Body Contouring After Weight Loss Surgery

[Laura_MD 5]

Obesity Surgery, 16, 673

Correspondence

Body Contouring after Weight Loss in Morbid

Obesity: Gain in Health and Leap in Psychosocial

Functioning

To the Editor:

The importance of an unsatisfactory body image in

causing psychological distress in obese patients has

been recently investigated.1 This psychological distress

encompasses lack of self-esteem, depression,

and tendency to avoid social and sexual relationships.

Body contouring following a significant weight loss

can re-establish a good psychosocial functioning

because of the perception of improved body image.

A 31-year-old morbidly obese man presented to

my plastic surgery clinic for body contouring. He

came accompanied by his mother who held his hand

in a protective and sympathetic manner. As routinely

occurs with these patients, I started describing the

therapeutic path that he should undergo, consisting

of a relevant weight loss first, through diet or

bariatric surgery, followed by multistep body contouring.

2 While I was explaining this to him, I kept

on thinking with human, rather than medical, sympathy

about that 31-year-old man’s hand in his mother’s.

I could not help feeling sadness for a human

being psychologically and socially harmed because

of obesity and with little hope of enjoying an emotional,

social, sexual and familiar normal life.

Years went by, while the patient underwent the

routine procedures of both bariatric and plastic surgery.

While he was under my care, I could gradually

appreciate the progressive gain in body appearance

allowed by body contouring. From an empty baglike

aspect, a more natural human body was returned

to the patient, despite the price of some scars. Plastic

surgery procedures also allowed an improvement of

the buried penis syndrome, which affects both obese

and formerly obese patients’ sexual life.3

Some years after the end of the entire therapeutic

process, 9 years after the first consultation at my

office, I saw this man for a follow-up. While he was

coming to me at the end of a busy clinic, with a

heedless glance I happily noticed that his hand was

no longer in his mother’s. After a more careful

examination, I realized that the woman beside him

was far younger than his mother. “I introduce you to

my wife” he said “and here is my daughter” he

added, caressing his wife’s abdomen.

Giacomo Datta, MD, Consultant Plastic Surgeon;

Filippo Boriani, MD, Fabrizio D. Obbialero, MD,

Maurizio Verga, MD, Residents in Plastic Surgery;

Department of Plastic Surgery,

University of Turin, Turin, Italy.

E-mail: filippo.boriani@fastwebnet.it

References

1. Friedman KE, Reichmann SK, Costanzo PR et al.

Body image partially mediates the relationship

between obesity and psychological distress. Obes Res

2002; 10: 33-41.

2. Datta G, Cravero L, Margara A et al. The plastic surgeon

in the treatment of obesity. Obes Surg 2006; 16: 5-11.

3. Fontana D, Rolle L, Ceruti C et al. [False penile shortness][

Article in Italian] Arch Ital Urol Androl 1998;

70, 241-5.

[Lap_dancer 8]

What a wonderful story.

[PATCHELTON 0]

What a shame we can't get the insurance companies to realize that plastic surgery after weight loss is not just "cosmetic" but reconstructive. I have lost 110 lbs, and some day hope to have at least a Tummy Tuck to get rid of that roll of skin known as the pannus. I could use an inner thigh lift, a butt lift, breast lift and my upper arms, but there is no money for any of it. I can make a slight case for irritation for the tummy tuck (the skin under the roll periodically breaks open and gets sore, heals up for a while, then does it again) but I don't know if that is even enough to get insurance to pay for the panniculectomy portion of the tummy tuck. I can hide my arms in sleeves and my legs in pants, but that tummy roll (other than stuffing it like a turkey into a girdle) just won't be gone. I don't want to be the world's oldest Barbie, but I wistfully watch PS shows on TV and dream about how much younger I could look with a nip and tuck.

Now if I could just win the lottery . . .:biggrin:

[2Flyguys 13]

i totally agree...body contouring shold b covered after weight loss...i just had a panniculectomy (totally covered by insurance) and a mini tuck...i would definitely see a plastic surgeon if i were u...the symptons u r having should b looked at as health issues by ur insurance company...my plastic surgeon and dermatologist totally took care of getting my insurance to cover my panni due to reaccuring sores...it was actually a smooth and fast process...i have pix posted if ur interested in seeing the end result...

[PATCHELTON 0]

I may have a consult one of these days just for the heck of it. I did take pictures the last time my skin broke open under my pannus, though. Since it doesn't happen constantly, any hope of having a consult right when they are there is slim at best, so I recorded the last batch so I could at least show them SOMETHING. Right now my money is so tight I don't even have the cash for a copay, but I will keep recording the evidence for when I can have one.

[tekker 0]

i totally agree...body contouring shold b covered after weight loss...i just had a panniculectomy (totally covered by insurance) and a mini tuck...i would definitely see a plastic surgeon if i were u...the symptons u r having should b looked at as health issues by ur insurance company...my plastic surgeon and dermatologist totally took care of getting my insurance to cover my panni due to reaccuring sores...it was actually a smooth and fast process...i have pix posted if ur interested in seeing the end result...

Hi There,

I am very interested in seeing pics, as I cant completely understand what you are meaning... Sores on ur belling where the skin hangs down? this is so depressing, you finally start to loose the weight, then you dont have the funds to get a tuck or lift...Its very upsetting! Any info would be greatly app. thanks!