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Case 3: The patient shown here had a tough time bending, twisting and stooping because of abdominal obesity.
Large volume abdominoplasty is not for everyone. For patients who have a lot of visceral (internal) fat, we prefer gastric bypass or gastric banding first, followed by abdominoplasty later. In the case shown here, this patient had gastric banding and lost about 150 lbs.
Weight loss and exercise alone will not burn off excess skin and will not tighten the loose fibrous tissues of the body, which lie under muscles. It does not matter how strong the abdominal muscles can be made, if the deep support layers (fascia) is loose, the abdomen will remain loose. Only surgery can remove extra skin and restore youthful “tightness”. In the case shown here, gastric banding was done first, followed by abdominoplasty.
On the other hand, for patients who have most of their fat superficial to their fascia, as shown here, abdominoplasty and liposuction may be performed as the initial and only procedure. When abdominoplast is performed as the initial and only procedure, the weight loss is immediate and the patient may return to office work in two weeks. Furthermore as compared to gastric bypass, abdominoplasty has many fewer complications and no nutritional problems.