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You are after bariatric surgery, have lost 30, 60 or maybe more kilograms, but you do not feel happy with the effects of the treatment. After losing weight, do you have too much skin on your arms, stomach, back and thighs? You can have it surgically removed. We suggest what is post-bariatric plastic surgery, or how to get rid of excess skin after losing weight.

Whetherexcess skin after slimmingbecomes a serious problem is determined by age, number of kilograms lost, exercises performed during slimming and proper skin hydration, but also the method of reduction excess body weight.

- If weight loss is accompanied by a properly selected diet and physical exercise, and the slimming process itself is spread over several years, we have a better chance that the skin will not sag - says Dr. Małgorzata Chomicka-Janda. - Once obese people undergo bariatric surgery, weight loss is extremely rapid. In this case, the skin may not shrink. Of course, people who have lost 20 kilograms will look different than those who have lost, for example, 100 kilograms.

The amount of unnecessary skin we will have after losing weight is also determined by our genes. If we were gifted by our ancestors with he althy, that is, very flexible, well-taut skin, which we did not destroy by excessive sunbathing (in the sun or in a solarium), we have a greater chance that even after losing many kilos, the operation to remove excess skin will not be necessary. In people who do not have a good genetic dowry and did not care for their skin, unnecessary folds almost always appear, which can only be reduced by surgery.

Excess skin after weight loss is a he alth problem

Sagging and sagging skin that remains after weight reduction is more prone to burns and blisters (superficial acute inflammation of the skin in the folds that touch and rub against each other). Fungi and bacteria accumulate in the folds of the skin, and moisture and heat favor their multiplication. Such skin very often requires specialized dermatological treatment, which lasts a long time and does not always bring relief after the first use of drugs. Another, but equally burdensome problem is the difficult daily hygiene, because thorough washing of all corners of the body and then drying them is a real feat.

Excess leather like a leather apron

Most patients who report to a plastic surgeon after rapid and intensive weight loss have a problem withexcess skin on their abdomen.It creates a substantial fold, as if an apron hanging down over the thighs. - The surgery that can be offered to such a person, however, affects the entire torso, because excess skin must be removed not only from the abdomen, but also from the sides and back - says Dr. Chomicka-Janda. - During the procedure, the buttocks can be slightly tucked up, because - according to the rules of surgical art - a strip of skin 15-20 cm wide can be removed from the back. You can cut a larger fragment from the belly, even 40-50 cm wide.

However, the problem may be not only excess skin on the abdomen.Thigh liftingis another treatment that can improve the appearance of the figure. - This is a difficult operation because the skin and muscles of the legs are most exposed to gravity. This, in turn, makes postoperative scars, which are initially invisible, because they are located in the groin, with time to shrink - explains Dr. Chomicka-Janda. Operationally removes the excess skin fromthe inside of the arms . Here, the lifting is sometimes combined withbust correction , which usually loses its firmness and falls unsightly after slimming.

Removing the skin after losing weight: indications and contraindications

People who visit a plastic surgeon because of excess skin after weight loss, as a rule, would like to get rid of their belly first. But the possibility of carrying out such an operation also depends on the method the patient lost weight. This is very important. If the weight loss is the result of a bariatric surgery, the blood count shows a reduced level of iron in such a person due to problems with absorption in the stomach. "Removing excess skin from the abdomen is a large operation with significant blood loss," explains Dr. Chomicka-Janda. - That is why the patient must be in good shape. To improve blood results, supplementation with folic acid and iron preparations is necessary for many months. So it happens that the doctor has to refuse the operation due to poor morphology.

In people who have lost weight through diet and exercise, the blood count is good, so the decision to undergo surgery is easier to make. The body is strong, so you can start the treatment faster. - If a patient decides to remove excess skin in several areas, such as the abdomen and arms, the treatment is divided into stages. There must be an interval of several months between the treatments. During this time, the patient has to addefforts to return to good general he alth, says Dr. Chomicka-Janda.

Concomitant diseases (hypertension, type 2 diabetes, thyroid diseases) do not disqualify patients and may undergo surgery, provided that they are under the supervision of specialist doctors. Abdominal hernias are not a contraindication to surgery to remove excess skin, as they can be operated on in one procedure.

The disappearance of the skin "at the National He alth Fund"

So-called post-bariatric plastic surgery, i.e. the removal of skin left over from weight loss, can be performed in private clinics, but they are expensive. For example, circular torso surgery costs from 16 to 20 thousand. zlotys. But such operations can also be performed within the National He alth Fund. The fund reimburses plastic treatments for patients who have undergone surgical treatment of obesity and for people who have lost weight without surgical intervention (diet, physical activity, medications), when excess skin makes it difficult to move freely or causes serious dermatological ailments. In order to apply for such a procedure, please contact the NFZ appropriate for your place of residence and find out which hospitals have a contract for such services. In addition, the patient must prove that excess skin significantly worsens the comfort of life and causes additional diseases, e.g. chafes or skin infections.

