After stomach stapling, more surgery

Jane Weaver Health editor • Profile • E-mail

Kirk Thompson, 41, had lost 400 pounds in the two years since his gastric bypass, or "stomach stapling," operation at Ohio State University Medical Center in October 2001. Down from a peak weight of 745 pounds, the West Virginia native was closer to a normal weight than he had been in decades. After years of suffering congestive heart failure and rarely leaving his home except to go to the hospital, Thompson’s health was improving.

But while he’d lost a huge amount of weight, when he looked in the mirror he saw the same obese man he’d been since high school. He was still carrying 100 pounds of extra skin, including layers of flesh around his abdomen that hung down nearly to his knees.

“It was hard to walk,” says Thompson, who works with a weight-loss support site called ObesityHelp.com. “It made me so off-balance that I was almost stumbling.”

So Thompson went back to Ohio State to have the skin around his abdomen and upper legs tightened.

About 25 pounds of loose skin were removed by a tummy tuck and lower body reshaping, an operation that is becoming one of the fastest growing areas of plastic surgery in the United States.

“It feels great and really strange,” says Thompson, who lost 12 inches around his waist from the plastic surgery. “It made my whole life different.”

Driven by the American obesity epidemic and by the high-profile success stories of celebrities such as NBC’s Al Roker and the novelist Anne Rice, the number of weight-loss, or bariatric, procedures is expected to top 144,000 this year, according to the American Society for Bariatric Surgeries. But the road to weight loss doesn't always end there. Many of those patients will seek a plastic surgeon to help their formerly obese bodies look more normal.

Courtesy of University of Pittsburgh Medical Center The abdominoplasty, which removes the hanging skin around the stomach, is the most common procedure after weight-loss surgery.

Statistics from the American Society of Plastic Surgeons show that 52,049 people had some kind of body contouring following massive weight loss in 2003, the first year the association has tracked that specific category. Plastic surgeons say it's clear there has been a significant increase in demand for these procedures.

"People are now a lot more aware that skin surgery may be part of their gastric bypass operations," says Dr. Robin Blackstone, a surgeon and director of the Scottsdale Bariatric Center in Arizona.

Five years ago Dr. Albert Cram, chief of plastic surgery at the University of Iowa, used to perform one tummy tuck or body lift a month on patients who had lost massive amounts of weight. Now his department averages one or two a week.

“It’s growing significantly,” he says.

People who have lost more than 100 pounds may find that weight-related illnesses like diabetes or hypertension go away, but they still don’t look thin. The skin becomes like an elastic band that has been stretched too far. No matter how much exercise, or what kind of exercise, they do, the skin doesn’t go back to its normal size.

“Expanded skin doesn’t have the same capabilities as before weight gain; it’s damaged skin with stretch marks,” says Dr. Jeffrey Kenkel, vice chairman of plastic surgery at the University of Texas Southwestern Medical Center in Dallas. “From the head down to the ankles, there’s a lot of overhanging skin.”

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