What About Weight Loss Surgery

Overweight and obesity are rising medical problems of pandemic proportions. There are many detrimental health effects of obesity: heart disease, diabetes, many types of cancer, asthma, obstructive sleep apnea, chronic musculoskeletal problems, etc. There is also a clear effect of obesity on mortality, though this is not so clear for those who are overweight.

Although not a Direct measure of body fat, the Body Mass Index is widely adopted and promoted as a marker for excess body weight. However, it is not flawless: a very muscular person may be assessed as obese, and an elderly person with low body weight but high body fat (this can happen due to low muscle mass and bone density) may be assessed as healthy. Other markers for the evaluation of obesity include waist circumference (associated with central obesity), and a patient's risk factors for diseases and conditions associated with obesity. Besides these indirect methods, body fat can also be measured directly.

Although diet, exercise, behavior therapy and anti-obesity drugs are first-line treatment, medical therapy for severe obesity has limited short-term success and almost nonexistent long-term success. Therefore, obesity surgery (or bariatric surgery) has been a popular treatment in the war against obesity.

Bariatric surgery

In response to a serious obesity crisis, medical science has devised a handful of bariatric (obesity treatment) surgeries, including gastric bypass, stomach stapling, lap banding, stomach reduction and other techniques that reduce the amount of food the stomach can hold.

Liposuction

Liposuction, also known as lipoplasty (fat modeling), liposculpture or suction lipectomy (suction-assisted fat removal) is a cosmetic surgery operation that removes fat from many different sites on the human body. Areas affected can range from the abdomen, thighs, buttocks, to the neck, backs of the arms and elsewhere. Liposuction is not a low-effort alternative to exercise and diet. It is a surgical way of body contouring with some risks and is not a weight loss method. It is ideal for the patient to be as fit as possible before the procedure.

Body lifting

Food-restriction operations to the stomach have several side effects. One such side effect is the loose, hanging skin that covers much of a weight loss patient's body. Because hundreds of pounds have stretched the patient’s skin to the maximum, it has lost its elasticity and the ability to spring back.

Most people who have lost massive amounts of weight complain about the difficulty of getting their fleshy arms into sleeves and their excess stomach skin tucked into clothing. Most women in this state condition require a mastopexy, or breast lift, often in conjunction with breast implants. Men who have body shaping surgery usually undergo male breast reduction surgery to remove the pendulous skin hanging from their chests.

Many patients become reclusive and are hesitant to enter romantic or social relationships.

Nonetheless, the body lifting procedure is growing in popularity, thanks to a concomitant rise in weight loss surgeries on the stomach. For instance, in the year 2000, 207 lower body lifts took place, according to the American Society for Aesthetic Plastic Surgery (ASAPS). But in 2006, 10,323 such lift operations took place, an increase of 19 percent over the previous year. Most surgeons break the surgical task into an upper, and a lower, body lift. A lower body lift removes the sagging skin on the back, abdomen, buttocks and thighs while the upper body procedure removes loose skin from the arms, breasts and chest.

Plastic surgeons advise patients that body shaping is not an obesity operation. A patient who is more than 50 percent over his or her ideal weight must first drop as many pounds as possible before proceeding. Reputable plastic surgeons will explain all the risks and complications in full to their patients and even encourage a second or third consultation visit with other plastic surgeons to get additional views on such a major undertaking.

Arm lift or brachioplasty

The extra flesh on the arms of bariatric patients virtually always appears on the underside of the upper arm and is sometimes referred to as "bat wings". Surgeons realize they must use long incisions made from the armpit to the elbow to remove the skin and create a more pleasing contour. A brachioplasty procedure can employ some liposuction after the incision is made.

Breast lift or mastopexy

By trimming excess tissue from the upper breast, the surgeon can move breasts which usually droop to the umbillicus to a more upright and full position. The procedure also often requires an implant to make up for lost fat and tissue inside the breast.

Stomach lift or abdominoplasty

Excess skin hanging down over the pubic region is often the distorting feature that most concerns and bothers patients. The stomach pannus retains moisture, and causes rashes due to skin rubbing against itself which usually leads to poor hygiene. The surgical procedure to remove it is known as a panniculectomy. To provide improved contours on the waist, back and flanks, surgeons sometimes perform a belt lipectomy, (also known as a torsoplasty or a circumferential lipectomy). The incision goes all the way around the patient’s midsection at the level of the lower waist. The surgeon uses more liposuction on the stomach and flanks while trimming excess skin from the patient’s back and sides as well.

Lower body lift trims excess skin on the buttocks and thighs. For an inner thigh lift, the surgeon makes an incision high on the inner leg, starting near the groin and continuing down to the knee. Some fat may be removed with liposuction. The surgeon then removes excess skin and redrapes the remaining skin before closing the long incision, leaving the patient with tighter and more attractive thighs.

The outer thigh and buttock can be lifted through a hip-to-hip incision across the back, above the buttocks.

Usual results

The outcome of body shaping is generally extremely satisfying to patients although it can require several months to see the full effects of the procedure. But with a flatter stomach, more curve to the waist and smaller hips, less "back fat" and smaller, better shaped buttocks, patients usually develop more self confidence and become more active. After healing, most patients can buy and fit into easily available clothing, participate in sports and physical fitness activities again and become more involved in social and romantic situations.

When researchers at the University of Pittsburgh enrolled 18 bariatric patients just before the subjects decided to undergo body contouring, their average age was 46, plus or minus ten years. The researchers studied the patients’ body perception, quality of life and mood at three and six months after the body contouring procedures. They found the subjects’ quality of life improved and significantly enhanced their moods which had remained stable at the six-month point. Most body lifting patients return to non-strenuous work in about two to three weeks.

Except for brachioplasty, virtually all body shaping procedures require the patient to wear a support or compression garment for two to six weeks. The garment speeds and aids in healing.

Patients can usually drive again within one to three weeks, depending on the extent of the surgery, their health and general robustness.

Dr. 90210

Dr. 90210 is a reality television series focusing on plastic surgery in the wealthy suburb of Beverly Hills in Los Angeles, California. The series began its run in 2004. Dr. 90210 gets its name from the zip code of the core of Beverly Hills, familiar to most viewers because of the former popular television series Beverly Hills 90210.

The show is produced by E!, but is broadcast on several other basic cable network channels, such as the Style Network. Each episode is approximately one hour long. The show stands out from other programs of this sort in that it also examines the lives of the doctors featured in its lineup.

The show features interviews with the patients, semi-graphic footage of the surgeries, and before and after footage of the patients. For example, for patients wanting breast augmentation, the show displays the doctor examining the patient's breasts before and after surgery.

Nip/Tuck

Nip/Tuck is an Emmy and Golden Globe award-winning American television medical drama series created by Ryan Murphy for FX Networks. The show follows the lives of two Miami plastic surgeons, Sean McNamara (Dylan Walsh) and Christian Troy (Julian McMahon). The show, while not strictly a soap opera, has some story arcs. Source: Wikipedia