Claudio A Guerra
Pontificia Universidad Catolica de Chile, Chile
Claudio A Guerra has completed his graduation from Universidad de Chile Medical School. He got trained in General Surgery and practiced for 5 years before starting his training in Plastic Surgery. He was a research Fellow at University of Alabama from July 2009 to February 2011. He currently works at Universidad Católica de Chile in the Plastic Surgery Unit performing most of the post bariatric surgery refered to the unit.
Overweight and obesity have become common health problems, which has increased the number of patients undergoing bariatric surgery. After the weight loss, the last step in the comprehensive treatment of obesity is the body contouring surgery. There are different surgical techniques, depending on the area to be treated and the patient's features and expectations. The current state of post bariatric body contouring surgery will be presented, with an overview of the preoperative evaluation and planning, the timing of the procedures and the strategy to achieve good results with safe surgery. A thorough and complete preoperative evaluation is crucial to define the best time to perform post bariatric plastic surgery, and to design a surgical strategy to address adequately the needs of these patients. Obtaining an accurate history is essential to establish whether the patient is at the optimal time for body contouring surgery, with a stable weight of at least 4 months, and an adequate nutritional condition to achieve lasting results over time. A very important issue to discuss with the patient is the extent and location of scars and the postoperative course they may have. The limitations of surgery have to be clearly explained and the patient must understand these surgeries as a process, considering staged procedures as a realistic strategy in terms of safety and results. The risk of thromboembolic events, bleeding, need of transfusions, infections must be discussed so the patient has all the information he or she needs in order to make a well informed decision. A careful medical evaluation and surgical planning are important to offer procedures with predictable results keeping safety as a main concern.