Bariatric surgery has become a major choice for patients incented to improve their health with massive weight loss leading to reductions in hypertension, diabetes, sleep apnea and joint pain.
Along with this massive weight loss of generally over 100 lbs comes significant problems with skin excess on the abdomen, arms, breasts, thighs and head/neck leading to both functional and psychological concerns. Principles for patient selection and preparation, preop, intraop and post op care have been developed with patient safety as forefront as these lengthy procedures can have a 50% complication rate if not followed.
Patients must be non-smoking for at least 3 months, weight must be stabilized for 3-6 months usually 12-24 months post-bariatric surgery, BMI <30, able to tolerate 75-100 g protein a day, be medically stable, have a robust social support system, participate in a regular exercise program, have realistic expectations and understand the financial implications and recovery times.
Pannectomy, Abdominoplasty, Circumferential Pannectomy, Mastopexy, Brachioplasty, Back Fold Excision, Mons Pubic Reduction, Thigh Lift, Facelift surgery are usually planned serially to keep the surgical time to within 6 hours. Protocols to minimize hypothermia, infections and thrombosis are designed.
Post-Bariatric Body Contouring surgery is performed at both University and community teaching hospitals.
A contingent of faculty involved with Post Bariatric Body Contouring working group included:
- Dr. Peter Brill – UHN /Toronto Western Hospital
- Dr. Atul Kesarwani – Michael Garron/TEGH
- Dr. Melinda Musgrave – St. Michael’s Hospital
- Dr. Alexandra Ruszkowski – Oshawa General Hospital
- Dr. Tim Sproule – Scarborough General Hospital
- Dr. Laura Tate – Michael Garron/TEGH