The weight loss surgery isn't the last surgery people undergo - not by a long shot, says Lawrence Reed, MD, a New York City-based plastic surgeon. "Post-bariatric surgery is a very important part of rehabilitation," he tells WebMD.
Reed says he typically does a series of procedures in three stages after weight loss surgery starting with a lower body lift "that will improve the tummy, the thighs, buttocks and back."
Then, several months later, "the patient will undergo a breast lift and complete inner thigh reconstruction because I only get some of it with lower body lift and then months down the road we do the face, neck and arms," he says. "You break it down because it's unsafe to do it all at once."
Follow-up surgeries are typically performed about 12 to 18 months after surgery when a patient has lost all their weight and has adapted to lifestyle changes, Smith says. Some may opt for nips and tucks when excess skin that hangs limits their ability to be as active as they like by flopping all over the place, he says.
Kathy says that "I wasn't that idealistic, but my surgeon said you will have to have plastic surgery afterward and I said 'I am flabby, baggy and saggy now - I am not doing this to be a swimsuit model, I am doing this to get my life back.'"
Elena says she plans to have follow-up surgeries after she reaches her goal weight and maintains it for a certain amount of months. "I am thinking, tummy, breast and upper arms," she says.
Reshaped body may not mean reshaped life.
"If you have a crummy marriage before surgery, you will have a crummy marriage after surgery," Odom says, addressing the issue that many people assume that re-shaping their body will re-shape their life.
Anita agrees. "I do feel much better, physically and emotionally, but some of the problems I thought would disappear with the excess weight have not," she admits. Namely anxiety. "I thought my anxiety was because of weight and now still have it," she says.
Would Anita do it again?
"If you asked me right after the surgery, I am not sure what I would have said because my recovery was rough physically and emotionally. I did a lot of vomiting and was nauseous and knew I did this all to myself," she says. But now, close to two years later, she feels much better about her decision and is enjoying her new life and body to the fullest.