Body Contouring Following Bariatric Surgery and Massive Weight Loss: Post-Bariatric Body Contouring


by

Bishara Atiyeh

DOI: 10.2174/97816080523871120101
eISBN: 978-1-60805-238-7, 2012
ISBN: 978-1-60805-548-7

  
  


Indexed in: Scopus

Body contouring is a rapidly growing field within plastic surgery. Safe and effective techniques have been developed in recent times w...[view complete introduction]
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Table of Contents

Foreword , Pp. i

Foad Nahai

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Preface , Pp. ii

Bishara S. Atiyeh

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List of Contributors , Pp. iii-v (3)

Bishara S. Atiyeh and M. Costagliola

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Overweight and Obesity: A True Global Epidemic , Pp. 3-11 (9)

Bishara S. Atiyeh and Karim A. Sarhane

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Bariatric Surgery: An Overview , Pp. 12-22 (11)

Bassem Safadi and Sami Masri

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Physiological and Nutritional Impact of Bariatric Surgery , Pp. 23-28 (6)

Dimitrios J. Pournaras and Carel W. le Roux

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Psychosocial Aspects of Massive Weight Loss after Bariatric Surgery , Pp. 29-38 (10)

Ronis Magdaleno

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Contour Deformities After Massive Weight Loss , Pp. 39-49 (11)

Steven Rueda, Mari Rebane and Seth Thaller

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Post-Bariatric Body Contouring Surgery and Patient Safety , Pp. 50-62 (13)

Bishara S. Atiyeh and Amir Ibrahim

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Abdominal Contour Surgery for the Massive Weight Loss Patient , Pp. 63-78 (16)

Ulrich M. Rieger

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Thigh Lift , Pp. 79-87 (9)

Bishara S. Atiyeh, Shady Hayek and Amir Ibrahim

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Gluteal Contouring and Enhancement for the Massive Weight Loss Patient , Pp. 88-101 (14)

Bishara Atiyeh, Shady Hayek and Amir Ibrahim

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Breast Surgery in Patients after Massive Weight Loss , Pp. 102-111 (10)

Moustapha Hamdi and Serhan Tuncer

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Gynecomastia and Male Chest Contouring , Pp. 112-120 (9)

Alaa Gheita and Bishara S. Atiyeh

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Torsoplasty , Pp. 121-126 (6)

Joachim Graf von Finckenstein

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Back Contouring after Massive Weight Loss , Pp. 127-131 (5)

Bishara S. Atiyeh and Saad A. Dibo

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Brachioplasty , Pp. 132-139 (8)

Sadri Ozan Sozer and Francisco J. Agullo

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Correction of Facial and Neck Excessive Laxity , Pp. 140-147 (8)

Mutaz B. Habal

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Anesthesia for Contouring Body in Post-Bariatric Surgery Patient , Pp. 148-166 (19)

Marwan S. Rizk, Cynthia J. Karam and Chakib M. Ayoub

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Index , Pp. 167-168 (2)

Bishara S. Atiyeh

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Foreword

Individuals who lose weight either through diet and exercise or surgical intervention physically feel better. However, rather than having their efforts rewarded and looking better, most have to deal with excessive folds of lax skin all over their body.These individuals are now seeking surgical removal of excess folds in order to restore their self confidence and body image. Our specialty has responded well to this growing demand.The need is not limited to one country or one continent. Obesity is a worldwide epidemic!

Body contouring following bariatric surgery and massive weight loss has become one of the most rapidly growing fields within plastic surgery. The techniques which have rapidly evolved over the past few years are now established and have a record of safety and efficacy.

In this timely publication Dr. Bishara Atiyeh and Michel Costagliola, who are themselves leaders and contributors in this field, bring a truly international group of authors together from all across the globe. Each and every one is an innovator, who has contributed to rapid advances in this most exciting field.

Because traditional or classical body contouring procedures are not suitable for the massive weight loss patient’s, procedures described in this book were developed. Procedures which maximize the removal of excess and unwanted skin whilst preserving volume and restoring contour. Patient safety with minimization of surgical risk is paramount for any operative procedures and is particularly so in this group of patients who may well be under nourished and otherwise at high risk. The issue of patient safety is addressed well by these experts and an entire chapter is devoted to this subject.

I commend the two editors and all the contributors for this comprehensive, beautifully illustrated, well written volume which will further advance the art and science of recontouring following massive weight loss.

Foad Nahai
ISAPS President


Preface

Morbid obesity is a chronic condition that is extremely difficult to treat. Unfortunately it is growing at an alarming rate in all age groups and is becoming a real epidemic in Europe and North America. Bariatric surgery is becoming the current standard treatment for severe obesity and its overall safety and effectiveness continues to improve. Even though success of bariatric surgery can be expressed by net reduction of BMI (Body Mass Index) global patient satisfaction does not usually exceed 6.2 on a visual analogue scale (VAS) of 10. Hand in hand with massive weight loss obtained with bariatric procedures comes the need to effectively and aesthetically manage the excess skin that remains as more patients are at present seeking the help of plastic surgeons to address the resulting aesthetic concerns.

