| SAN ANTONIO - With the growing popularity of gastric
bypass surgery to treat morbid obesity, body contouring after massive weight
loss has become a focus of the plastic surgery community. An updated and innovative
method that adjusts treatment according to body type is creating improved results
and enhancing the shape of patients' bodies, according to a study presented
today at the ASPS/PSEF/ASMS 71st Annual Scientific Meeting. With massive weight
loss in a short period of time, skin does not retain its shape, leaving the
patient with excess, baggy skin, according to ASPS Member Dennis Hurwitz, MD,
and author of the study. Also, patients lose different amounts of body fat before
the weight loss plateaus, leaving them either thin, moderate or still heavy.
Although previous body contouring techniques worked well on smaller patients
who had gastric bypass surgery, larger patients often had visible scars above
and below the underwear region after surgery as well as skin that did not conform
well to the body.
Building on current techniques from colleagues at the University of Pittsburgh
and other experts in body contouring, Dr. Hurwitz found that effectively mapping
incisions before surgery as well as using a combination of new and current cutting
and shaping techniques led to the most successful surgeries for moderate to
larger body shapes.
"All the patients who participated in the study are extremely pleased with
the end result," said Dr. Hurwitz. "In fact, 39 of the 40 patients in this study
rated the outcome of their surgery very good or excellent."
With moderate to larger patients, not only is it important to map the excess
tissue to be removed but to anticipate the movement of the skin left behind.
This allows the plastic surgeon to visualize where the scars will be after the
tissue is removed and place them where they will be hidden by underwear or in
a belt-like position. Ultimately, it allows the patient to feel better about
their body after the surgery.
The second step is use of particular cutting and shaping techniques. For
instance, when the patient is a moderate to large size, Dr. Hurwitz feels surgeons
should use more liposuction than had been used during this procedure previously
to allow the skin to shift into place and reduce overall bulk, giving a more
pleasing volume and look to the body.
Other methods include using a scalpel instead of electrocautery to minimize
skin damage, placing the patient in various positions to make it easier to stitch
the skin together, using permanent stitches rather than absorbable stitches
placed deeper in the tissue. Suturing deeper with permanent braided stitches,
which are significantly stronger than absorbable smooth stitches, holds the
skin better for moderate- and heavy patients, making it less likely for the
wound to open or slowly spread.
"The phenomenon of massive weight loss is a new development in the medical
community due to gastric bypass surgery," said Dr. Hurwitz. "As a board-certified
plastic surgeon, I'm proud these updated methods allow patients to look as good
as they feel while addressing some very fundamental issues that come with massive
weight loss."
ASPS, founded in 1931, is the largest plastic surgery organization in the
world and the foremost authority on cosmetic and reconstructive plastic surgery.
ASPS represents physicians certified by The American Board of Plastic Surgery
(ABPS) or The Royal College of Physicians and Surgeons of Canada. For referrals
to ABPS-certified plastic surgeons in your area and to learn more about cosmetic
and reconstructive plastic surgery, call the ASPS at (888) 4-PLASTIC (1-888-475-2784)
or visit www.plasticsurgery.org.
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