It is understandable and natural for patients who have undergone large amounts of weight loss to want to complete their body contouring surgeries as soon as possible. Getting the exterior part of the body to reflect your weight loss accomplishments completes the final physical step in the journey. But the concept of staging is an essential consideration in anyone considering bariatric plastic surgery.
Staging is the separation of a large number of body contouring changes into a series of operations over a period of time. This is of great importance in most body contouring procedures due to the size of the operations and the physical stress that they place on one’s system during the procedure as well as in the recovery phase. While many weight loss patients will never complete total body contouring ( or the number of operations that can maximally improve their body), many will have at least two operations which are usually staged three to six months apart.
Because of the magnitude of major body changing surgeries, the realization of potential risks and the time needed for adequate recovery…..safety is absolutely paramount. Body contouring surgery is not just a technical exercise to see what can be done…but an operation planned that can be done with maximal safety and very visible results. For this reason, I will not do a body contouring procedure that exceeds five hours. This limits the exposure of the patient to general anesthesia and the chance for significant blood loss. In addition, I like to do a single operation in which the patient can still go home the same day. By keeping it to a five hour time limit, common combinations could be abdominoplasty/arm lifts, circumferential body lift (by itself), breast lifts/abdominoplasty, etc. Enough is done to make the surgery very worthwhile but still keeping safety as the utmost concern. And recovery is still a very manageable two to three weeks for all of the potential combinations that can be done in this time frame.
Doing body contouring surgery in stages is not only safer but usually leads to better results in my experience. I do not get too tired (plastic surgeons are just human) and attention to detail in a long operation is not lost. Furthermore, the amount of stretching and pulling on loose skin is not in too many directions at one time.
Dr. Barry Eppley
Indianapolis, Indiana