beginning down this path, the questions are many. Who will do my surgery? How is recovery? What can I expect? Choosing and Evaluating a Plastic Surgeon Many of the surgical procedures performed on the massive weight-loss patient are complex and labor-intensive. The wide spectrum of body contour deformities that can follow massive weight loss often exceed the magnitude of what plastic surgeons have traditionally addressed. That is why weight-loss surgery patients need to work with a surgeon who specializes in bariatric plastic surgery. Dr. Joseph F. Capella, a plastic surgeon in New Jersey, affirms: Post-bariatric body contouring is a relatively new area within the field of plastic surgery, in that bariatric surgery only has become popular in the last 10 to 15 years. And because of that, many surgeons have come through their training not having been exposed to post-bariatric body contouring. Because of that these surgeries are not considered traditional procedures, in the sense that they’ve been honed over decades like many of the other plastic surgery procedures. And so what plastic surgeons may do is use these more traditional procedures and apply them to the post-bariatric patient, which often will lead to sub-optimal results. So, it’s very helpful then, in that regard, to go to a plastic surgeon who has committed to this kind of surgery and does this surgery frequently — and this would be true for any kind of plastic surgery, for that matter. But what’s different about post-bariatric surgery contouring is it is relatively new, and probably greater than 50% or more of plastic surgeons out there right now did not have any exposure to it in their training. Obviously there are on-going conferences to educate surgeons but there’s a difference with having it as part of your training rather than learning about it from a lecture. Read Dr. Capella’s comprehensive list of criteria for choosing and evaluating a plastic surgeon. Healing Body and Mind After a Post-Weight Loss Body Lift Once you’ve removed the loose skin and sagging, is the journey over? Are you obstacle-free? Well, not quite. The Plastic Surgery Center in New Jersey says: You’ve been through a life-altering experience, and with that, your body and mind need time to heal and adjust. It’s important to acknowledge that, so you can assist in your own recovery and eventually move on … Recovery from body lift surgery is extensive, which sometimes catches people off guard. And it can be painful, depending on the extent of the surgery and your perception of pain. You should be prepared for swelling (or even numbness) that can last for weeks and sometimes even months. In fact, most surgeons say that complete recovery and final results take up to a year. Of course scarring is a fact of body lift surgery, and scars are particularly distinct up until the first year following the procedure. Many (if not most) people experience strong emotions following plastic surgery. While excitement and elation are a natural result of such a positive life change, it is also customary that an entire range of feelings can result, including a phenomenon called post-plastic surgery depression which can resemble post-partum depression. Recovery creates the time and opportunity to focus on these emotions. On the plus side, the surgical results of a body lift are apparent almost immediately. They will remain permanent if you are able to maintain a stable weight (although normal aging obviously results in physical changes). And, depending on the person, the body’s healing process should mitigate scarring. Read The Plastic Surgery Center’s great advice for healing body and mind after a post-weight loss body lift. Plastic Surgery Improves Appearance, Mobility, Health and Emotional Well-Being People may not be fully aware of the many benefits of plastic surgery after weight loss. There are aesthetic refinements in the appearance and improvements in functional mobility, as well as an increased sense of emotional well-being. Dr. Edward Domanskis, a plastic surgeon in California, says: I think that the benefits of plastic surgery after weight loss are tremendous. When you’re massively overweight it’s one problem. When you lose the weight I think a lot of times the patient doesn’t realize that the problems don’t really go away; it’s just a different problem. It’s a problem of all this hanging skin. And to some people that can be almost as much of a problem as being overweight and having all this excess fatty tissue — physiologically for sure. In my experience I think it [plastic surgery after weight loss] is a very, very satisfying type of surgery not only to the patient but also for the physician to see the transformation in the patient. To see the reaction of their friends and family to what they’ve gone through and how their overall appearance and psyche tend to change. There’s no question that these procedures are very. very beneficial to the patient. Watch Dr. Domanskis’ video segment, “What to Expect: Improving Appearance, Mobility, Health and Emotional Well-Being through Bariatric Plastic Surgery.”

Pre-Op Diet The pre-op diet has a few purposes. The critical one is to shrink your liver so it’s not blocking your surgeon’s view of your insides during surgery. That makes your operation easier and safer. The pre-op diet also helps you lose weight. That may be surprising since you’re expecting to start your weight loss after surgery, but it’s actually a good idea to start losing weight beforehand. In fact, the more you lose before surgery, the safer surgery will be, and the better you’ll feel afterwards. Different surgeons suggest different pre-op diets. The diet has about 1,000 calories. It could depend on lean proteins and other nutrient-rich foods, or it could be a liquid diet with protein shakes. Or, it could be a combination of the two, with each day including two protein shakes as meal replacements plus one meal with vegetables and protein. The pre-op diet can last from a few days to several weeks or even months. In general, the longer you’re on it, the better. You’ll lose more weight, shrink your liver more, and gain confidence that you’ll be able to continue a strict eating program long-term after surgery. Get in Shape Why exercise before surgery? One reason is that, like with a good diet, it can make surgery safer. In this case, it’s because exercising can strengthen your heart, lungs, and blood vessels. Of course, exercise also burns calories and can help you lose a little extra weight before surgery. Another reason to get in shape before surgery is because it will make recovery easier. Many weight loss surgery patients find that walking around the house and then the neighborhood is their best tool for fighting post-op pain. If you’re used to being active before surgery, you’ll have an easier time walking after surgery. You don’t need to go crazy on your pre-op exercise regimen. If you’re not used to exercising, start small. As long as your doctor approves you to be active, just find a few minutes each day to walk at a comfortable pace. Clean and Stock the Kitchen Fact: you can’t eat food that’s not there. So, clean out your kitchen. Get rid of sugary desserts, starchy snacks, and fatty meats and cheeses. Anything you know you shouldn’t be eating shouldn’t be in your kitchen. Get rid of it before surgery because for weeks after surgery, you won’t be physically able to carry out heavy trash bags filled with forbidden foods. Once your kitchen is cleaned out, stock it up! At least get the protein shakes and powders you’ll need for weeks or more after surgery. Consider getting some flavored water in case you’re unable to tolerate water post-op. You can also stock up on non-perishable staples, such as canned chicken and tuna, frozen fruit and vegetables, and instant oatmeal packets. Take Your Nutritional Supplements You know you’ll be taking nutritional supplements post-op. If you have the sleeve or bypass, you’ll be taking them for life. With the band, you’ll need supplements for months, years, or life. Did you know you shouldn’t wait until after surgery to start taking your supplements? At a minimum, take a multivitamin beginning when you start your pre-op diet. Even if you’re eating a balanced diet, the supplement helps make sure your body has the nutrients it needs to heal your surgery wound. Also, it’s an insurance policy so that if you have trouble eating and swallowing supplements for a few weeks after surgery, your body will still have a good store of nutrients in reserve. Practice Your Healthy Eating Habits Consider the pre-op period practice for the post-op diet. That includes eating slowly, measuring portions, and choosing nutrient-dense instead of processed, high-calorie foods. Also consider making exercise a habit now, so it’s easier to get back to it after surgery. You cannot guarantee an easy surgery, but you can certainly do a few things to improve your chances. Use these tips to take control of your pre-op prep as soon as you’re ready to lose weight and get healthy!