Postbariatric Surgery

WHAT IS POST BARIATRIC SURGERY? (AESTHETIC AFTER OVER WEIGHT LOSS)

Still lifestyle, increased computer time, especially in young people, especially weight gain and obesity has increased. If we say what is post-bariatric surgery, it is useful to first look at what is bariatric surgery, because of the body's body mass index (BMI) 40 or excess weight, people with diabetes or various health problems and body mass index 35 by general surgery specialists, especially in the last gums. It is a surgical procedure performed by various methods in the digestive system. These are tube gastric surgery, gastric bypass, duadenal switch, etc .. operations. It is important that the patient has tried other normal weight loss methods but has not achieved any results. After the operation in the stomach, the person loses weight rapidly as it significantly reduces their nutrition.

Another important point that patients need to know here after surgery is that a completely different life awaits them. It is of great importance to apply a low carbohydrate-high protein diet under the guidance of nutritionist and diet expert, to organize more meals in small portions, to gain good chewing habits, to make daily multivitamin, calcium and vitamin D supplements and to add physical exercises to it. Since the patients can be saturated with small portions after the surgery, they have no problems getting used to their new lives.

Given the excess weight given in the patient profile, it is almost impossible for a person's body to be deformed, but this deformation varies from person to person. This varies depending on the individual's genetic characteristics, connective tissue and how much time he spends on exercising while losing weight.

Post-bariatric surgery comes into play right at this stage, ie after weight loss. This time is actually exactly the weight to fall to the desired weight. This is approximately 1 year after bariatric surgery. After losing weight, it should be ensured that the weight is maintained for a minimum of 3-6 months. Because after the stretching operations, even if everything is in accordance with the rule, there is already some loosening due to permanent damage to the skin quality and structure. If the weakening is continued, deformations will occur again after stretching. Therefore, a constant weight should be reached, maintained and blood values to support wound healing should be planned after the surgery.

The process of collecting the deformed areas of plastic surgery is called post-bariatric surgery.

When we look at what we have told so far, we can easily say that bariatric surgery will definitely be a complete success with a whole team.

Here we can help the patient get through this difficult and patient process with the help of general surgeons, plastic surgeons, dieticians and psychiatrists. Looking at the process, undoubtedly, the greatest motivation is that the person can lose weight quickly by experiencing problems with weight for years, breathing problems, various health problems and even experiencing community pressure (such as the difficulty of buying clothes and the gaze of people eating in crowded places). Some patients still feel obese despite the weight loss. It is important to get psychological support here.

POST BARIATRIC SURGERY SURGERY

Post bariatric surgery is the operation of shaping the deformed areas of the person after bariatric surgery. Compared to classical recovery surgeries, the amount of discharged skin is higher and the amount of skin to be removed from the body is also higher. Especially the abdomen, breasts, inner legs and arms are the main areas where recovery is needed.

Different techniques are used according to the intensity of deformation in post bariatric surgery operations. The need for recovery is high in these patients, resulting in combined surgery. If the patient wants to reshape all areas, operations are ordered according to the degree of deformity. Generally, lower body stretching is started with 360 degree abdominal stretching. Depending on the preference of the physician, this operation may include back-stretching, breast shaping or arm-stretching. I prefer not to do leg stretching, breast aesthetics and arm stretching in the same session because it affects each other in my own experience. If the patient's lower body, the abdominal waist region does not stack up in the first session, I prefer to stretch the upper body. Because stretching that starts from above affects the following tissues, the correction should be from top to bottom.

In post-bariatric patients, breast and back should not be separated from each other. Shaping the breast without stretching the back is not sufficient in most patients. For this reason, the incision marks in the bra and bikini can be hidden in the back of the back stacking and folding, stretching should be done. Upper body stretching can be done by removing excess skin from the back that fits the lower curvature of the breasts from the back to the anterior body. Since this incision is on the same line as the lower incision made when shaping the breast, there is no new scar, and the upper body stretching makes the correction in the abdomen and waist area more minimal. Actually, we can call this operation Reverse Stretching.

The degree of deformity is important in breast shaping. As the breast tissue in the breasts is often completely lost, it is necessary to place an implant under the muscle for volume support while collecting excess skin. So augmentation should be done mastopexy. However, in some patients, despite severe sagging, the breast is recovered and if the remaining tissue is sufficient, only lifting can be sufficient. Regardless of the technique, the aim is to remove excess skin, which means that the scar will be reverse-T-shaped.

The abdominal region is the area most surgeons first attempt to correct. Because most of the skin accumulation is seen in this area. Stretching of the lower body positively increases the quality of life of the patients. I would prefer to start with the lower body in these patients if the improvement in the quality of life of my patient is much more. In post-bariatric patients, excision of the skin with classical abdominal stretching may not be sufficient. In this case, the technique of forming a reverse-T-shaped scar, known as a fleur-de-lis or anchor incision, including vertical skin removal, should be chosen. In this way, the midline skin piles are recovered while the waist play is also highlighted. For relaxation in the abdominal muscles, the abdominal wall is stretched and strengthened by plating. Most of the time, the incision is completed to 360 degrees while shaping this area and the pile up of the lumbar region is corrected. In this way, the lower body is stretched butt is removed. If the sagging is too severe, the navel may be canceled because the old navel may die because tissue blood can be disrupted. With this in mind, patients with skin excess overhanging almost to the knee should be aborted and the neo-umbilicus should be created.

