Charles K Herman1, Ari S Hoschander1, Anselm Wong1. 1. Dr Herman is the Chief Medical Executive, Chairman of the Department of Surgery and Chief of the Division of Plastic and Reconstructive Surgery, Pocono Health Systems, East Stroudsburg, PA; Clinical Professor of Surgery, The Commonwealth Medical College, Scranton, PA; and Assistant Clinical Professor of Surgery, Albert Einstein College of Medicine, New York, NY. Dr. Hoschander is the Chief Resident and Dr. Wong is a Resident in the Division of Plastic Surgery, University of Miami, Miller School of Medicine, Miami, FL.
Abstract
BACKGROUND: The "epidemic" of obesity has recently been accompanied by a new "epidemic" of massive weight loss. The demand for post-bariatric contouring is rising and, as such, it is extremely important for plastic surgeons to be well versed in the treatment of these patients. Unfortunately, the problem is not solely surgical. OBJECTIVES: The aim of this article is to understand the nutritional and psychological complications that can occur in patients following massive weight loss, to understand the anatomic deformities in massive weight loss as a means to correct those deformities surgically, and to understand the complications from post-bariatric contouring procedures in an effort to avoid them. METHODS: This article discusses the nutritional and psychological considerations in the massive weight loss patient, anatomical considerations in this patient group, and the surgical techniques designed to address these anatomic concerns. Important pertinent studies are reviewed and discussed. RESULTS: Anatomical changes are encountered in each region of the body: there are surgical options available to correct them, although potential complications are associated with these surgical procedures. These surgical options are reviewed as well as the risk and benefits associated with them. CONCLUSIONS: There are many problems that need to be addressed in the massive weight loss patient prior to embarking on surgical treatment. Additionally, surgery on massive weight loss patients has unique considerations that distinguish these operations from those performed on the non-bariatric population.
BACKGROUND: The "epidemic" of obesity has recently been accompanied by a new "epidemic" of massive weight loss. The demand for post-bariatric contouring is rising and, as such, it is extremely important for plastic surgeons to be well versed in the treatment of these patients. Unfortunately, the problem is not solely surgical. OBJECTIVES: The aim of this article is to understand the nutritional and psychological complications that can occur in patients following massive weight loss, to understand the anatomic deformities in massive weight loss as a means to correct those deformities surgically, and to understand the complications from post-bariatric contouring procedures in an effort to avoid them. METHODS: This article discusses the nutritional and psychological considerations in the massive weight losspatient, anatomical considerations in this patient group, and the surgical techniques designed to address these anatomic concerns. Important pertinent studies are reviewed and discussed. RESULTS: Anatomical changes are encountered in each region of the body: there are surgical options available to correct them, although potential complications are associated with these surgical procedures. These surgical options are reviewed as well as the risk and benefits associated with them. CONCLUSIONS: There are many problems that need to be addressed in the massive weight losspatient prior to embarking on surgical treatment. Additionally, surgery on massive weight losspatients has unique considerations that distinguish these operations from those performed on the non-bariatric population.
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