Liposuction & Bariatric Procedures

Individuals who desire to lose weight usually try various methods like exercising, vibrations, dieting and all sorts of non-medical or harmful treatments. When they realize that none of this helps they consider about surgical procedures such as bariatric surgeries, liposuction, abdominoplasty etc. which might seem as the only assured available option. Let us take a closer look on these procedures and understand what they are and is it worthwhile to opt for such surgeries.

BARIATRIC SURGERIES

It means surgery for weight loss. Any type of Bariatric surgery tends to produce weight loss by restricting food intake and, in some cases, interfering with nutrition through mal-absorption. Types of Bariatric Surgeries:

  • 1) Adjustable gastric band (AGB) A silicon band is placed which can be inflated/deflated and with this the amount of food consumed can thus be controlled.
  • 2) Roux-en-Y gastric bypass (RYGB)Â As the name suggests it is a bypass surgery. Here, a small stomach pouch is created with a stapler device, and connected to the distal small intestine. The upper part of the small intestine is then reattached in a Y-shaped configuration thus bypassing a major part of the stomach and whole of the duodenum
  • 3) Gastric sleeve (GS) In this procedure part of the stomach along its greater curve is resected thus reducing the volume of the stomach and making it a tubular structure. This procedure is anatomically and functionally irreversible.
  • 4) Biliopancreatic bypass with a duodenal switch (BPD) Part of the stomach is resected and then sutured directly with the ileum. This procedure is associated with severe malnourishment and hence is not practiced nowadays. All the individuals who undergo such surgeries must take vitamin and mineral supplements above and beyond that of the normal population. Patients who undergo bariatric surgery must also commit to a lifetime regular physical activity.

The term bariatric surgery does not include procedures for surgical removal of body fat such as liposuction or abdominoplasty.

COMPLICATIONS OF BARIATRIC SURGERIES
Common problems experienced include gastric dumping syndrome in about 20% (bloatedness and diarrhoea after eating, necessitating small meals and medication)
There might be leaks at the operative sites due to recurrent contraction and relaxation of the stomach wall.
An individual after undergoing such a bariatric surgery usually ends up with nutritional deficiencies.
There is severely reduced absorption of the necessary vitamins and minerals which then have to be invariably supplemented throughout life.
Gall stones are a common complication of such weight loss surgeries.
-There is a risk of developing incisional or internal hernia.
Further, research indicates that about 10 percent of patients who undergo bariatric surgery may have unsatisfactory weight loss or regain much of the weight that they lost, so the assurance that one will surely lose weight after a bariatric procedure is not true.

LIPOSUCTION
Suction of the subcutaneous fat done using a cannula (a hollow tube) and aspirator (a suction device) is described as liposuction.
It is either suction assisted or ultrasound assisted followed by suction.
It has been described that liposuction is not a procedure for weight loss and when done is usually for cosmetic purposes only.
The amount of fat that is removed from a fat containing area (abdomen) is usually around 4 kg or even less.
As excessive removal might lead to complete skin sag.
Since the fat is removed from under the skin and suddenly there is tremendous pain post liposuction and always the risk of the skin becoming very loose which would then require tightening.
We need to remember that the cause is not yet being addressed.
Recovery of the patient may take from 3 days to 15 days during which the patient has to wear a supportive garment over the area which supports the skin, underneath which the liposuction is done. There is associated soreness and pain in the operated area for a few days as there is accumulation of blood which takes a few days to be absorbed.

COMPLICATIONS OF LIPOSUCTION Disfiguring skin irregularities and depressions are frequently encountered as one area is void of fat while the other remains as it is.
Prolonged exposure to anesthesia is dangerous and is an important cause for serious liposuction complications.
Unusual “lumpiness” and “dents” in the skin can be seen in those patients who have been “over-suctioned”.
Also there may be focal necrosis of the skin, seromas, pigmentation of the skin etc. The more fat removed the higher the surgical risk.
Since the cause of weight gain is not considered there is high incidence of putting on the lost weight.

One may end up with gastric dumping syndrome, not satisfactory food intake and other complications associated with the respective surgeries.
* There are no guarantees for any method to produce and maintain weight loss.
* Doing surgery to produce weight loss is a serious issue. Anyone thinking about undergoing this type of operation should understand what it involves.
* Also the effects and outcome of the surgery largely depend on the skill of the surgeon.
* Before opting for a surgical procedure for weight loss please ask yourself, Is my stomach larger than others?