Over 60% of Americans are obese. Many of these obese patients have medical conditions that arise as a result of their obesity. Such medical illnesses include diabetes, high blood pressure and obstructive sleep apnea. Losing weight with diet and exercise, although effective, can be quite difficult. Many patients therefore undergo surgical weight loss to melt away the pounds. After they have lost their weight, many of their pre existing medical illnesses may be cured, such as those listed above. Diabetes, high blood pressure, and obstructive sleep apnea, if left untreated can lead to premature death.

However, during the time that these patients are obese they may not even show any symptoms. This means that although they are diabetic and have high blood pressure they feel fine. Once they lose all the weight after surgery they feel lousy. The reason is that although they are “healthier” they may show significant areas of excess skin over various parts of their body. These areas may be prone to rashes, infections and overall hygiene issues that result in numerous trips to their doctor, not to mention the psychosocial burden that it imposes on self esteem.

If you have been searching to find someone with experience who cares for their patients, then search no more. The experience I have had with Dr. Ravi and his staff has been remarkable from start to finish and, most important of all, I am very excited and pleased with my results, and plan on coming back at a later date for my breast augmentation! Dr. Ravi, you are the best!

LARA S. // BODY CONTOURING

Plastic surgery after massive weight loss completes one’s’ journey from obesity to well being. By surgically removing the excess skin from various parts of the body, the rashes, infections and moisture buildup in these areas are completely gone. After patients lose weight, many areas of their body begin to change shape. The face may begin to sag and may show signs of premature aging. Many of these patients will require a facelift and necklift to improve this.

The breasts also begin to deflate and sag. To restore the shape, a breast lift is typically needed typically with a breast implant to restore the lost volume. Sometimes fat grafting can be performed as well in the breast to improve the shape.

The skin in the arms also sags. These so called “bat wings” or “angel wings” also pose a problem for many patients. Some people find it difficult to wear their favorite dresses and sleeveless shirts. A brachioplasty or arm lift will be required to contour these areas. Typically, liposuction of the arms may also be performed at the same time.

In the tummy there is often excess skin in the lower part of the abdomen. A tummy tuck is typically needed to remove the excess skin. During this procedure, the muscles of the abdominal wall are also tightened in order to improve the abdominal contour to create a nice flat tummy. Many patients also have excess skin on the back as well. These patients will require a circumferential body lift. Moving towards the feet, many patients also develop excess skin in between the thighs. A thigh lift removes the excess skin in the inner thighs. Often this is combined with liposuction.

The ideal candidate for body contouring surgery is a patient whose goal weight has been stable for at least 3 months. If a patient has lost more than 90 pounds, then blood work will be obtained to ensure that patient can undergo surgery safely. Also the patient’s BMI gives the surgeon a global number as guide to ensure proper healing and recovery. The body mass index takes into account a person’s height and weight. The ideal patient’s BMI is

When a patient comes to the office to see Dr. Ravi, during the initial consultation, he will discuss the areas that bother the patient. He will ask the patient for pertinent medical conditions and surgical procedures they may have had including the type of surgical weight loss procedure that was performed. A full examination is then performed. After discussing the patient’s concerns for that particular body part, he will then discuss the procedure that will be required to best address that concern. Then he will go over what can be expected during the recovery period. Since body contouring requires multiple areas of the body to be contoured, they cannot all be done at one time. The operations are staged. This means that if multiple areas bother a patient in the first operation, the breast and tummy can be contoured, followed as soon as 6 weeks later by the arms and thighs, etc.

The patient will then be seen in the office 2 weeks before their scheduled surgery date to go over any questions and the postoperative recovery instructions. This is done to ensure that the patient is completely comfortable prior to their scheduled procedure.

Questions to Ask

  • Do you have excess hanging skin at your abdomen?
  • Do you have excess hanging skin at your arms?
  • Do you have sagging, deflated breasts?
  • Are you at your goal weight?
  • Has your weight been stable for 3 months?
  • Do you have rashes or infections under hanging skin that has been treated by your primary care physician?