Removal of excess skin: the course of the operation

- The operation to remove excess skin is performed under general anesthesia. It lasts many hours, especially when circular torso is performed, i.e. excess skin is removed from the abdomen and back at the same time. - explains Dr. Chomicka-Janda. - It is a heavy burden for the patient because the cut is extensive. The seam goes all the way through the abdomen and through the back. For this reason, in people who have he alth burdens, the removal of excess skin is divided into stages. First, the abdomen is operated, then the back. The seams are removed after 2 weeks. The patient should not exercise intensively for about 2 months.

- Excess skin can be corrected using various techniques, says Dr. Chomicka-Janda. - There are special cuts and methods of joining the skin that make it possible to achieve the best aesthetic effect, thanks to which the scars are hardly visible. Flabby skin has very little or no elastic fibers, which makes it sometimes difficult to achieve the effect of fully correcting the removal of excess skin. Anyone who undergoes this type of surgery must also be aware that it will leave more or less visible scars. The ones on the stomach or back are easy to hide under clothes. But in the case of a shoulder lift whenThere is a lot of unnecessary skin, the cut - and thus the scar - will run from the armpit to the elbow. However, if the excess skin on the arms is small, the scar can be hidden under the armpit and the treatment effect will be very good. However, in the case of the thighs, the scar may run from the groin to the knee, or - when a smaller correction is needed - it can only be located in the groin, where it will hardly be visible - explains Dr. Chomicka-Janda.

Scar care after skin removal

After removing the stitches, it is necessary to lubricate the scar systematically. For this, creams with vitamin A, olive or creams that allow the proper nourishment of the scar are recommended. After it is completely healed, we start using preparations containing silicone. You can also use silicone plasters, the duration of which is much longer, and therefore the appearance of the blin improves much faster. You can also use laser therapy and other treatments to accelerate the process of scar involution, i.e. its disappearance.

I weighed 100 kg, now I am a size 36

Anna W. (wants to remain anonymous) admits that she has always had problems with maintaining the right weight, and the pregnancy added another 15 kilos. As a result, when she was 160 cm tall, she weighed about 100 kg. - Before losing weight, I ate 3 meals a day, then 5 but smaller portions - he recalls. - The basis of the diet was vegetables and fruits. But there was also rice, pasta and poultry. Since we lived in India for over a year, we didn't eat pork or beef at that time. But from time to time I indulged in something sweet. I also drank a lot, but most of all I rode my bike every day. As a result, my weight after returning to Poland was about 54 kg. After she finished losing weight, Annie was most bothered by the loose skin on her stomach and sides. Maybe it wasn't very much, but it didn't look aesthetically pleasing, so she decided to remove it.

- During the first visit to the clinic, after talking to Dr. Małgorzata Chomicka-Janda, I received a list of recommendations and tests that I had to perform - says Anna. - The ordered tests included blood count, blood type, urinalysis, coagulation assessment, CRP and lung x-ray, because I was supposed to have my abdomen operated on. It was also necessary to determine the level of electrolytes, sodium and potassium. Three weeks before the procedure, I started to make sure not to take any acetylsalicylic acid tablets.

At Anna, the doctors performed circular torso plastic surgery, i.e. they simultaneously removed excess skin from the abdomen, sides and back. After the operation, she spent three days in the clinic. On the second day she sat up in bed, and the next day she startedgo. - I knew exactly what awaited me after the surgery - says Anna. - Nine years ago, I had a caesarean section, so I knew that instead of bending down, I had to squat, that the skin would be a little stretchy, which was not a nice feeling. Yes, it did hurt a bit, but it wasn't terrible pain. I wasn't even taking painkillers. Only after the operation, I got one injection. For six weeks after the procedure, Anna wore special tightening underwear to make the postoperative scars as little visible as possible. Before the procedure, despite the fact that she lost a lot of weight, she did not wear tight dresses because she did not like the visible folds of the skin. This problem no longer exists. The dressing room has been replaced with a size 36. Anna is very pleased that she has undergone surgery. He wholeheartedly recommends the treatment to all those who struggle with excess skin after slimming.

Important supports safe treatment and a dignified life of people suffering from obesity. This article does not contain discriminatory and stigmatizing content of people suffering from obesity.

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