Aesthetic rehabilitation after bariatric surgery

Abstract

Sustained and lifelong weight loss for severely obese people is not anymore an impossible dream, and a Swedish article suggests, half jokingly, that this is the new fairy tale of the ugly duckling (Olbers, Lakartidningen 108:2570-2573, 2011). The example is appropriate because for health care professionals, resolution of obesity means reversal of diabetes, hyperlipidemia, and other cardiovascular risk factors. For the majority of the patients all these results are secondary. Priority is getting beautiful and achieving a rich and fulfilling emotional life. That is the reason why plastic interventions are the most frequent new operations after bariatric treatment, and as many as 85 % of this population desire subsequent body contouring maneuvers (Gusenoff et al., Plast Reconstr Surg 122:951-958, 2008; Highton et al. J Plast Reconstr Aesthet Surg 65:426-432, 2012). Fortunately this specialty has responded to the challenge, and both old and new techniques are being successfully adapted to the specificities of the patients who shed much weight and suffer from lax and redundant skinfolds and widespread lipodystrophy. Principal procedures such as abdominoplasty, mammaplasty, thigh lift, brachioplasty and others are described, emphasizing the experience of the Hospital das Clinicas Service during more than 15 years.