Bariatric surgery has proven to be a successful treatment for severe obesity. Different methods have evolved, with the Roux-en-Y gastric bypass becoming the most common. Patients who lose a lot of weight have disfiguring skin laxity that necessitates surgical removal of the redundant tissue. For the post-bypass patient with subcostal and midline scarring, the groin flap or cross-abdominal flap, or both, are presented as options. In exceptional cases, a reverse abdominoplasty is still an option. Furthermore, we concentrate on the complications that these patients are more likely to develop, which are primarily related to affiliated incisional hernias and more.
The post-bariatric patient usually complains about both functional and cosmetic issues. Functional concerns should be meticulously documented in the patient’s chart. Skin rashes and breakage in the abdominal or thigh folds, the historiography of skin infections necessitating topical and/or oral antibiotics or antifungals, difficulty maintaining hygiene, and complexity ambulating due to the weight of the abdominal pannus are all examples. Cosmetic complaints differ according to the body region. They’re all caused by skin ptosis, so they’re all the same.
Skin surplus, adipose deposit location, and musculofascial laxity in each area should be assessed. The specific deformities that must be addressed are discussed later in this article by body area. Scar placement is critical because scars can impair the skin flap circulatory system. Vertical scars from open gastric bypass surgery, as well as Kocher scars, are prevalent in this group of patients. The location of the port in patient populations who have had gastric band surgery requires special attention. Ports positioned very medially may obstruct abdominal wall plication.
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