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Liposuction, Tummy Tucks, and Stomach Surgery

Fat Removal…Literally

Perhaps you have thought that rather than trim the amount of food you eat, you could just pay a surgeon to trim the fat out of your body. We're talking about liposuction, tummy tucks, and other surgical fat-removal techniques.

Liposuction and tummy tucks certainly can take away the fat. The surgeon cuts it out or siphons it out. When you come out of surgery, you will have thinner thighs, a smaller derriere, or a flatter tummy. These days, plastic surgery isn't just limited to below the waist. People are having their upper arms, waists, breasts, and other body places liposuctioned.

If you've inherited saddlebags that no amount of exercise or diet will reduce, liposuction could be a choice. But we need to tell you that those saddlebags can grow back even after liposuction. Body fat tends to be stored in the same places as before surgery. Several girlfriends have had their thighs “done” more than once.

Lean Lingo

Liposuction is a surgical process in which fat is suctioned from the areas of your body where excess amounts are stored. A plastic surgeon will make one or more small incisions through your skin layers and then suction out the fat cells. The procedure is usually performed in a doctor's office or clinic rather than a hospital.

Is liposuction or a tummy tuck for you? Only you and your bank account know the answer to that question. They're definitely not long-term answers to your weight problems. A surgeon can't cut out your poor eating habits. The weight will come right back if you overeat. So approach surgery knowing that your long-term success depends on eating as a thin person for the rest of your life.

Liposuction is serious surgery. It requires anesthetics and can have complications. Make sure that you find a surgeon who is board-certified and get recommendations from your regular doctor. Good plastic surgeons want you to be at your ideal weight before they operate so that they can take away the saddlebags you were, in essence, born with.

Plastic surgery is expensive and is not covered by health insurance. Expect to pay several thousand dollars for a surgeon to rid you of saddlebags or give you a flat tummy.

Stomach Surgery

This is serious stuff. Don't even think of this drastic step unless you have a BMI of 40 or above. The operation, commonly referred to as “stomach stapling,” is called “gastric bypass” or bariatric surgery. More than 146,301 bariatric surgeries were performed in the United States in 2003. This number is growing yearly. Many people have good results—they lose weight and keep it off. The physical surgery is only the first phase of the weight-loss process. The next phase is the one that lasts for years—eating frequent small meals that are nutrient-dense. This phase requires major behavioral modification and discipline.

Lean Lingo

Bariatric surgery is derived from the Greek words for weight and treatment. Bariatric surgery is a major operation that (a) seals off most of the stomach to reduce the amount of food one can eat, and (b) rearranges the small intestine to reduce the calories the body can absorb.

The surgery is not a guarantee that you won't regain your weight. We have participants in our weight-loss classes who have had their stomachs stapled. Some of them are still paying off the loans for their surgery, yet they're back in class to lose weight. The surgery works when you change your eating habits for life. To do this, take classes in how to eat and cook differently and attend support group meetings or counseling to ensure your long-term success.

The Roux-en-Y is abdominal surgery in which the stomach is stapled to a lower area in the small intestine—bypassing approximately 155 centimeters of small intestine. Problems with this surgery include increased complications of leaking at the bypass sites, significant and persistent diarrhea, and a mortality rate of about 1.5 percent. About 20 percent of patients need additional surgery to remedy complications and 30 percent develop nutritional deficiencies.

The adjustable gastric band is a new and reportedly safer and easier form of stomach surgery. The adjustable gastric band (or the abdominal band, as it is sometimes called) has been more popular in Europe, although it is now being used in the United States. It is safer then Roux-en-y surgery, which until now has been more commonly used in the United States. People lose two to three pounds per week over the first year and then usually maintain weight after that.

The adjustable gastric band is installed laparoscopically through small incisions in the abdomen rather than through a major incision. Essentially, the band clamps around the stomach to limit the amount of food you can get into it. A valve is inserted in the chest area, and the doctor can use it to tighten or loosen the band.

If you choose bypass surgery, here's what you need to know:

  • It's not a quick fix or a “walk in the park.” This drastic alternative includes pain, hospitalization, and high risk factors.

  • You must change your eating habits after the surgery and keep them for life. Absolutely no more overeating.

  • You might or might not lose all the weight you want to lose. On average, a person loses 60 percent of their excess weight. So if you're 100 pounds overweight, you could expect to lose 60 pounds.

  • You must be 100 pounds overweight with a BMI of 40+ to qualify.

  • Insurance seldom pays for bariatric surgery.

  • You are at risk for nutritional deficiencies, so you'll need to take vitamin and mineral supplements.

  • Seldom is bariatric surgery recommended for teenagers or people over 60.

Even after stomach surgery, you must make a lifetime commitment to exercise and diet to stay at your ideal size. Because this is really serious surgery, be prepared to handle complications and side issues. Some people find the surgery to be a dream come true. They have much less appetite and few side effects. Others have trouble eating even simple foods and risk an increased problem of vomiting after meals. No one can predict your outcome. Before you downsize your stomach, learn everything you can about the process and talk to others who have had the surgery. Many good Internet sites offer chat rooms for you to meet people who have had the surgery.

Although there are exceptions, don't expect this surgery to be covered by your health insurance.

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Excerpted from The Complete Idiot's Guide to Healthy Weight Loss © 2005 by Lucy Beale and Sandy G. Couvillon. All rights reserved including the right of reproduction in whole or in part in any form. Used by arrangement with Alpha Books, a member of Penguin Group (USA) Inc.

To order this book visit the Idiot's Guide web site or call 1-800-253-6476.


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