Dr. Cherny has received extensive training through the American society of Plastic Surgeons and the American Society of Plastic Surgery in the special needs of the post gastric bypass patient. He has performed extensive surgeries in all areas of the body for the many problem areas that arise from major weight loss, with or without bariatric surgery.
Three principles of major weight loss surgery have to be kept in mind. Generally, patients who have had major weight loss often need multiple areas to be addressed. With this, it is unfortunate that insurance coverage is usually in doubt for most, if not all of these operations. Lastly, patients who have had major weight loss are tucked as tightly as can properly be done in the operating room, but because of loss of skin tone, there is often the development of postoperative skin laxity that may very well necessitate revision at some point in the future.
Procedures often indicated in this situation, with which Dr. Cherny has experience, are primarily panniculectomy, with variations that could include abdominoplasty, extended abdominoplasty or circumferential or belt lipectomy. Total upper body lifts have also been developed as well, which include various options for lifting or reducing the breasts, excising the excessive tissue of the armpit and the side of the breasts, and the arms and upper back. Lastly, the inner thighs are commonly done as well and there are several variations of this procedure as well. The lateral thighs and buttocks are included in a circumferential abdominoplasty, but the posterior thighs are not and this is a separate procedure.
For the patients safety, if the patient is having multiple procedures, they are staged to avoid excessive stress upon the patient and to have the most rapid rehabilitation possible.
Surgeries typically are done eighteen months to two years after gastric bypass has been performed. Ideally, patients should be at maximal weight loss and have been at this point of maximum weight loss for some time. Because of the nature of the gastric bypass operations, patients who undergo reconstructive surgery after gastric bypass should have Vitamin K to improve clotting preoperatively, as well as other nutritional supplements, and a thorough examination and laboratory work-up by their personal physician.