[Kde-i18n-vi] Noted Plastic Surgeon Sees Rising Trend in Body Contouring Surgery Among Weight-loss Surgery Patients - David A. Hidalgo MD

[paul.kholer paul.kholer]

David A. Hidalgo MD

With more than 100,000 Americans undergoing gastric bypass and lap-band
surgery each year, many are finding that their skin simply can't keep up
with their rapid weight loss. The American Society of Plastic Surgeons
reports that the number of body contouring procedures after massive weight
loss rose 22% in one year alone -- from 55,927 in 2004 to 68,134 in 2005.

"The fact is, skin becomes very loose and has no tone after losing 50 pounds
or more in a very short time," says Allan Parungao, MD, a board-certified
plastic surgeon and author of A Woman's Guide to Cosmetic Breast Surgery and
Body Contouring (Addicus Books, 2006).

Carmen, age 59, was overjoyed when she lost 75 pounds from her 4' 11" frame
after having gastric bypass surgery. But she soon found that although the
fat was melting away from her body, her skin would shrink only so far.



"Everything was hanging -- especially on my belly," she recalls. "My
overhang was literally sitting on my lap."

You can lose fat, but you can't lose skin.

Exercise will build muscle tone, but it cannot improve skin tone. After
bariatric surgery, many people are left with large amounts of loose excess
skin on their abdomen, arms, waist, thighs, breasts -- even their eyes and
face.

What's the answer? "Many people who have lost a massive amount of weight are
turning to body contouring or skin reduction surgery to free themselves of
loose, hanging skin and enjoy a normal appearance," says Dr. Parungao. "The
most common skin reduction procedure is the panniculectomy."

What is a panniculectomy?

A panniculectomy is a plastic surgery procedure to remove the apron of loose
excess skin, tissue and fat -- known as the pannus -- that occurs in the
lower portion of the abdominal wall after massive weight loss or sometimes
after pregnancy.

"The pannus can weigh as much as 100 pounds in some individuals, and can
extend as low as the knees," Dr. Parungao explains. "Some patients have two
or three of these redundant skin folds."

Not surprisingly, a pannus can interfere with personal hygiene. "The extra
skin hanging over the pubic region gets moist and often has a bad odor,"
says Dr. Parungao. "People may suffer from skin infections beneath the skin
folds. Often, a pannus also leads to back pain."

Living with a pannus is extremely uncomfortable. The loose, hanging skin can
make it very difficult to find clothing to fit appropriately. Even walking,
sitting or standing may become difficult.

Is a panniculectomy the same as a tummy tuck?

No -- there's an important distinction between the two. "A panniculectomy
simply removes the overhanging skin and fat from the lower abdomen,"
Dr.Parungao explains. "A tummy tuck removes excess abdominal skin and fat as
well -- but unlike a panniculectomy, it also tightens the muscles of the
abdominal wall and repositions the navel."

Tummy tucks are commonly performed on women who have overstretched abdominal
skin following pregnancy -- and who don't intend to bear more children.

Does insurance cover a panniculectomy?

In many cases, insurance will cover a panniculectomy if:

* The pannus hangs below the crotch level;

* The patient has lost 100 pounds or more, has been at a stable weight for
at least six months, and, if the patient has had weight loss surgery, the
operation was at least 18 months ago;

* The patient has a documented history of recurrent rashes or non-healing
ulcers for at least three months; and

* The pannus causes demonstrated difficulty with walking, sitting and
standing, or interferes with the activities of daily living.

Each insurance plan has its own provisions for panniculectomy -- check your
policy for details. If your insurance covers medically necessary
panniculectomy, your plastic surgeon can provide the documentation the
insurance company requires before surgery.

What about other loose, hanging skin?

Carmen is very happy with the results of her panniculectomy -- but, like
many people who have had weight-loss surgery, she's still dealing with
excess skin on other parts of her body.

"I have 30 bras and can't get a good fit because of the overhang on the
sides," she says.

Carmen plans to undergo a plastic surgery procedure known as an arm lift or
brachioplasty, to remove the loose, excess skin under her arms.

A thigh lift or thighplasty is another popular procedure among people who
have lost massive amounts of weight and have loose, hanging skin on their
lower body.

www.drdavidhidalgo.com
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