How Safe Is It?
Among problems that have been cited are wound infection, reopening of wounds needing surgical drainage, and excess bleeding requiring a second surgery, Rubin says. Blood transfusions are also needed about 15% of the time. In rare instances, patients have developed fatal blood clots.
While some of these problems still occur (notably the need for transfusions), experts say it's on a much smaller scale in the last few years. In a study presented in 2003 at an American Society of Plastic Surgeons conference in San Diego, researchers found that many such complications could be avoided if patients allowed more time to elapse between weight loss surgery and plastic surgery.
The research reported that patients who underwent bariatric surgery (weight loss surgery on the stomach and/or intestines) who waited about a year before undergoing body-contouring surgery saw a reduction in the complication rate -- and ended up with shorter hospital stays. The researchers also reported that waiting allowed the death rate to drop dramatically, from 14% for those who had body-contouring surgery soon after losing the weight, to 0% for those who waited.
Today, Colon says, most patients are advised to wait at least one year after bariatric surgery.
But even when patients do wait, problems can still occur -- including a dramatic loosening of the newly tightened skin that sometimes requires a second round of surgery, Rubin says.
"We can't predict who will be affected and we don't know why it happens, but it does. Some people actually need more surgery," says Rubin.
Body Contouring: Is It For You?
Not everyone who loses a lot of weight needs body-contouring surgery. Moreover, experts say, not everyone needs it for the entire body.
"A lot depends on your age, your genetics, level of sun exposure, how evenly the weight was distributed, and, more importantly, how you feel when you look in the mirror," says Colon. "If you're not unhappy about the way you look, you shouldn't be made to feel you need body- contouring surgery."
Those least likely to want or need the procedure, he says, are usually under age 40. "The majority of the patients I see for this surgery are over 40. It's pretty hard to avoid the slackening effect of the skin after that age," says Colon.
What can also make a difference, however, is where you lose the weight. While a loss of 50 pounds that was concentrated in your midsection might leave you with a lot of loose skin in that area, a 100-pound loss that was more evenly distributed on your body may have less of an effect on skin.
If you do end up with droopy, sagging skin and think there's some other way around it, experts say, forget it.