Post Massive Weight Loss
Along with the increasing popularity and success of bariatric surgery, we have seen a tremendous increase in demand for the surgical correction of bodywide skin laxity. Although there are similarities with the popular “mommy makeover”, the massive weight loss patient poses greater challenges. The tissues tend to be thinner and more atrophic, the severity of skin excess is greater and the geometry involved in sculpting and shaping such tissues is definitely more complicated. The surgeon’s eye, expertise and attention to detail are critical in these procedures. Dr. Stagnone has been doing these for over 20 years. He is a perfectionist and, unlike many surgeons in these extensive cases, does 100% of his own suturing.
As with mommy makeovers, the main focus for most of our patients is breast reshaping and tummy tuck. Along with our team of highly skilled board certified anesthesiologists and careful planning, our safety record for these cases is extraordinary. Metabolic lab work is routinely performed along with EKG and medical evaluations when indicated. Most are done on an outpatient basis in our accredited ambulatory surgery center but occasionally Dr. Stagnone may recommend the hospital setting with an overnight stay. Consultations for these procedures are extensive, with 30 minutes to an hour spent directly with Dr. Stagnone to plan each patient’s procedure individually and uniquely. A great deal of this time is spent educating each patient about their aftercare and preparing for recovery.
For safety reasons, there is a limit to what can be achieved in one surgical procedure. Comprehensive reconstruction may take two, and occasionally three major surgical procedures. The most common sequence involves starting with the abdominoplasty (tummy tuck) and breast reshaping, which can involve implants (augmentation) and/or breast lift (mastopexy). Additional stages may involve the flanks, outer thighs, buttocks and arms. Inner thigh lifts are not performed by the majority of plastic surgeons because of frequent disappointment. This is due to limitations in positioning and tightening in this area. Dr. Stagnone does perform these procedures in his patients if goals are reasonable and expectations are realistic. The consultation process is especially important in these cases.
Although each case is unique, ideally, prior to surgery, each patient will have reached their target goal for weight loss and be relatively stable for about a year. The closer to ideal weight, the more spectacular these procedures tend to be, but we do see patients who are still overweight yet might be considered for procedures under the right circumstances. Our goal with each patient is to establish a realistic expectation and make sensible choices with careful attention to detail. Patient safety is our highest priority.
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