Will I need plastic surgery after weight loss surgery?
Significant weight loss may lead to excessive skin in areas such as the neck, abdomen, arms and thighs. For some patients, the excessive skin may cause problems with skin irritation and rashes. For others, it may be bothersome from a cosmetic perspective. A plastic surgeon will be able to determine the type of procedure that is needed and if there is a medical necessity. It is recommended that you wait until you have lost most of your weight loss goal before considering plastic surgery.
Will I need to take vitamin supplements after surgery?
This is a common question. A multivitamin is recommended for all patients who have had bariatric surgery. Additional supplementation of vitamin B-12, calcium, iron and thiamine may be necessary depending on the surgical procedure. Your surgeon and the dietitian will discuss this with you before surgery.
What about weight loss surgery follow-up?
Your surgeon will see you approximately one week after surgery. For patients who have had a band or band with plication, your first adjustment will generally be 4-6 weeks after surgery. You will need to be seen frequently to determine the need for further adjustments.
Patients who have the RYGB, sleeve gastrectomy and duodenal switch are generally seen at one week, one month, three months, six months and one year postoperatively and then annually.
It is imperative that you continue to follow up with your bariatric surgeon and/or the support staff including the nurses and dietitian. For patients who have had a band, your first adjustment will generally be 4-6 weeks after surgery.
What about pregnancy after bariatric surgery?
Morbidly obese women may often have problems with fertility and the ability to become pregnant. Obesity may also increase the risk of complications during pregnancy.
Pregnancy is not advised during the first year when the most rapid weight loss is occurring as it may deprive the fetus of essential nutrients that it needs to grow. Because weight loss may improve fertility, it is imperative that a reliable form of birth control be used following surgery. Women who are contemplating bariatric surgery and future pregnancy should discuss this with their obstetrician/gynecologist.
How much weight will I lose?
Weight loss varies from patient to patient, as a number of factors can influence your weight loss including age, pre-operative weight, gender and compliance with follow-up, dietary guidelines and lifestyle changes including exercise.
Generally, patients who have laparoscopic adjustable gastric banding (LAGB) will lose about 50 percent of their excess body weight. The majority of the weight is lost in the first year but continues over a period of 2-3 years. Patients must have a regularly scheduled follow-up with the surgeon for adjustments in order to achieve maximum success.
What if my insurance doesn't cover bariatric surgery?
The MyNewSelf Surgical Weight Loss Program will communicate with your insurance company to determine if you have benefits for bariatric surgery.
Unfortunately, some insurance companies do not cover bariatric surgery due to an exclusion in the plan. Below are some options to consider in the event you do not have benefits for weight loss surgery.
- Your employer may offer more than one insurance plan at open enrollment time. If so, find out if any of those plans provide coverage.
- You may have the opportunity to purchase benefits on a spouse's plan. If your primary plan has an exclusion for weight loss surgery, your secondary plan may cover your surgery.
- You may pay for the surgery without insurance coverage. Call us at 314-966-9640 for cash pay pricing information.
Patients who have the Roux-en-Y gastric bypass average a weight loss of 60-80 percent of excess body weight. Most patients will lose most of their weight in the first year. Some patients may experience about a 20 percent weight regain, but will generally maintain a 60-70 percent loss of excess body weight.
Sleeve gastrectomy patients lose an average 50-60 percent of their excess body weight. As with the gastric bypass, most of the weight is lost within the first year. Because we do not yet have long-term data on the sleeve gastrectomy, weight regain may be a possibility and a conversion to another bariatric procedure may be necessary.
Please keep in mind that bariatric surgery is only a tool. Patients must learn to utilize that tool effectively. We are here to help you by providing ongoing educational classes with our registered dietitian and support groups to assist you with making the necessary lifestyle changes. These are all factors that help answer the question of how much weight you will lose.
How soon will I be able to return to work after weight loss surgery?
