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Summary: For those who are significantly overweight, massive weight-loss can truly be a lifesaving decision. However, many patients do not consider the psychological effects of massive weight-loss. While everyone agrees that the surgery is worth it, there are some factors to consider for recovery.

Post Weight Loss SurgeryBariatric surgery patients who lose more than 100 pounds and later undergo body shaping surgery to remove excess skin have a higher risk of complications during recovery, according to a new study.

The study sheds more light on the many issues facing patients following major weight loss, including the cost of post-bariatric body contouring surgery, which is often deemed a cosmetic procedure and therefore not covered by most health insurance plans.

“This is one of the first large-scale studies comparing outcomes in patients losing significant amounts of weight via surgical and nonsurgical means,” Dr. Jeffrey Kenkel, professor and acting chairman of plastic surgery at the University of Texas Southwestern Medical Center, told the Medical News Today website. Dr. Kenkel, the senior author of the study, which was published in the Aesthetic Surgery Journal, says, “Major weight loss was a significant risk factor for wound complications in body contouring surgery.”

Losing a significant amount of weight, either through exercise and dietary changes or bariatric surgery, is a life-changing accomplishment. And for most men and women, the results include long-term health benefits such as lower risk of suffering heart attacks or strokes. It’s also important for patients to take into account both physiological and psychological issues related to undergoing a bariatric procedure.

Dr. Eric Mariotti, who performs major body contouring procedures at his plastic surgery center near Walnut Creek, California, sees patients who undergo weight-loss surgery at one of the finest bariatric surgery centers in the nation, John Muir Medical Center in Concord.

“Massive weight loss is defined as the loss of greater than 100 pounds or 100 percent above the person’s ideal body weight,” Dr. Mariotti’s website says. “Patients are usually left with a large amount of excess skin. The need to remove this excess skin is not only for aesthetic benefit but, in some cases, (to) help treat medical conditions.

“Body contouring surgery,” he says, “is planned only for patients who are psychologically stable and willing to accept staged operations to achieve expected goals.”

In addition to the study finding wound-healing complications following body contouring surgery, other studies have examined psychological impacts of bariatric surgery. Those impacts can be both positive and negative. For example:

  • A Norwegian doctor who interviewed bariatric patients up to 4 years after surgery found that some gained self-esteem, were more outspoken, and believed co-workers were more likely to listen to them. But the interviews also revealed feelings of embarrassment about having the surgery, and that excess skin led to a negative self-image. None of the patients interviewed, however, said they regretted the decision to have the surgery.
  • A study published this year in the medical journal Plastic and Reconstructive Surgery® showed significant mental health benefits for weight-loss patients who later underwent body contouring surgery. But that same study identified cost as the main barrier to patients getting plastic surgery, even though virtually all the study’s participants wanted the follow-up procedures. The American Society of Plastic Surgeons® has recommended that insurers cover body contouring procedures for bariatric patients.

In the most recent study, however, patients with weight loss of more than 100 pounds were found to be at higher risk for complications following body contouring surgery, regardless of weight loss method. Complication rates for post-bariatric patients exceeded those for patients who lost weight without surgery.

“It is imperative that patients account for their dietary deficiencies and prepare their bodies for surgery,” says Dr. Kenkel. “Nutrition plays an important role in skin healing, collagen production, and the generation of new blood vessels, all of which are important during recovery.

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