Tuesday, April 10, 2012

Plastic Surgery after weight loss surgery

RNY-loose skin-

The following is from my notes watching a program called "The Real Skinny" on TLC.  (The Real Skinny, program on gastric bypass patients and loose skin on "Discovery Health".)

"after all my hard work, after all the foods I've cut from my diet, I still have to deal with my excess skin...  If I have to live like this all my life, I'd rather be fat again. " (male gastric bypass patient)

Dr Katzen has done many loose skin surgeries on gastric bypass patients.. His comments about operating on gastric bypass patients echo what many many other surgeons have said about it. Though being fat is thought to be very unhealthy, the fragility of these weight loss surgery patients raises the question that having a surgery which depletes the body of nutrients might be much more unhealthy that is, the cure seems to be, in some cases, worse than the "disease".

"A lot of surgeons are afraid of these plastic surgeries for a multitude of reasons...these surgeries are very risky surgeries ... I'm taking off a lot of skin, a lot of fat..."

"These patients are higher risk just because of their gastric bypass: they are typically malnourished... Just the fact that you've had gastric bypass increases the risk of bleeding, infection, and wound separation. For a circumferential body lift, I use 1000 to 1500 stitches...these surgeries typically take 8 hours... We pretty literally cut them in half and put them back together." --- Dr J. Timothy Katzen, MD plastic surgeon, Los Angeles, CA

Carnie Wilson, who admitted to have regained up to 250 lbs, 12 years after her gastric bypass surgery, was, none the less, much more fragile, healthwise than she was before surgery.  She said she was pre-diabetic and more.  It took her 4 weeks to recuperate after her lap band surgery...whereas her recuperation after a much more invasive surgery, gastric bypass, was much faster.  That is, she was much more healthy going into her gastric bypass despite weighing almost 300 lbs, (she's 5'1") than when she was when she went into her lap band surgery.  The difference was even though she weighed 40 lbs less than she did when she had the bypass, she had been not absorbing many vitamins and nutrients for 12 years.

When my DH had a brain bleed from taking the daily aspirin, there was another lady in the ICU - she had been over 300 lbs before her gastric bypass...her husband told me, tearfully, she was so frail now.  She did not survive.

Back to the show, Dr Katzen was shown doing a loose skin surgery on a male patient.

On this patient he did thighs and a circumferential lower body lift. There was a lot of fat left...

"we put him together with a type of super glue...the problem is too much super glue...the drain sucks out the fluid and allows the body to stick together."

"These patients usually exercise a lot to try and get rid of the loose skin but exercise alone won't get rid of the loose skin.  That's where I come in."

Dr J. Timothy Katzen, MD plastic surgeon, Los Angeles, CA

There is a lot of pain after these plastic surgeries for a few weeks after. "It's taking a lot longer to recover than I thought it would.". Four weeks after the surgery, the male patient was still not healed. He had a hole in his body about the size of an egg. "I felt wetness and my incision had opened up.", he told the camera crew. He had developed a staph infection in his open wound.

"we can't stitch up the open wound because if there is one germ left in there, they can develop a huge infection i.e. sepsis". Sepsis is a general body-wide infection from which there is a poor survival rate. This patient's relationship with his girl friend was strained, he said, and at filming they were hardly talking to each other.  He had a wound vac to suction out the hole.

It took him 6 weeks to heal and he still needed another surgery.

"my friends ask me why I want to go ahead with another surgery when I suffered all those complications, infections etc but I want to finish the job.", he explained.

Both patients have a huge scar which goes all around their bodies.

Note: part of Carnie Wilson's reasoning for having the "band over bypass" surgery is that she's got a job as a spokesperson for Allergan which manufactures the lap band.

The providers have nothing to lose. If the patient regains the weight or gets sick, they blame it on the patient...or quote statistics which suggest this type of reaction is very rare.  And if the patient lives and regains, the surgery is no longer mentioned.  If the patient dies or becomes very ill, the providers often make the patient afraid to speak out.

"I bury my mistakes" one gastric bypass surgeon joked to me.

In this surgery as in all commodities, it's a case of buyer beware.

Research sources:


"Wilson Phillips Still Hanging on" show on the TV Guide network