Post-Bariatric (massive weight loss) Surgery

This is a group of operations to deal with the excess skin, unwanted scars, stretch marks, residual fat and folds after massive weight loss.  The commonest procedures include a form of abdominoplasty (tummy tuck), medial thigh lifts (removing the excess skin between your upper inner legs), mastopexy (breast up-lift +/- implants), arm lifts(removing the "bat-wing" flaps under your upper arms) and total body-lifts (combination of tummy tuck, outer thigh lift and bottom lift).

Who is suitable for this surgery?

People should have reached their new ideal weight, be well and happy in themselves and have no on-going medical problems.  This is often long and complex surgery. Mr Fleming will discuss with you the areas of excess skin and folds which most trouble you and a treatment plan will be discussed. Various areas may be operated on at the same time but this means longer operating time, increased risk and perhaps the need for blood transfusion . Recovery will also be longer than would be the norm for any of the individual operations. The scarring will also be more extensive. These are the type of operations which may be discussed:

Classic Tummy Tuck

Mastopexy +/- Augmentation

"Fleur-de-lys" Tummy Tuck
In patients with an even greater degree of slack/excess skin, excess fat and splaying of the muscles, a classic tummy tuck may not be sufficient . An extra incision is made from the lower breast bone to the classic tummy-tuck incision in the groin, around the bully button and a larger wedge of skin is excised from above the belly button to just above the pubic hair. This will leave a an inverted "T" scar on your tummy. Although this operation leaves the biggest scar, it provides the greatest degree of improvement in shape.

Medial Thigh Lifts

This operation removes excess skin and fat from between your upper legs (where it rubs together as you walk or run). The resulting scar usually runs in the groin crease. If there is a lot of tissue here you may even end up with "T" shaped scar running down the inner leg.

Arm Lifts

This operation removes the "bats- wing" flaps of skin below the upper arms.

Body-lifts

This operation removes excess skin and fat from not only the front of your tummy but also going round your back. This lifts your bottom and upper outer thighs.

What to expect at the initial consultation?
At the initial consultation, Mr Fleming will discuss your thoughts and needs with you and elicit a past medical history.

It is important that you mention to Mr Fleming any previous abdominal surgery, pregnancies, previous leg or lung blood clots and whether you smoke. If you are on any long-term medication, if you have any allergies, if you have a tendency to bleed or bruise easily, if you have had any previous surgery, if you had any problems with local or general anaesthesia and if you have any medical ailments, tell you surgeon.

Where does the treatment take place?
Your operation can take place at either Parkside Hospital Wimbledon, St Anthony’s Hospital, Cheam or The New Victoria Hospital, Kingston upon Thames. You can expect to spend 2-3 nights in hospital recovering from the operation before going home.

What can go wrong?
No surgery is without risk and Mr Fleming will explain the risks and possible side-effects of treatment with you at your consultation.

How long does it take to recover?
Recovery can take up to 4 weeks and you are not advised to return to work during the recovery period.

How satisfied can you expect to be with the procedure?
In most people, the results are long- lasting, especially if you avoid weight-gain, follow a balanced-diet and exercise regularly. Patients will experience improved self-confidence, better fitting clothing and a real "rounding off" of their weight loss campaign.

Scars are inevitable with any operation, but with time these should decrease and appear much less conspicuous.

Mr Fleming can discuss the exact nature of your treatment, including procedure details, recovery times and any possible side-effects at a consultation. This will reflect your exact circumstances and needs. The information included here is provided for general guidance only.

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