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Removal of excess skin after massive weight loss: challenges and solutions

Authors Giordano S

Received 21 January 2015

Accepted for publication 31 March 2015

Published 8 June 2015 Volume 2015:8 Pages 51—60

DOI https://doi.org/10.2147/OAS.S62235

Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 3

Editor who approved publication: Professor Cataldo Doria

Salvatore Giordano

Department of Plastic and General Surgery, Turku University Hospital, Turku, Finland

Abstract: The advent of bariatric surgery has led to a subspecialty in plastic surgery for skin and fat contouring which remain after massive weight loss. The author discusses the preoperative assessment, surgical treatment plan, postoperative management, possible complications, and benefits of postbariatric surgery. Preoperative planning includes medical history and patient assessment. Surgical procedures for brachioplasty, upper back lift, breast reshaping, abdominoplasty, panniculectomy, lower back lift, and thigh lift are discussed. Indications, postoperative complications, and benefits are also discussed. The best candidates for postbariatric plastic surgery are those who have achieved weight loss stability with a BMI of 32 or less and who have adequate nutrition in order to heal the surgical excisions. Abdominal and truncal deformity are the most common presenting complaints in massive weight loss patients, and the procedure of choice to address this region is a body lift. Postoperative care focuses on patient safety, prioritizing in deep venous thrombosis (DVT) prophylaxis and seroma prevention. Postbariatric body contouring aims to correct the deformity due to the excess of skin after massive weight loss and to restore a sense of normalcy.

Keywords: morbid obesity, bariatric surgery, weight loss, massive weight loss, body contouring, panniculectomy

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