An Inspirational Weight Loss Story, and Why It Shouldn’t Be Considered Cosmetic Surgery Trillium Plastic Surgery

February 26th, 2014

One group of patients that stands out from my general surgery training was those going through weight loss surgery. I saw them as they were contemplating surgery, immediately before, and then afterwards. I performed their weight-loss operations. I saw the rare, devastating complications and helped manage them at every point of the way. Now, I have the privilege to see this special group of people through the last stages of their weight loss journey - removing all the extra skin that is left over after their weight loss is complete.

Body contouring after weight loss is considered cosmetic surgery, but it shouldn't be. Those of you who have gone through this journey can attest to that, but for those of you who haven't or for those that disagree, let me explain myself with an inspiring, incredible example.

I recently saw a young woman in my office who lost about 150 pounds after a gastric bypass. She had recently completed a half-marathon (13.1 miles for you non-runners out there). This young woman completed the race, in a pretty respectable time, not having had any surgery other than her gastric bypass. I was kind of curious as to how. She confided that every time she ran, she had to tuck all her extra skin into oversized spandex to keep it from preventing her from exercising. This happened every day for the almost 6 months she trained for the race. When you think about it, that fact alone makes her race that much more impressive.

For those of you who don't know, all the extra skin - in her example almost 20 pounds worth - is not "tight"; instead, it hangs off the body and is subject to the laws of momentum and inertia. Once it gets moving in one direction, it takes a lot of energy to stop it and get it moving back the other way. As you might imagine, strenuous physical activity like running or biking, and even slower activities such as doing routine housework, take much more physical and mental stamina to do when you are battling all that extra skin. Tell me that you wouldn't quickly burn out on exercise if you had to tuck 20 pounds of skin away each time you wanted to do something? This is why this skin removal is much more than just a "cosmetic" surgery procedure.

For those of you who doubt (insurance company executives are in this group), take a 20-pound weight from your local gym, tie it around your waist with between 6 and 12 inches of "hang" and take off for a run. This is what this young woman did - every day, for MONTHS, leading up to her race. Not only is that an impressive physical feat, but the mental strength it takes to train for and run that race is incredible. Her story is inspiring, to say the least.

The two pillars of disease prevention are proper nutrition and exercise. If my weight loss patients can't exercise because of all the extra skin they are carrying around, how can they be expected to maintain a healthy lifestyle? If we truly want to do right for these patients, a shift in the way we look at their surgery needs to happen. We need to enable them to take the steps to live an active, healthy life. Taking the power away from the insurance companies to decide what to and what NOT to pay for (and directly influencing the decision-making that SHOULD be between a doctor and a patient) is the key needed for this type of change to be made.

Whether I agree with whether or not what this patient needs is cosmetic or reconstructive, however, hearing her inspiring story of determination and perseverance made my day.