What does bariatric surgery (obesity surgery) mean?
Bariatric surgery refers to surgical procedures performed to address significant health problems in individuals who have gained weight through diet programs or treatments and are unable to lose it, especially those with a Body Mass Index (BMI) higher than 40 or a BMI higher than 35 who also have chronic illnesses. These surgical operations, which play a crucial role in obesity treatment, help individuals return to a normal weight and correct the physical and general health problems caused by excess weight.
What is obesity?
Obesity is defined as an excessive accumulation of body fat that impairs health. Generally, it is defined as an adult woman having more than 30% body fat and an adult man having more than 25% body weight. Obesity, which is increasing worldwide, is one of the most significant health problems. Obesity surgery aims to improve aesthetic appearance and also to prevent many diseases such as diabetes, coronary artery disease, hypertension, heart failure, respiratory disorders, gastroesophageal reflux, depression, infertility, menstrual irregularities, impotence, joint diseases, varicose veins, cerebral hemorrhage, stroke, and depression.
Who can have obesity surgery?
Today, Body Mass Index (BMI) is used to define obesity. Calculated by dividing body weight by the square of height, a BMI of 35 or higher indicates that if a patient cannot lose weight through diet, exercise, and medical treatment, obesity surgery is recommended.
- Those aged between 18 and 60,
- BMI of at least 40 kg/m2,
- Patients with a BMI between 35-40 kg/m2 who also have conditions such as diabetes, heart disease, respiratory disease, and joint disease may be candidates for obesity surgery.
What are the types of bariatric surgery?
There are two different methods in obesity surgery. These are;
- Reduction of stomach volume (Sleeve Gastrectomy, Mini Gastric Bypass)
- It is the blocking of food absorption at certain stages (Biliopancreatic Diversion, Duodenal Switch).
The surgical method used varies depending on the patient. In operations that reduce stomach volume, the size of the stomach is decreased. However, because of the possibility of it growing back over time, after obesity surgery, the patient must follow the instructions given by the doctor and dietitian and continue with the diet. In malabsorption-restricting operations, both the size of the stomach is reduced and absorption in the intestines is decreased. Since the absorption of beneficial nutrients is also prevented, regular medical check-ups and necessary nutritional supplements should be provided.
What are the procedures involved in obesity surgery?
- Sleeve Gastrectomy (Tube Stomach):The stomach is cut lengthwise, and the remaining portion is discarded. This reduces the stomach’s size to approximately a 2 cm diameter tube, about the size of a teacup. This results in a feeling of fullness sooner. Additionally, since the cells that secrete the appetite hormone “Ghrelin” are also removed, the patient does not experience appetite problems.
- Mini Gastric Bypass (MGB):The stomach is reduced to a tube approximately 2 cm thick and with a volume equivalent to about 4 tablespoons of water. This stomach tube is then sutured to a section in the middle of the small intestine. This technique preserves the integrity of the intestine, and the procedure is performed in a single area.
- Biliopancreatic Diversion (BPD): In this technique, which involves disrupting the absorption of fat and starch in the intestine, the stomach size is not as small as in other techniques. One-third of the stomach is removed, and the remaining stomach is sutured to the junction of the small and large intestines. A section of the intestine with restricted absorption is then sutured 50 cm away from this point.
- Duodenal Switch:The stomach is cut longitudinally, preventing the bypass of the first part of the duodenum. This results in less risk of dumping syndrome and less impairment of iron absorption.
What is body shaping after obesity surgery (post-bariatric surgery)?
Weight loss can lead to increased skin sagging. However, plastic surgery techniques can reshape the body, reducing fatty tissue and skin in many areas.
The main body contouring surgeries performed after obesity treatment are as follows:
- Abdominoplasty (Tummy Tuck),
- Mammoplasty (Breast Lift)
- Gynecomastia,
- Upper Arm Stretch
- Upper Leg Stretch,
- Lower Body Stretching,
- Liposuction,
- Facial Rejuvenation,
- Genital Stretching.
Post-Bariatric Surgery Frequently Asked Questions
The most frequently asked questions about aesthetic procedures before, during, and after.
The Turkish Ministry of Health prohibits aesthetic clinics and centers approved by the ministry from listing prices for post-bariatric (obesity) surgery procedures on their websites, and imposes penalties on aesthetic centers that do not comply with this rule. Furthermore, Professor Dr. Şükrü Yazar, a specialist in Aesthetic, Plastic, and Reconstructive Surgery, needs to thoroughly examine the patient before providing accurate information regarding post-bariatric (obesity) surgery prices.
