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  • Plastic surgery

    Plastic surgery after obesity surgery

    The main objective of obesity surgery is its beneficial effect on health by resolving or improving co-morbidity (problems caused by obesity). It is also accompanied by significant weight loss. After such an operation, patients generally feel much healthier, with a greater joy in life. People feel better about themselves. But it is precisely the skin that can be a little disappointing. Four out of five patients have excess skin after bariatric surgery. In some cases, this can be so pronounced that it can cause problems in social or intimate relationships. But it can also cause health problems such as skin fissures in the folds under the hanging tummy. In some cases, the skin can even start to hang down under the upper arms or create friction on the thighs.
    It’s an illusion to think that certain ointments or muscle strengthening can solve this problem. With pronounced excess skin, only plastic surgery can offer a solution. To solve this problem, we offer an arm, tummy, and thigh lift.

    We work with a plastic surgeon for breast problems or other plastic or aesthetic corrections.

    We briefly describe these operations. Photos with examples cannot be freely put online.

    Abdominoplasty –Abdominal lift

    As a result of significant weight loss, many people develop a “fatty apron” or “hanging belly”. Four out of five patients suffer from this. It can be very pronounced in some patients. Under the folds, the skin sometimes becomes defective, leading to cracks and fungal infections.

    In this procedure, the skin with subcutaneous fat is removed from just above the pubis above the belly button. The belly button itself is left in place and re-implanted in the correct location. This operation requires a scar from one hip crest to the other. This scar is usually placed completely under the edge of the briefs so that a bikini can still be worn afterwards.

    Before the procedure, it is first clearly explained what can be expected, so that there are no unreal expectations.
    After the procedure, a large adhesive bandage is applied for a fortnight. Once the bandages have been removed, an elastic abdominal bandage is recommended for a few weeks.

    Like any surgical procedure, this operation can also lead to complications.

    Possible complications

    • Hemorrhage: before the wound is closed, everything is thoroughly checked for any bleeding. However, blood may still accumulate under the skin the following day. Sometimes this collection must be removed under a light anesthetic.
    • Infection: infection under the skin can occur, but is rare. The pus must be removed, and the wound cleaned.
    • Reduced sensitivity above the pubis: the skin is cut above the belly button and then brought down and attached to the pubis so that the skin is well stretched. This sometimes results in reduced sensitivity of a piece of skin between the umbilicus and the pubis. This loss can recover over time, but sometimes a piece of skin can remain insensitive.
    • Skin necrosis above the pubis: in very rare cases, a piece of skin above the pubis may die. This can happen exceptionally, particularly in diabetic patients or heavy smokers. Healing will take much longer. A new procedure may be needed later to excise a large scar.

    Reimbursement by mutual health insurance / hospital insurance?

    After major weight loss, partial reimbursement may be obtained from your health insurance company and hospital insurance, in the event of functional problems. This is explained during the consultation.

    Brachioplasty – Arm lift

    Embarrassing excess skin can also occur on the arms. Not only does this pose an aesthetic problem, but it can also cause discomfort when moving the arms (snapping sensation).
    The excess skin is removed through an elliptical incision on the inside of the arm. The scar lies completely between the arm and the body and extends from the elbow to the armpit.

    Reimbursement by the health insurance company / hospital insurance company?

    Partial reimbursement may be obtained. This is comparable with abdominoplasty (mentioned above).

    Thigh lift

    In the case of “heavy” thighs, after significant weight loss, an embarrassing excess of skin can also appear here. The skin can hang down, especially on the inside of the legs. In addition to the aesthetic problem, the skin can rub between the thighs when walking and even “crack”. Some patients solve this problem by wearing cycling shorts, for example, to counteract the friction. Sometimes this problem can be resolved with an incision just below the groin, but in most cases a more extensive resection with a scar up to the knee is required. The scar is located between the thighs and slightly behind so that it is not visible when standing or walking normally.
    After the procedure, elastic trousers are applied up to the knees. These should be worn for several weeks to ensure the best possible healing.

    Possible complications:

    • Haemorrhage and major infection are fairly rare.
    • A seroma or accumulation of fluid under the skin sometimes occurs and is difficult to predict. This may be persistent and needs to be aspirated regularly. It may even require another operation.

    Reimbursement by the health insurance company / hospital insurance company?

    Partial reimbursement may be obtained. This is comparable with abdominoplasty (mentioned above).

    Hospitalization

    Patients are generally admitted on the morning of the procedure. A 2-day hospital stay is recommended, but this of course depends on the course of the procedure and the patient.

    Breast correction

    With significant weight loss, the breasts also lose volume and may “hang” (ptosis). For breast corrections (breast augmentation or lifting), we would like to refer you to our plastic surgeon.