Post Bariatric Patients Have Special Nutritional Concerns

A new free article on the website of Plastic and Reconstructive Surgery is about a study of the nutritional status of post-bariatric patients — specifically, persons who have undergone bariatric surgery (gastric bypass or lap band) and subsequently seek body-contouring procedures from a plastic surgeon.

As the bariatric surgery patient rapidly loses body weight, he or she may become prone to nutrient deficiencies.  In this study of 98 gastric bypass patients and 2 lap band patients, nearly 18 percent of the subjects showed protein intake levels that were lower than the recommended intake.  Additionally, 39.7 percent showed low iron intake and 11 percent had low intake of vitamin b12.

Why is Protein Important for the Post-Bariatric Patient?

Protein intake is important for general health reasons as well as surgical reasons.  Protein aids the healing process during recovery from body contouring and its deficiency has been linked to problems such as “decreased wound tensile strength and increased rates of skin and fascial wound breakdown.”

The authors found certain predictors of low protein intake in their subjects. Those with increasing age and those who underwent a greater change in BMI after bariatric surgery were more likely to have a low daily protein intake.  Because food intolerance is relatively common in post-bariatric patients, a higher daily protein allowance may be recommended, the authors suggest.

Read more

Nutritional Assessment of Bariatric Surgery, Patients Presenting for Plastic Surgery: A Prospective Analysis Naghshineh, Nima; O’Brien Coon, Devin; McTigue, Kathleen; Courcoulas, Anita P.; Fernstrom, Madelyn; Rubin, J. Peter.  Plastic & Reconstructive Surgery. 126(2):602-610, August 2010.

U.S. Plastic Surgeons Perform Millions of Body Contouring Procedures In 2009

Global plastic surgery statistics recently released by the International Society of Aesthetic Plastic Surgery suggest that last year, U.S. plastic surgeons performed more surgical and non-surgical cosmetic procedures than plastic surgeons in any other country.

In 2009, plastic surgeons in the U.S., Brazil and China performed more than 1 million procedures each, with U.S. plastic surgeons topping the charts at more than 3 million total surgical and non-surgical procedures performed.

Several hundred thousand procedures were also performed by plastic surgeons in India, Japan, South Korea and Mexico, however they made up a much smaller percentage of the total plastic surgery procedures performed worldwide in 2009.

Body contouring plastic surgery, including liposuction, breast augmentation, breast reduction and tummy tuck procedures were among the most popular surgical procedures last year in both the U.S. and the entire world.  Facial plastic surgery procedures, such as nose surgery and eyelid surgery, were also frequently performed by plastic surgeons internationally.

Only three cosmetic procedures addressed by ISAPS statistics in the surgical and non-surgical categories were performed in excess of 1 million times in 2009.  In the surgical category, these procedures included:

• Liposuction
• Breast augmentation
• Eyelid surgery

In the non-surgical category, these procedures included:

• Wrinkle-relaxing injectables (e.g. Botox and Dysport)
• Hyaluronic acid fillers (e.g. Restylane and Juvederm)
• Laser hair removal

Non-surgical procedures were so popular in the U.S. last year that unlike plastic surgeons in most other countries, U.S. plastic surgeons actually performed more non-surgical procedures than surgical procedures in 2009.  Other popular non-surgical procedures that were frequently performed by plastic surgeons last year included laser skin resurfacing, including Fraxel Laser treatment, as well as sclerotherapy and laser vein treatment.

Although ISAPS statistics suggest that plastic surgeons most frequently perform non-surgical injectable and laser treatments, their primary areas of expertise are generally breast surgery, body contouring, facial plastic surgery and revision surgery.  Houston plastic surgeon Dr. Bob Basu is a breast reconstruction and body sculpting expert.

How Can a Mommy-Makeover Improve My Body Shape?

When plastic surgeons refer to a “mommy makeover,” they are generally referring to body and breast contouring with the tummy tuck, breast lift and breast augmentation.

These procedures are very effective in restoring the shape and volume of your breasts and restoring the contouring of your abdominal area. Dr. Basu performs 1-2 mommy makeover procedures each week.

Some moms even say that after surgery their body looks better than before they had kids. These patients love the transformation, so for a surgeon it’s a satisfying procedure to perform.

What’s the best way to get a bigger butt?

Don’t laugh. If you don’t look good in jeans because of your genes, getting that shapely figure may require cosmetic surgery.

There are several surgical options for buttock sculpting and butt augmentation.

One option is to sculpt the shape of the buttocks with targeted liposuction and to add volume to the desired areas with fat micrografting.

Other options include buttock lifts with tissue augmentation, a popular option for people who have lost volume in that area because of weight loss. Buttock implants are also an option.

Most plastic surgeons will recommend the first option – liposculpting and fat injections, a procedure often called the “Brazilian butt lift.”

What is the tumescent liposuction technique?

With all the marketing out there for different liposuction platforms, it’s easy to get mixed up about the different techniques.

First, all liposuction techniques are surgical procedures. Therefore, for your safety, it is critical to check the credentials of your surgeon and their board certification status.

Now, the liposuction performed by most plastic surgeons involves the tumescent technique. This procedure infiltrates (filling) the areas to be treated with a solution that helps constrict blood vessels and makes the fat cells more “swollen.” Doing this minimizes blood loss and facilitates aspiration (sucking out) of the excess fat.

What is a lower body lift?

Plastic surgeons will often use different terms for the same procedure, causing confusion for prospective patients.

We’ve seen terms such as body lift, lower body lift, belt lipectomy, and circumferential body lift interchangeably used. Usually, for my patients who have lost a significant amount of weight, the first choice is a circumferential body lift = belt lipectomy = lower body lift. This procedure is 3 procedures all in one:

1. tummy tuck
2. waist/lateral thigh lift
3. buttock lift +/- buttock augmentation

These procedures require about 5 hrs of surgery and an overnight stay at our Houston practice.