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Post Weight Loss Abdominoplasty Washington DC

Post Weight Loss – Abdominoplasty Washington DC

Surgical procedures to address the excess skin in the abdominal region after weight loss range from simple removal of the hanging skin (panniculectomy) to full reshaping of the abdominal region with tightening of the underlying fascia and muscles (abdominoplasty).

Some patients experience a premature plateau in their weight loss due to the hanging excess skin interfering with exercise.  For this select group of patients, staged surgery with removal of the hanging abdominal skin (panniculectomy) as an initial procedure may allow him/her to achieve further weight loss prior to undergoing the final definitive abdominal contouring surgery.  If a patient has had symptoms related to the overhanging skin such as fold irritation or infection, then insurance may possibly cover some of the costs associated with the panniculectomy.

Before
After
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No matter how vigorous an exercise program may be, it is difficult for a patient who was previously obese to obtain a firm abdomen without surgical tightening of the fascia surrounding the abdominal wall muscles.  An additional benefit is the cinching of the waist that creates a more shapely figure.  A common finding in weight loss patients is the hanging, full pubic region that creates a pouch-like appearance with the genitals pointing towards the ground.  This area is rejuvenated in both men and women with an abdominoplasty as the entire pubic region (mons pubis) is elevated and if necessary, liposuctioned.  An abdominoplasty results in a scar that extends hip to hip across the lower abdomen and a separate scar around the umbilicus.  In patients with an existing vertical midline scar or in select patients with extreme amounts of excess abdominal skin, a revised or new vertical midline scar may be necessary in order to maximize the tautness of the trunk and improve the final result of the abdominoplasty.

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Post Weight Loss Surgery

The procedure is performed either in an outpatient setting or in the hospital under general anesthesia.  This may be scheduled in conjunction with other body contouring procedures depending upon the patient’s overall goals and at the surgeon’s discretion.  The patient is first marked in an upright position prior to entering the operating room, and the proposed skin to be excised is outlined.

At the end of the procedure, temporary drains will be placed to prevent fluid from accumulating underneath the skin.  A urinary catheter (Foley) remains in place overnight.  Patients who undergo this surgery in an ambulatory setting may have a pain pump placed that delivers local anesthesia to the operative site.  Patients who remain in the hospital overnight will receive pain medication through their IV.  Following surgery, the patient is wrapped in an abdominal binder.  The operative dressing is changed at the first postoperative visit, and the drains are removed when the output is minimal.  Patients typically wear a compression garment for one month following surgery.

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Recovery from Post Weight Loss Surgery

The recovery period for an abdominoplasty ranges from 3-6 weeks.  Patients typically remain flexed at the waist for the first 5-10 days.  Driving should be avoided for the first 2-3 weeks.  While each patient is different, most are back to full activities by 6 weeks, and many patients are back to their normal exercise program by 8-10 weeks.  It is important that patients wear a compression garment when exercising for the first two months following surgery.

Scar massage can begin 3-4 weeks postoperatively.  Scars are initially red and raised, but flatten and fade over the course of a year.  Also, during this first year, the final lower trunk shape will be achieved.  If any revisions or touch-ups are necessary, they typically will be performed at 9-12 months following surgery.

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Post Weight Loss Surgery Risks and Complications

Risks and complications are uncommon, but may occur.  They include, but are not limited to: bleeding, infection, asymmetry, wound separation, loss of the umbilicus, skin loss, fluid collection under the skin following drain removal requiring drainage (seroma), prolonged numbness and/or swelling, widened, hypertrophic or keloid scarring, and need for revision surgery in the future.

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