Nişantaşı Şükrü Yazar Clinic Communication
You can obtain information and schedule an appointment by calling +90 212 257 1515 or +90 541 334 3484, or by contacting our live support line with specific questions such as “How much do obesity treatments cost, how much does gastric reduction surgery cost, what should I do, and how do post-bariatric (obesity) surgery processes progress?” etc. You can also request an appointment to discuss your obesity issue with a specialist doctor.
Patients who undergo obesity surgery need to maintain a regular and healthy diet and exercise regimen after the operation. There is a very carefully followed dietary program for 6 to 8 weeks after surgery. After that, patients can return to their normal eating habits.
Like other surgeries, obesity surgery carries some risks, although these are rare. These can be listed as follows:
- The mortality risk of obesity surgery ranges from 0.1% to 0.4%.
- Anesthesia carries general risks, although these are very rare.
- Pulmonary embolism and blood clots in the legs can occur.
- The risk of bleeding is 1-2%.
Many obesity centers today focus on obesity surgery, but in every disease and treatment process, the doctor’s experience and expertise are crucial factors that increase the chances of success.
Following bariatric obesity surgery, aesthetic procedures should be performed on the following areas of the body.
- Breast Area:
In women, breast lift surgery is performed to address volume loss and sagging after weight loss. The patient’s own tissue can be used to increase breast volume, or implants can be applied depending on the patient’s preference. In men, excess sagging tissue is removed from the breast area, and the breast is repositioned to its ideal location. Additionally, excess skin accumulated on the sides of the breast is removed, completing the shaping process in this area. For all your questions about breast aesthetics… breast aesthetics You can visit this link. - Arm Region:
After weight loss, skin can sag in the arm area, starting from the armpit and extending to the elbow. Sometimes this excess skin extends to the front of the chest. These patients may undergo arm lift or liposuction. Sometimes both procedures are combined. Abdomen and pubic area: As the navel shifts downwards, significant sagging and deformities can occur in the abdomen and genital area. Excess skin in the abdomen is removed and tightened to flatten it. The navel is recreated and repositioned. Sagging skin is also removed and reshaped in the pubic area. - Back Region:
Excess skin and folds can form on the back after weight loss. This excess skin is surgically removed, correcting the folds and creating a defined waistline. - Leg Area:
Significant sagging and excess skin are particularly common in the inner thigh area. These are surgically removed and reshaped. The incisions can be made in the groin area, the inner thigh, or both. - Buttock Area:
Weight loss can cause flattening and deformities in the buttocks area. Excess sagging skin is removed, and a lifting procedure is performed while adding volume and firming the skin. This shaping can be done using the patient’s own tissue or with implants.
Obesity surgery is recommended for anyone between the ages of 18 and 65 who suffers from obesity. However, for young people aged 13 to 17 with serious health problems, obesity surgery should be performed by expert and experienced doctors.
In general, the things that should be done before obesity and body contouring cosmetic surgery can be listed as follows:
- A detailed assessment is made by reviewing the patient’s medical history.
- Detailed blood tests are performed to determine if the patient has any contraindications for surgery.
- The patient undergoes a psychological examination.
- The patient undergoes gastroscopy and upper abdominal ultrasound.
- Patients do not need to have enemas, take laxatives, or shave before surgery.
- No food should be eaten after 11:00 PM the night before the surgery.
After obesity surgery, patients begin to lose weight rapidly. With significant weight loss, the skin becomes deflated, leading to considerable excess skin and deformities. This excess skin mostly appears on the arms, breasts, sides of the breasts, back, abdomen, sides of the abdomen, legs and inner thighs, while the buttocks become less defined.
Since obesity surgery doesn’t involve a large incision in the abdomen, post-operative pain is minimal. Some patients experience nausea during the first 1-2 days, but this usually lasts for a maximum of 36 hours. Patients are typically helped to stand and walk 3-4 hours after surgery. Mechanical compression stockings and blood-thinning injections are used to prevent blood clots in the legs. Patients are usually discharged on the third day and can return to work or school after a week. Weight loss typically stops after about 1.5 years. Regular check-ups are necessary to prevent weight regain after obesity surgery.
In body contouring operations following obesity surgery, very large amounts of skin tissue are cut and removed from the body. This skin loss results in the loss of blood, protein, and electrolytes/fluids. Therefore, it is crucial that the procedure is performed by an experienced team in an operating room setting and in a hospital with an intensive care unit.
The first stage involves completing the weight loss process. This process typically takes between 1.5 and 2 years. The timeframe is determined in consultation with nutritionists, dieticians, and general surgeons.
Because large incisions are made during body contouring operations following obesity surgery, surgical scars are also large. These scars can be reduced using gels, massage, silicone bandages, steroid injections for raised scars, or laser treatments.
