The truth about weight loss and body contouring surgery

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Although losing a significant amount of weight will certainly make you healthier, it won’t necessarily make you happier. At the start your weight loss journey, whether it be through diet and exercise alone or through bariatric surgery, the expectation is usually that reaching goal weight will be the pinnacle of achievement.

However, the truth is that many men and women find they are still not satisfied with their bodies. Often patients that visit my Leamington cosmetic surgery clinic comment that they were actually happier, in some ways, with their body previously.

The truth about losing excess weight

Even if you have maintained a steady weight throughout your adult life, the effects of gravity on the skin and other tissues will cause sagging and loss of tone in all areas of the body. However, men and women that have spent even some time significantly overweight will have extensively stretched their skin. Once the pounds are lost, particularly if it is the result of rapid weight loss associated with bariatric surgery, patients will often find that the rolls of fat have been replaced with folds of sagging skin.

Although general health and quality of life will be drastically improved, the excess skin is a constant reminder of their previous self and they can still find themselves restricted in what they can wear or do.

Body contouring surgery procedures

The procedures individually have all been performed for many decades and include tummy tucks and breast, arm and thigh lifts. What is relatively new is the amount of skin that has to be removed and the fact that a number of areas of the body may require surgery.

The first step is to assess whether you are suitable for body contouring surgery. Much depends on the extent of skin elasticity and that will be affected by a number of factors, such as your age, genetics and sun damage. It also depends on where the weight was distributed prior to it being lost. I will also assess your general health to ensure you are fit and well to undergo a surgical procedure. Patients who have previously undergone bariatric surgery may have nutritional deficiencies that can affect their recovery process.

It is also important that you are at or close to your ideal body weight and this has been stable for a while before undergoing body contouring surgery. Any weight fluctuations, either loss or gain, can affect the results you’ve achieved and may make a repeat procedure necessary.

If you wish to discuss in more detail what can be achieved with post weight loss surgery, please book a consultation with Mr Richard Matthews at his Leamington plastic surgery clinic.

BAAPS and BAPRAS unveil cosmetic surgery training fellowships

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At the BAAPS conference in September focus was on the training – or lack of it – that future plastic surgeons are receiving on the NHS in ‘cosmetic’ surgery procedures and the worrying repercussions for patients.

To become a consultant plastic surgeon on the specialist registry, trainees complete a two-year foundation programme after finishing medical school. This is to gain experience in all specialties and working in a variety of healthcare settings. After this they can apply for a further two-year core surgical training programme – the plastic surgery sub-specialty is often oversubscribed and is highly competitive. Trainees will then complete a further six years of plastic surgery training to gain the qualification FRCS (Plast) when they can then begin to apply for consultant posts.

During my plastic surgery training we covered the full range of reconstructive treatments for burns, trauma and other medical conditions and the current trainees still receive this reconstructive training, but a number of factors mean that their exposure to cosmetic surgery procedures on the NHS, such as breast augmentations or eyelid surgery, is far less extensive. This has raised concerns about a potential lack of experience and training when the next generation of surgeons enter private practice.

Changes in the NHS

BAAPS trainee member Reza Nassab presented a study to the conference illustrating the change in approach to cosmetic surgery procedures by the NHS since Primary Care Trusts were replaced by Clinical Commissioning Groups in 2013.

It is now highly unlikely that a cosmetic surgery procedure will be provided for by the NHS except in extreme cases. For example, there has been a 14 per cent reduction in breast augmentation provision and a third less funding for facelift surgery and only for medically significant conditions such as congenital deformities.

BAAPS President Michael Cadier also pointed to the growing worry about litigation that has resulted in trainees not being offered as many opportunities to perform surgery under supervision than was possible during my training.

Cosmetic surgery training

In light of these developments, BAAPS announced at the conference that it was working with fellow plastic surgery organisation BAPRAS and the National Institute of Aesthetic Research to launch a series of fellowships with experienced plastic surgeons working in private practice that offers hands-on practice and an understanding of how to deal with complications. This form of mentorship and training can only help to safeguard patients in the future.