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Massive Weight Loss Surgery

So one of the surgeries I perform very, very commonly is patients who've had significant weight loss, so we call massive weight loss. And this is one of those types of surgeries that it can be a huge transformation. Patients losing hundreds and hundreds of pounds, either with diet and exercise, or this new trend in society with gastric surgery, where they have gastric sleeves and bypasses. And so the result of that is just a significant amount of weight loss fairly quickly. So the consequence of that is that you have all this skin of the human body. So it depends on the amount of fat that the patient has in different parts of the body. So it affects the arms, it affects the legs, affects the abdomen, the breasts. And what happens, the skin gets really stretched out and the skin has to be removed. That is the bottom line of it. There's no cream, there's no lotions, no lasers that are going to help tightening that skin. At this amount of the skin stretch, the answer is skin removal surgery, or it's almost like a reconstruction. So the surgeries are really tailored to the patient. The ideal time that patients are best candidates for this type of surgery is when their weight stable. Is that they've done all their weight loss that they're happy with, and their lifestyle of work and personal life and diet and exercise lifestyle. And the patients are coming in, and that's when you do the contouring surgery. It's really contouring surgery. We're taking all the skin off and the idea is going, going to have tighter legs, tighter arms, and tighter abdomen, perk your breasts. And all the skin is retailored, basically with the trade off with a scar. And the idea is to hide these scars in areas of the human body that we can conceal them in shadows, conceal them in folds. So typically on the back of the arms or on the inside of the arms and the legs, usually on the inside of the legs. [inaudible 00:02:02] you want to hide in a bikini line or in a bra line for breasts and upper back. So the transformation for these massive weight loss patients is dramatic. I'm talking about removing pounds of skin so they can fit better in their clothes, they'll look better in clothes, they'll feel better about their bodies, and really give them the body they deserve. That they've worked so hard for, from years of having overweight complications. So patient health is super important when patients are considering this type of surgery. Patients who have lost a lot of weight maybe have a medical history of diabetes, they've had high blood pressure, and then losing all that weight, they've been cured of it. Some continue medications, some are on nutritional supplements to supplement some of the deficiency they've had, such as gastric bypass surgery. Those can affect on how patients recover and if they're good candidates to have major surgeries like this. So ideally we want patient optimization in their health so they can have these reconstructive surgeries. So there's a detailed questions that I ask my patients about their health at their current state, and if they were any medical supplements that they're taking for their nutrition. The idea is to get them very healthy and get them ready for the surgery they're about to undergo. Once they've been optimized and in good health, then these surgeries are performed and readdress these areas that they're concerned of. Typically we do these in stages. The stages for these surgeries include, arms, legs, abdomen, breasts, sometimes even face. All the stretched out skin has to be addressed. And so we carefully stage these procedures so we can have surgery safely. Recovery from this surgery is very typical for any cosmetic surgery. The surgery is not as invasive as other reconstructive surgeries I've performed historically. It's really just skin. So most of my patients that are considering massive weight loss surgery are doing multiple parts of the body. I'm doing breasts with arms and abdomen at the same time. You can't do too much because of the amount of blood that can be lost, but typically the amount of surgery that can be done is usually between five and six hours of surgery straight. And most patients who are in good healthy condition can tolerate these surgeries very well. I keep them overnight for the recovery to monitor their vital signs, make sure they're well hydrated and we're feeding them and they're getting good pain control, and then they can leave in the morning. So it's really outpatient surgery. Very well tolerated. We get them into the recovery setting for the next two months. So patients that recover from this surgery are usually back to full life at two months, believe it or not. And then I'm having them in some kind of exercise routine at three weeks. And we have a detailed instructions and protocols of what they can and cannot do based on what kind of reconstructive surgeries they've had addressed, of either the arms or legs or abdomen, and sometimes breasts.