Post-Bariatric Body Contouring Consultation – What to Expect

While the life-changing journey of losing 50 pounds, 100 pounds, or more after weight loss (bariatric) surgery is quite exciting, most people find that their new figure needs additional improvements. My Philadelphia post-bariatric body contouring patients often drive or fly in from more than five different states to undergo a range of body sculpting procedures designed to remove and tailor excess skin left behind after massive weight loss. They usually travel these distances because they like our before and after photos or they’ve spoken to our receptive staff. They’ve certainly done their homework, but more often than not, they are misinformed as to what to expect and how to prepare for their consultation appointment.

Most massive weight loss patients have experienced a dramatic change in their body, their psyche, and their attitude for life. They frequently want to “fix everything” as fast as possible. My first piece of advice to them is to slow down and expect to undergo several post-bariatric body contouring procedures gradually. Ninety percent of my post-bariatric patients wish to address multiple aesthetic issues affecting the breasts, the abdominal area, buttocks, inner and outer thighs, arms, back, and face. About 50 percent ultimately undergo all of the following five procedures: breast enhancement surgery, body lift, arm lift (brachioplasty), tummy tuck, and inner thigh lift. Typically, we’ll perform a lower body lift (aka trunk lift) first, followed by breasts and arms second. These surgeries can generally be performed within a month of each other. Facial surgery and less invasive procedures are usually saved for last.

Why multiple procedures instead of one? Because these procedures take time, and the longer the surgery, the greater the risk for complications. For this reason, I try to limit surgeries to 6 hours in length. I’ll joke with patients that our first rule here at Chapin Aesthetics is that “you get to see your results.” In other words, let’s keep the surgery safe. It must be working, as I’ve never lost a patient in my 15 years of practice.

Another important factor my massive weight loss patients need to be prepared to address is insurance coverage. Here at Chapin Aesthetics, we always do everything we can to help you submit for insurance coverage for a requested procedure. In order to obtain coverage, the insurance company needs to know what medical condition the patient has as a result of excess skin. And if you are well prepared, you win. Here’s how.

Have your doctor treat and document any rashes or back pain that may be the result of excess overhanging skin acquired through your weight loss. Once your weight loss has plateaued, you should have your doctor write a support letter explaining why you have failed medical therapy for these rashes. Our office can provide you with sample letters to give to your doctor, if necessary. Basically, the insurance companies want to know that you have exhausted all medical therapies for your rashes or back pain. It is then that they might consider covering all or a portion of your surgical procedure to remove the excess skin.

If I could offer any further advice to the massive weight loss patient, it would be this: Research your doctor. Does he or she perform this surgery often? Does the practice have photos to support their dedication to this type of surgery? In other words, do the surgeon’s results look nice? Check it out. You’ll see a wide variation in results. Then find the practice with the nicest results and the most supportive staff.

Dr. Scott Chapin, www.drchapin.com