Post-Bariatric Surgery
What Are Bariatric and Post-Bariatric Surgeries?
Bariatric surgery, also known as obesity surgery, refers to gastric and intestinal operations performed by general surgeons on obese or morbidly obese individuals who are unable to lose weight through medication, diet, or exercise. These procedures, which are increasingly common today, allow patients to lose large amounts of weight in a relatively short time. As a result of this rapid and significant weight loss, sagging and loosening of the skin occur in many parts of the body.
Operations performed by plastic surgeons to correct the deformities caused by weight loss following bariatric surgery are called post-bariatric surgeries.
Why Does the Skin Sag?
The elasticity of the skin is provided by its elastic fibers. If we compare the skin to an elastic fabric, the role of these fibers is similar to that of Lycra in the fabric. When a fabric is overstretched and kept that way for a long time, it does not return to its original shape and becomes loose and deformed.
A similar process occurs in our skin. Due to excessive weight, elastic fibers become overstretched or ruptured, which leads to sagging and stretch marks after weight loss.
What Should Be Done and When in Post-Bariatric Surgery?
The degree of body deformation varies depending on exercise routines and the patient’s skin quality; therefore, post-bariatric surgery is not a standard procedure and must be tailored to each individual. In general, sagging is most frequently seen in the abdomen, breasts, upper arms, and thighs.
Depending on the patient’s needs, these areas can be corrected individually or in combination. Timing is also crucial — at least 18 months should pass after bariatric surgery, and the patient should have maintained a stable weight for at least the last 6 months. This ensures that the weight loss process is complete and that the sagging and deformities have stabilized before surgery.
What Should Be Considered Before Surgery?
Although post-bariatric surgeries are often classified as aesthetic procedures, they should actually be regarded as reconstructive surgeries. It is very important that patients understand and accept the possibility of permanent surgical scars.
Another important consideration is that these operations are more complex than standard aesthetic procedures such as abdominoplasty or breast lift.
Most patients in this group have experienced prolonged nutritional deficiencies, resulting in low levels of trace elements and vitamins, anemia, and fluctuations in hormonal and immune systems. Therefore, potential complications such as bleeding, wound healing problems, and infections must be carefully anticipated and managed.
For this reason, such surgeries should only be performed in fully equipped hospitals by experienced plastic surgeons.
Types of Post-Bariatric Operations
• Breast Lift (Mastopexy):
If there is sufficient tissue after weight loss, a classic breast lift may be sufficient. However, if volume is lacking, a small silicone implant can be used to restore fullness.
• Arm Lift (Brachioplasty):
Sagging in the upper arms can be corrected through liposuction to remove excess fat and surgical excision of loose skin. The resulting scar is usually placed along the inner arm to remain discreet.
• Thigh Lift:
Performed through an incision along the inner thigh, this procedure removes excess skin and tightens the area. If residual fat remains despite weight loss, liposuction can be combined with the surgery.
• Abdominoplasty (Tummy Tuck):
This surgery removes the sagging skin and remaining fat from the abdominal area. If necessary, the abdominal wall muscles can be tightened and hernias repaired during the same operation. The result is a firmer, flatter abdomen.
Post-bariatric procedures can be combined according to the patient’s needs. Recovery time varies depending on the procedures performed, but most patients can return to their social and professional lives within 1 to 3 weeks.