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GBRx™ or Post Gastric Bypass Reconstruction
Reprint of Dr. Batra's March 2009 Bariatric Times article on his
Staged Approach to Post-Gastric Bypass Body Reconstruction
GBRx: The Prescription for Looking Like You Again™
A Brief Description of GBRx™ or Post Gastric Bypass Reconstruction
Following the significant amount of weight loss (major or massive weight loss, also called `MWL`) such as after Gastric Bypass/Banding surgery, surgeries like Lap-Band® and other bariatric procedures, a person can be left with a tremendous amount of excess hanging skin throughout many areas of the body that do not shrink back to the person's new body shape. This tissue is sometimes referred to as the "pannicule" and removal is called a "panniculectomy." The muscles may also become loose after the dramatic weight loss. The lack of elasticity of the remaining skin often causes excessive amounts of skin to accumulate and hang in various areas, including the face, neck, breasts, upper and lower abdomen, flanks, armpit (axilla), back, buttocks, arms, forearms, thighs, legs, and calves. This excess skin also can cause hygienic problems, skin irritation, skin breakdown and pain, and infection. GBRx™, Dr. Batra's Reconstructive surgery after Gastric Bypass or Bariatric surgery is sought to solve these common issues.
Coastal Plastic Surgeons perform numerous post Gastric Bypass Reconstructive (GBRx™) plastic surgery, providing this specialized care for over 100 peopleevery year.
Case Studies in the Before and After Slideshow
Case 1: This is a 27 year old male who lost 110 pounds through diet and exercise. Despite his best efforts the skin would not tighten any further and he requested a tummy tuck. I suggested a circumferential abdominoplasty(all the way around the waist) and lipo of his chest wall. Here is the 1 year post operative picture. The scar is hidden in the underwear line and the belly button looks very normal.
Case 2: This 37 year old had a laparoscopic gastric bypass with a 90 pound wt. loss. Her skin did pretty well but she still required an abdominoplasty and breast lift with augmentation to get the best outcome possible(her "rewards" surgery). This is a 4 month follow up, her belly button looks very normal and her scars will take a year to fade out.
Case 3: This 37 year lost 80 pounds and after pregnancy wanted to fix the abdominal wall. She had a "tummy tuck" and lipo of the thighs. This is a six month follow up and she went on to lose another 20 pounds after the procedure. She has a very natural appearing belly button and looks great!
Case 4: This patient underwent an open gastric bypass and lost over 100 pounds. After trying to get the skin to tighten up through exercise for 3 years she opted to undergo and abdominoplasty and a breast lift with augmentation. We also utilized her vertical scar from the open gastric bypass to tighten her up even further. This is a year follow up, she has a nice waistline and her breasts have good symmetry and shape.
Case 5: This patient is 34 years old and lost 80 pounds through dieting and exercise. She underwent a bodylift and this has improved her lateral thighs as well. Her belly button looks normal and she is haapy with the outcome.
Case 6: This 37 year old came in post-pregnancies and after a 60 pound weight loss. This is a six month follow up after a tummy tuck, and breast lift with augmentation.
Case 7: This is a 27 year old woman who underwent open gastric bypass and had a 110 pound weight loss. She underwent an extended abdominoplasty and had removal of about 7 pounds of abdominal tissue. This is a 6 month follow-up. Her muscles have all been retightened and her umbilicus looks normal.
Case 8: This 57 year old had a gastric bypass and lost 85 pounds. He wanted to remove as much skin as possible and we decided to use a vertical incision as well as the standard tummy tuck incision. On the lateral profile you can see that fixing his muscles made a big difference in his appearance.
Case 9: This 43 year old patient lost 140 pounds and desired an abdominoplasty and breast lift. She underwent a vertical extended abdominoplasty and breast lift which took about 6 hours and a two week recovery. As you can see there is some laxity that recurs in the abdomen, which is always the case in patients with massive weight loss.
Case 10: This patient lost 94 pounds, she had an augmentation with a lift and then decided to have a body lift and arm lift. This is a four month followup. Her arm scars will take a full 2 years to fade and soften.
Case 11: Tis patient had a 110 pound wt loss and went to Kaiser for a panniculectomy. She still had a large amount of loose skin on the upper abdomen and we opted to do a vertical abdominoplasty tightenenig the abdominal muscles at the same time and an arm lift. She went on to lose another 25 pounds after the procedure.
Case 12: This is a 63 year old female who lost a substantial amount of weight which revealed serious wrinkles after a fair amount of sun damage and age related changes. She underwent a facelift, necklift, upper and lower blepharoplasty, and this is a six month followup. She looks natural and is very satisfied with her outcome.
Case 13: This patient underwent a body lift, arm lift and at the third stage a facelift and necklift. This is a six month follow up. Note she looks natural and like a younger version of herself.
Case 14: This 34 year old woman lost 90 pounds and this is a follow up after her breast lift and augmentation and tummy tuck. The uneven nature of her breasts is much better also.
Case 15: Tis is a 6 week follow up on a patient with an 80 pound wt loss. The blue marks outline the skin to be removed. It will take 6 months for scars to fade.