Can you have plastic surgery if you are overweight?

Surgery is coming to the rescue of people who are grossly overweight and who have tried all the usual remedies without success.

It is called “cosmetic” or “reconstructive surgery” because it is done for cosmetic reasons – an effort to gain a more attractive body – and because it truly is a reconstruction of the body shape.

In the U.S., surgeons are adept at reshaping unattractive figures and producing pleasing results. They are called plastic surgeons, although the name “reconstructive surgeons” is becoming more popular.

“By making a dramatic alteration in a patient’s contour, plastic surgery can raise morale so that dieting is much less onerous an undertaking,” Dr. Denis Craddock, a doctor with a lifetime interest in the overweight, stated recently.

Excessively large breasts can be reduced, resulting in a loss of perhaps 3 to 6kg (7 to 14 pounds) of weight, and the loss of the huge “apron” of fatty tissue so often found over the abdominal wall in grossly obese people can produce an immediate loss of up to 25kg (55 pounds).

This apron frequently hangs down from the lower part of the abdomen. Apart from the problem of its sheer bulk, the undersurfaces can rub, becoming raw, inflamed, and very uncomfortable.

The immediate result of its removal by surgery can be frightening because of the size of the scar and the number of stitches, but time has a magical effect and the scar heals extremely well.

Incisions are often made in natural skin creases and fine sutures are used so that after a few months it may be difficult to pick the scars.

Surgeons often advise their patients to lose as much weight as possible by dieting before surgery. This may reduce the extent of the operation so many women do this first. The end product of diet and surgery is often a much more attractive, firm body. Overstretched, irreparably damaged skin (through broken elastic fibers) is removed as well as loose fat, and the result is a smaller abdominal wall and firm fitting skin again.

Today, surgeons appear to be divided over “cosmetic surgery.” Many specialists believe they should reserve their time and the ability for repairing serious and severe disorders like victims of motor vehicle smashes and persons involved in industrial or domestic accidents. Some feel facial disfigurement or loss of function of limbs, hands, and fingers are far more important reasons for operating than vanity.

But not all doctors feel this way, and over the past few years, more and more material has appeared in medical journals alerting doctors to the possibilities of using surgery to enhance the quality of life in those afflicted by overweight or similar cosmetic disabilities.

The quality of life includes the psychological aspect. Many women are depressed, tense, and anxious about their appearance. Some become social outcasts and refuse to enjoy normal social intercourse because they feel they look unattractive. Domestic problems are manufactured and marriages jeopardized.

“It is amazing how many young women in the 20-30 year age group are depressed and morose about their shape,” said a reconstruction surgeon practicing in a Sydney suburb. “Commonly it is the lack of decent breast development and appearance that worries them but it may be overweight also. It seems to play on a morbid part of their psyche.”

“After they have undergone plastic surgery, their personalities change in a rapid and remarkable manner in most instances. It makes the procedure well worthwhile. I believe that any woman who wants cosmetic surgery to improve her looks (and psychological outlook on life) should be able to have it.”

“While obesity cannot be cured with plastic surgery, it produces problems which may be helped with surgery,” Dr. C. E. Horton and J. E. Adamson recently wrote in the British Medical Journal.

When the patient who is obese loses a great deal of weight, the subcutaneous and fatty tissues diminish, but the skin will not shrink because it has lost its elasticity. In such a patient an abdominal apron of the skin may stretch as far as the knees. This can be removed by surgery. If the incision is placed in the groin tissues, it keeps the scars from being obvious.

“The less obese patient who goes to her specialist with a crumpled wrinkly tummy or with stretch marks due to pregnancy may want a tightening of the abdominal wall and skin so that she looks more attractive in a bathing suit. In this type of surgery, the incision is kept low to avoid scars on exposed skin areas.”

“Stretch marks caused by pregnancy are impossible to eradicate. Only those scars contained in the skin segment which is totally cut away can be removed. This type of surgery usually necessitates a general anesthetic and several days in the hospital.”

Other obvious “risk” areas in the overweight are thighs, hips, and buttocks.

“Some patients want a lift of wrinkled, heavy thighs,” Dr. Horton says. “This can be done through an incision in the groin, extending backward into the buttock area. If the upper legs are extremely obese, an incision in the thigh may be necessary also, but scars on the leg do not heal well and may produce an obvious blemish.”

When it comes to the buttock area, there is hope there. Drooping and enlarged buttocks may be corrected by taking out a large wedge of tissue.

You must be referred to the reconstructive surgeon by your family doctor. It is worth discussing the matter with him first, and then the surgeon will tell you how successful an operation may be in your particular case.

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