Massive weight loss (MWL) patients present a very different profile than those who have not been obese. Their deformities are more severe and present with bi-dimensional skin excess which is usually poor in tone. Patients who experience massive weight loss are left looking “deflated” with disfiguring skin laxity circumferentially around the torso including the breasts in addition to redundant tissues on the upper arms, buttocks, and thighs leading to poor social acceptance and quality of life. To answer these problems, body contouring is mandatory. When expertly and effectively performed global satisfaction of patients increases to 8.5 VAS.

MWL patients present extremely diverse, disordered, and often complex and unpredictable contour deformities requiring lifts in areas previously rarely seen. Body contouring for these patients is unlike routine cosmetic surgery. It is evolving from traditional body contouring procedures, in particular from abdominoplasties, to a series of very specialized surgical procedures designed to aesthetically improve specific areas of the body. The subspecialty of body contouring surgery after massive weight loss is indeed a rapidly evolving field of plastic surgery and as an individual plastic surgeon continue to gain more experience with the massive weight loss patient and continues to refine their techniques, it is important that new learning and insights are shared within aesthetic surgical subspecialty.

List of Contributors

Editor(s):
Bishara Atiyeh
American University of Beirut
Lebanon




Co-Editor(s):
Michel Costagliola
Faculté de Médecine Toulouse-Rangueil
France




Contributor(s):
Francisco J. Agullo
Department of Surgery
Texas Tech University Health Sciences Center
1800 Alberta Avenue, El Paso
Texas, 79912
USA


Bishara S. Atiyeh
Clinical Professor, Plastic and Reconstructive Surgery
American University of Beirut
Beirut
Lebanon


Chakib Ayoub
Associate Professor of Anesthesiology
American University of Beirut Medical Center
Beirut
Lebanon


Saad Dibo
Resident, Plastic and Reconstructive Surgery
American University of Beirut
Beirut
Lebanon


Alaa Gheita
Emeritus Professor Plastic and Reconstructive Surgery
Faculty of Medicine Cairo University Egypt
Cairo
Egypt


Mutaz B. Habal
Director, Tampa Bay Craniofacial Center Research Professor
University of South Florida, Adjunct Professor of Material Science, University of Florida
205 W. Dr. Martin L. King, Jr. Blvd Suite 103
Tampa
FL
USA


Moustapha Hamdi
Professor and Chairman of Plastic Surgery Department
Brussels University Hospital
Laarbeeklaan 101
Brussels, 1090
Belgium


Shady N. Hayek
Assistant Professor, Plastic and Reconstructive Surgery
American University of Beirut
Beirut
Lebanon


Amir E. Ibrahim
Chief Resident, Plastic and Reconstructive Surgery
American University of Beirut
Beirut
Lebanon


Cynthia J. Karam
Resident, Department of Anesthesiology
American University of Beirut
Beirut
Lebanon


Carel W. le Roux
Department of Investigative Medicine
Imperial College Faculty of Medicine, Hammersmith Campus
Du Cane Road
London , W12 ONN
UK


Ronis Júnior Magdaleno
Department of Medical Psychology and Psychiatry, Faculty of Medical Sciences
University of Campinas—UNICAMP
Campinas
Brazil


Sami Masri
Research Fellow, Surgery Department
American University of Beirut
Beirut
Lebanon


Gracia Héctor Javier Morales
Belisario Dominguez 2501, Col. Obispado
Monterrey
N.L., C.P. 64060
Mexico


Dimitrios J. Pournaras
Department of Bariatric Surgery, Musgrove Park Hospital, Taunton, Department of Investigative Medicine
Hammersmith Hospital, Imperial College
London
UK


Mari Rebane
Fellow Division of Plastic
Reconstructive Surgery University of Miami School of Medicine
1475 NW 12 Ave. Miami
Florida , 33136
USA


Ulrich M. Rieger
Department of Plastic, Aesthetic & Reconstructive Surgery
Innsbruck Medical University
Anichstrasse 35
Innsbruck
N.L., 6020
Austria


Marwan S. Rizk
Instructor, Department of Anesthesiology
American University of Beirut
Beirut
Lebanon


Steven Rueda
Third year medical student, University of Miami School of Medicine, Miami
Florida
N.L., 33131
USA


Safadi Bassem
Associate Professor of Clinical Surgery
American University of Beirut Medical Center
Beirut
Lebanon


Karim A. Sarhane
Master of Science student, Department of Biochemistry and Molecular Genetics
American University of Beirut
Beirut
Lebanon


Sadri O. Sozer
El Paso Cosmetic Plastic Surgery Center
1600 Medical Center Suite 400, El Paso
Texas
N.L., 79902
USA


Seth R. Thaller
Professor and Chief, Division of Plastic Surgery, The DeWitt Daughtry Family Department of Surgery
University of Miami School of Medicine, Miami
Florida
USA


Serhan Tuncer
Department of Plastic Surgery - Gent University Hospital Gent
Medical Institute Edith Cavell
Brussels
Belgium


Joackim von Finckenstein
Department of Plastic and Aesthetic Surgery
Wittelsbacherstrasse 2a, 82319 Starnberg
Klinikum Starnberg
Germany




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