Butt is also very important in the genetic characteristics of the person, sometimes it is enough to just cut off the excess skin, but some patients want to be removed from the flat image in the butt region. In this case, instead of removing the excess skin in the waist section, the tissue is folded in and the volume loss in the butt region is eliminated.

In post-bariartric surgery on the legs and arms, it is necessary to give importance to the hiding of the sutures and aesthetic appearance of the sutures.

The technique is determined according to the degree of weight loss in the legs. If sagging is limited to the upper leg of the inner leg, this operation can be completed only with the scar hidden in the groin area, ie the bikini line. However, if there is more sagging of the inner leg as much as the knees of skin piling up the groin area from the inside of the leg towards the knee to make a straight incision and may need to remove the skin from this region. In patients with severe loss and severe sagging in the leg region, the leg is formed by taking the excess skin in the leg with a transverse incision extending from the upper outer line to the lower inner line parallel to the skin build-up. With this technique, there is no incision in the groin, no negative effects such as withdrawal due to surgery in the genital area, strain during sexual intercourse. The leg is shaped in a much more anatomical way. Since it is not entered into the groin region, we do not encounter negative effects in lymphatic circulation. But there is an invisible scar that appears on the front of the leg. Here, it is necessary to make a profit and loss account when choosing the technique. Is it a more beautiful technique, less complicated, but a visible scar? Or is it a technique that can be hidden with the leg closed but still visible, affecting the genital anatomy?

Arms are usually the most vulnerable areas of these patients after slimming sagging is one of the areas, because the person has difficulty in hiding the deformation here. Again, according to the degree of sagging technique we can choose. If the sagging is small, we can reach a small watch result that can only be hidden in the armpit area. If the armpit is tight but the arm is sagging like a bat, the arm can be recovered by an elliptical skin removal to be formed on the inner side or the back of the arm. However, in the case of excessive arm sagging, the arm is formed by removing the excess skin from the incision made with an L-shaped straight line extending from the armpit to the elbow and the breast on the inside side of the arm.

In fact, compared to normal recovery surgery, post-bariatric surgery surgery, I see that patients have less problem with the scar. Naturally, this is because they prefer to carry a suture that will become dull over time, rather than carrying sagging skin, which affects their quality of life, and continue to live with their bodies that seem more disturbing than naked.

I don't find liposuction right in post-bariatric patients. It may be done in a very limited area, but irreversibly deteriorating, stretching surgery continues to loosen despite the skin to evacuate even more do not find it right.

Post bariatric surgery is performed under general anesthesia just like normal plastic surgery.

POST BARIATRIC SURGERY AFTER POST

After post-bariatric surgery, the patient is now at the end of a difficult process has shown great patience and dedication. The exact shape of the body of a person who has undergone bariatric surgery will only reach full results at the end of post-bariatric surgery.

The patient undergoes general anesthesia and stays in the hospital for 2 days if more than 1 area of the operation, which is often operated on multiple areas of patients, wound healing and large dissection areas due to the accumulation of seroma and hematoma under the skin to follow drainage application at the end of surgery and necessary precautions should be taken in order to prevent the development. Patients should wear a corset for 1 to 3 months depending on the operation. Possible side effects of the operation include bruising and swelling. These effects disappear after a few weeks with healing of wounds.

Patients need to use antibiotics for 7 days against the risk of post-operative infection, and if pain occurs, they can take painkillers.

6 weeks of heavy lifting and should not do intense exercise.

Smoking is at the top of the ban. Pre-surgery and non-smoking are of great importance for a healthy wound healing.

You should rest for the first few days after surgery. Avoid taking blood thinners. It is a good idea to have someone who can help you right after your surgery. You will have pain for the first few days, but then it will be reduced to a minimum.

You must come for a check-up within the first week after surgery. During this check, your surgery site is examined and your bands can be removed.

It is important that you start to walk shortly after the surgery in order to open your legs and strengthen the blood circulation to accelerate the flow.

It is important to raise awareness of patients before postbariatric surgery. Slimming does not mean that the treatment is complete and this is a process for patients. The actual treatment is completed as a result of Postbariatric surgery, which will bring the patient's self-confidence.

POST BARIATRIC SURGERY PROCEDURE

Managing the post-bariatric surgery process is very important, a process that must be managed in a fully coordinated manner. After the patient is operated by the general surgeon, the person should be fed with a multi-disciplinary approach and follow the advice of his / her doctor. If necessary, these patients should receive psychological support. The important thing in this process is to monitor the metabolic balance of the patient regularly, to maintain the nutritional order and to maintain the normal blood levels. If all these conditions are met, the patient will be ready for post-bariatric surgery after bariatric surgery.

The patient who has lost weight rapidly may also want to quickly remove the deformation of his body, at which point after bariatric surgery, he should wait for 3-6 months after reaching his target weight and the intervention of plastic surgery will be more accurate at the end of this period.

In the post-bariatric surgery process, my advice to the patient as a physician is to give him at least 1 week total of 10 days for a healthy recovery and to spend this period by resting and returning to work after this period if he is working.

In post-bariarric surgery, the patient will feel unbearable pain and pain in normal sutures. These can be relieved with painkillers.

When we consider the treatment process in general, the post-bariatric surgery process is now the most important of the last points put into the event, and in a period of 1 month in total, the person is recovering and having a new body is a pleasant period.

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