Dr. Joseph F. Capella performing a lower body lift. The patient is lying on her side in what is called the left lateral decubital position. Photo courtesy of Joseph Capella, M.D.
Choosing the Right Surgeon for Body Contouring After Weight Loss: Surgical Experience
My Bariatric Life: Dr. Capella, your book, Body Contouring Surgery after Weight Loss, states that many of the surgical procedures performed on the massive weight-loss patient are complex and labor-intensive, and that the wide spectrum of body contour deformities that can follow massive weight loss often exceed the magnitude of what plastic surgeons have traditionally addressed.
Please help us to understand why weight-loss surgery (WLS) patients need to work with a surgeon who specializes in bariatric plastic surgery.
Dr. Capella: Post-bariatric body contouring is a relatively new area within the field of plastic surgery, in that bariatric surgery only has become popular in the last 10 to 15 years. And because of that, many surgeons have come through their training not having been exposed to post-bariatric body contouring. Because of that these surgeries are not considered traditional procedures, in the sense that they’ve been honed over decades like many of the other plastic surgery procedures. And so what plastic surgeons may do is use these more traditional procedures and apply them to the post-bariatric patient, which often will lead to sub-optimal results.
So, it’s very helpful then, in that regard, to go to a plastic surgeon who has committed to this kind of surgery and does this surgery frequently — and this would be true for any kind of plastic surgery, for that matter. But what’s different about post-bariatric surgery contouring is it is relatively new, and probably greater than 50% or more of plastic surgeons out there right now did not have any exposure to it in their training. Obviously there are on-going conferences to educate surgeons but there’s a difference with having it as part of your training rather than learning about it from a lecture.
MBL: Since there is no accreditation to certify that a plastic surgeon is specialized with WLS patients, what criteria should the patient look at to determine that the surgeon has concentrated expertise in post-bariatric body contouring? Put another way, how does the patient discern between marketing hype and evidence-based fact?
Dr. Capella: I think the most important question you can ask your plastic surgeon is, specifically, for each of the procedures you’re considering: How often do you do them and how many have you done? The doctor should make other patients readily available to you who have had these plastic surgeries done. And, of course, the doctor should have a wide array of images to show you of hopefully body types that are similar to yours. I think that if the doctor can fulfill all those things, he or she probably is qualified to do your surgery.