Most patients who have the laparoscopic adjustable gastric banding can return to work after one week. For patients who have gastric bypass or sleeve gastrectomy, the average return to work is two weeks. For patients who have the duodenal switch, the average recovery is two to three weeks. Time off work may vary depending on the type of work you do. Your bariatric surgeon will discuss your individual situation with you.
How long will I be in the hospital?
Generally, patients who have the laparoscopic adjustable gastric banding will spend the night in the hospital and be discharged the next day. Patients who have the Roux-en-Y gastric bypass, sleeve gastrectomy or duodenal switch will generally spend one to two nights in the hospital.
How do I know if insurance covers weight loss surgery?
Many insurance plans do cover bariatric surgery. There are two ways you can check your benefits:
- You can call your provider directly, by calling the member benefits line.
- We can call your insurance company for you after you have attended one of our free informational seminars. At the seminar, you will receive a new patient packet to fill out that includes health and diet history forms and an insurance form. Bring your insurance ID card with you to the seminar so you can complete the insurance form. By submitting your insurance information to us to verify, you are not obligating yourself to surgery. While deciding if bariatric surgery is right for you, weighing your financial responsibilities is part of the decision-making process.
In the event that your insurance does not cover bariatric surgery, here are some alternatives to consider.
- Does my employer offer more than one insurance plan at open enrollment? If so, does one of the other plans include coverage for bariatric surgery?
- Does the plan that my spouse has include bariatric surgery coverage? If so, can I be added to that plan?
- Do I want to pay for this surgery myself? If self-pay is an option, please call our office at 314-966-9640. We will be happy to discuss specific financial information with you.
Within a week or two after the seminar, our insurance verifier will call within 3-4 business days not 1-2 weeks. We will explain the steps you will need to complete in order to be approved for bariatric surgery. At this time, you can schedule an appointment with your chosen surgeon. Be sure to figure out if insurance covers weight loss surgery.
Are there risks associated with bariatric surgery?
There are risks associated with bariatric surgery and other potential complications, including death, associated with all surgical procedures. Morbid obesity may increase your surgical risks. It is important that your surgeon has as much information as possible about your medical and surgical history so that he can discuss your risks, benefits and alternative treatments with you, and thus allow you to make an informed decision about bariatric surgery.
Risks of bariatric surgery include but are not limited to bleeding, infection, pulmonary embolism, gastrointestinal leak (for RYGB, duodenal switch and sleeve gastrectomy), band slippage (for LAGB) and injury to surrounding organs.
The surgeon will discuss the benefits and risks of surgery at the educational seminars and again at your office consultation.
What are the benefits of bariatric surgery?
Bariatric surgery serves as a tool to assist you in weight loss. Many of the benefits of bariatric surgery are related to improvement in other medical conditions as a result of the weight loss. Conditions such as diabetes, high blood pressure, sleep apnea and high cholesterol may be resolved or improved after surgery.
Our patients also describe to us an improved quality of life and the ability to participate in activities that were too difficult before their weight loss.
Am I a candidate for weight loss surgery?
The National Institutes of Health have studied morbid obesity and determined that bariatric surgery is considered medically necessary in patients who have a body mass index (BMI)
(hyperlink) of 40 kg/m2. This is the equivalent of being about 100 pounds above your ideal body weight. Patients are also considered a candidate if they have a BMI between 35 and 40 kg/m2, if they suffer from a serious medical condition such as Type 2 diabetes and if they have high blood pressure or sleep apnea.
The Food and Drug Administration (FDA) has approved use of an adjustable gastric band for patients with BMI > 30 who also have at least one condition linked to obesity, such as heart disease or diabetes.
If you are considering weight loss surgery, you should understand and be willing to make the lifestyle changes needed for successful weight loss and to improve your overall health.
Certain medical conditions may prevent you from having bariatric or weight loss surgery, and our surgeons evaluate each patient to determine if bariatric surgery is an option. We are happy to discuss your individual situation with you. Please call us at 314-966-9640
for more information.