Procedure Name:   Post-Bariatric Surgery ( Dermolipectomy )

What is it?

It is an operation in which excess roles of skin and fat are directly removed from the body or extremities. Liposuction may or not be incorporated in this operation to obtain ideal results. After Bariatric surgery (Gastric Stapling or Gastric By pass) the patient may lose considerable weight. The skin however may not contract down to the smaller size of the abdomen and extremities. This excess skin may be very burdensome and difficult to keep clean. At times it becomes very difficult for the person to wear certain outfits or clothing. Dermolipectomy consists of a spectrum of procedures that are designed to eliminate the excessive skin and fat. Whether you have lost weight through dieting or by Bariatric surgery, Dermolipectomy can make the fruits of your hard work become visible and manifest.

What does it accomplish?

Dermolipectomy is performed when the skin has lost its ability to contract after massive weight fluctuations. In some people it may be due to genetic predisposition for having loose skin. With Dermolipectomy the plastic surgeon can remove the loose skin and fat from the, abdomen, arms, or thighs so as to improve the shape and to make the skin tighter and more youthful. Dermolipectomy can be used for any area of the body that has excess skin. This is often seen in patients who have had Gastric by-pass surgery and need to address the excess skin that remains after weight loss.

What happens during the first consultation?

In the first consultation you will get a chance to discuss your concerns with our patient care coordinators and Dr.Marefat. We will tell you what you need to know about your procedure and will help you determine what is best for you.   You will receive information booklets and pricing on the procedures.

How is it done?

Dermolipectomy is done by removing excess skin and fat directly. The incisions are usually placed in areas that would be less conspicuous. The extent of the incision will depend on the amount of loose skin present. Sometimes it can be done through limited incisions. At other times the skin excess so much that the incisions are necessarily long. The final contouring and shaping of the area may be done with selective liposuction. Unless it is necessary this procedure does not address underlying muscle or fascia.  

Procedure: Post Bariatric Surgery ( Dermolipectomy ) continued

What can I expect after surgery?

After surgery you will have a moderate degree of discomfort. The amount of recovery will depend on the extent of skin excision. Larger cases may need up to 2 weeks, while smaller cases may need only a few days. Since the surgery is limited to the skin the down time associated with it is not as much as procedures that also address muscle and fascia (outer layer of tissue covering the muscle).

When are the sutures removed?

  The sutures are removed between 10-14 days depending on the area of surgery.

How many visits do I have after surgery?

We like to see our patients frequently after surgery. You are seen by the Doctor or nurse within 2-3 days of surgery. Then the normal postoperative routine is: 1 week, 1month, 3 months.6months, and 12 months. Of course we will see you more if there is any need. After a year we encourage our patients to come for routine follow-up visits every 3-5 years.

When can I wear make-up?

You should be able to wear makeup if you have had Dermolipectomy. We do not recommend your putting makeup on your incisions until they have healed completely however, because this may result in tattooing by the pigments of the makeup.

Am I a good candidate?

Generally the younger you are the better a candidate you are for surgery. But the physiologic age of person is more important than the chronological age. That is to say you may be 60 years old, but your skin and general health could be better than most who are 50 years old. The best candidates for Dermolipectomy are those that are in good health and have realistic expectations about surgery.

Procedure: Post Bariatric Surgery ( Dermolipectomy )   continued

What does the surgery cost?

  The cost of surgery varies but here are some guidelines that will help you determine roughly what you could expect. Remember that these are only rough estimates. The best way for you get an accurate cost analysis is to see a doctor.

How do I pay for surgery?

You can pay for surgery by certified check, Credit card, or cash. Payments for cosmetic surgery are expected prior to the procedure. If you are scheduling several weeks in advance of surgery you can pay by personal check.

Are there scars?

Yes. In fact the scars after Dermolipectomy could be quite long. This depends on how much extra skin is being removed. A great amount of skin excess will necessitate a longer incision. We usually try to hide the incisions in areas that are less visible. Sometimes it is possible to keep the scar limited to the armpit area or in the groin. At other times the amount of excess skin is so much that the incision has to be extended down the arm. Scars do fade with time, however they never go away completely. If you are contemplating this operation you must be comfortable with the idea of having permanent scars. Remember that you are exchanging the inconvenience of extra rolls of skin for scars. This compromise is necessary in this operation.

Does it hurt?

Yes, however, the pain involved in Dermolipectomy is very tolerable. We have heard our patients describe it as 'aches' or 'soreness', but not as severe pain. Many patients do quite well with medications prescribed to them for pain relief. Dr.Marefat usually injects the incisions with a solution that helps minimize the postoperative pain.

Will I be awake during surgery?

Not usually. Most Dermolipectomies are done under general anesthesia. In certain cases the amount of excess skin is so little that we can remove it by injecting it with local numbing medicine. This would be an exception however.   Your doctor will be able to tell you if your procedure can be done without general anesthesia.

Where is the surgery performed ? (i.e. office suite or hospital)

The surgery can be done either in the hospital or the outpatient facility depending on the size and number of areas treated. Usually we can perform this operation in the outpatient facility. Occasionally the operation is so minor that it can be done under local in the office operating room. Your Plastic surgeon can tell you which facility would be required in your case.

Are medical photographs taken?

Yes. In all cosmetic and reconstructive cases medical photos are taken. Photographs are mandatory because this is the only way for us to compare your before and after results. Photographs in Plastic Surgery serve the same role as x-rays do in other medical specialties.

Date Revised: 1-23-07

To see Before and After pictures of Post Bariatric Surgery in Virginia and Washingon DC Click Here

To read more about this Post Gastric Bypass Surgery Click Here

To see patient Prices and Costs for Surgery after Massive Weight loss Click Here

To see patient Testimonials for Post Bariatric Surgery Click Here

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