Frequently Asked Questions

Your overall physical health is an important consideration, as well as having a definite sense of your plastic surgery goals, priorities, and expectations. Your plastic surgeon will discuss the benefits and risks, and together with you and your primary care physician, will decide what surgical procedure is right for you.

The best time to consider plastic surgery is when you are as close to your goal weight as possible and your weight is relatively stable – usually 12 to 18 months after gastric bypass surgery.

We prefer that patients be at a stable weight for a minimum of three months before having surgery because:

• During rapid weight loss, your surgical wounds may not heal as quickly.
• Your risk of complications decreases as your BMI decreases.
• Surgical results tend to be better the closer you are to your goal weight.

If you are having difficulty reaching your goal weight, the Life After Weight Loss nutritionists and lifestyle counselors will work with you to find solutions that will help you get closer to your desired weight.

Finally, you want to consider if having surgery fits into your life at this time. You will need to arrange for adequate time away from work to complete the healing process, and you also may need to arrange for postsurgical support from family and friends.

The massive amount of weight that you have already lost undoubtedly has changed your life. You look and feel better, and probably are taking part in activities that you may not have thought possible in the past. Although your weight loss has been a positive experience, the excess skin it has created can affect your comfort and self-confidence, and can be a daily reminder of your past obesity.

There is nothing wrong with wanting plastic surgery to help you look better and feel better about yourself. You made a major commitment to improve your physical appearance by losing the weight, and plastic surgery can be the next logical step in your journey.

Ask questions about your surgeon’s credentials and experience, such as:

• Question: Is your plastic surgeon board-certified by the American Board of Plastic Surgery? This certification means they have graduated from an accredited medical school, have the required training in their specialty or subspecialty from an accredited residency program, and have passed a rigorous set of comprehensive exams.
• Answer: J. Peter Rubin, MD, Chief, Endowed Professor, Department of Plastic and Reconstructive Surgery, Director, Life After Weight Loss, and Jeffrey Gusenoff, MD, Co- Director, UPMC Life After Weight Loss Program, Associate Professor, Department of Plastic Surgery,  are both certified by the American Board of Plastic Surgery. In addition, Dr. Rubin is certified by the American Board of Surgery.
• Question: Does your surgeon have experience specifically with post-weight loss patients?
• Answer: UPMC's Life After Weight Loss program is solely devoted to the post-weight loss patient, and Dr. Rubin is the primary author of a textbook used by other plastic surgeons to learn body contouring techniques.
  
• Question: Does the surgeon perform the procedure in a hospital or freestanding surgical facility? A hospital setting gives patients the full complement of routine and emergency resources. Additionally, if you are having multiple surgeries performed at the same time, you will probably need to stay overnight.
• Answer: The Life After Weight Loss program's physicians perform surgery at UPMC Magee-Womens Hospital, UPMC St. Margaret, and UPMC Montefiore.
• Question: Can your surgeon provide you with examples of his previous work? Although every patient reacts differently to surgery, scarring, etc., you’ll still be able to get a general sense of the surgeon’s capabilities, and once you see others’ postsurgical results, it may prompt you to ask additional questions about your own experience.
• Answer: Our Life After Weight Loss surgeons routinely share their previous work with prospective patients.

At your first consultation, the doctor will review your medical history carefully, perform a physical examination, and discuss your goals and priorities. The surgeon will talk with you about your current weight and overall medical condition and how they might impact the safety and effectiveness of surgery, so please answer all questions honestly. He or she may also consult with your primary care physician to discuss any health concerns.

During the consultation, the surgeon will talk with you about the possibility and safety of doing multiple procedures at the same time, if that is what you want. Don’t be alarmed or embarrassed if your surgeon wants to take photographs; these are used to plan operations, provide documentation for the insurance companies, and help record your progress.

You also will also meet with our lifestyle coaches and other individuals who will evaluate your eating and exercise habits so that your successful efforts will continue into the future.

We are always available to offer a second opinion. It is important, however, that we have realistic expectations about your desired outcomes.

Yes, there will be scars after a body contouring procedure. The way the scar looks is determined primarily by your body’s natural healing process, which varies from person to person. Some people make thicker heavy scars, while others make thin scars.

Your surgeon can help predict the types of scars you may have based upon any previous scars and your skin type. In most procedures, the scars are hidden in places that are covered by clothes, such as along the waistline. In other procedures, however, such as an arm lift (brachioplasty), the scars can be visible.

Unless the procedure is performed to relieve documented severe symptoms that do not respond to less invasive treatments, insurance companies are unlikely to cover post-weight loss plastic surgeries. You should call your insurance company for additional information or visit the financial considerations section of this website.

Like most surgeries, there is risk and a chance of complications with body contouring surgery. Because these can vary from person to person, we make every attempt to minimize the risk and complications by working closely with your primary care physician to make sure your health is optimal for surgery.

Some of the risks and complications of body contouring surgery may include:

• Permanent scars
• Bleeding or blood clots
• Infection
• Fluid accumulation
• Poor wound healing
• Numbness
• Side effects from anesthesia
• Skin discoloration and/or prolonged swelling
• Pain
• Deep vein thrombosis (DVT), cardiac, and pulmonary complications
• Persistent swelling in the legs

Recovery times vary by procedure and by person. The recovery time for multiple procedures or procedures on larger body parts is generally longer. For example, some patients choose to have multiple procedures done at the same time, such as a tummy tuck and breast reshaping, so this will increase your recovery time. Your surgeon will advise you about what combinations of procedures are reasonable and safe to do at the same time, and what type of recovery you can expect.