Post-Bariatric Surgery

"Morbid obesity" is a true public health scourge in our industrialized societies, where sedentary lifestyles and poor dietary habits produce generations of people in significant health precariousness.

Indeed, obesity causes a major increase in the incidence of cardiovascular diseases, colorectal cancers, osteoarticular problems, diabetes, Alzheimer's disease, etc...

The various "bariatric" surgery procedures allow these individuals to lose an impressive amount of weight and regain a healthy life expectancy equivalent to the rest of the population. They involve restricting caloric intake and/or ensuring that these calories are not absorbed by the body (malabsorption).

FOOD INTAKE RESTRICTION

• Gastric band: this technique involves reducing the stomach's capacity by creating an upper gastric pouch
• Gastroplasty: the procedure involves reshaping the upper part of the stomach to create a small upper pouch. Below this pouch, the surgeon creates a narrowing that regulates the flow of food into the remaining stomach
• Gastrectomy (sleeve): the procedure involves removing part of the stomach without interrupting digestive continuity. The gastric tube is calibrated on a gastric probe to avoid excessive narrowing

RESTRICTION AND MALABSORPTION

Bypass: the aim of this procedure is to reduce gastric capacity and create malabsorption by bypassing the food bolus on the small intestine; thus, the food is not fully absorbed by the body.

However, the consequence of this type of procedure is significant skin laxity with an unaesthetic appearance of the entire body.

"Post-Bariatric Surgery" refers to all the procedures we perform in Plastic Surgery to restore a pleasing and harmonious body image. For this, certain criteria must be met:

• A delay of at least 1 to 1.5 years after bariatric surgery
• Weight stability for at least 3-4 months
• Close to the comfort weight
• The nutritional deficit due to bariatric surgery (proteins, vitamins A, B, C, iron, zinc, arginine, glutamine, selenium) can cause wound healing problems and a suboptimal immune response (European Society of Clinical Nutrition and Metabolism): therefore, dietary supplements must be taken
  While the complication rate in plastic surgery is extremely low, in post-bariatric surgery, this rate is very high. 44% of patients experience wound dehiscence, over a third of which require surgical revision. These complications are all minor, but specialized care is necessary.