While the life-changing journey of losing 50 or 100 pounds after weight loss surgery is quite exciting, most people find that their new figure needs additional improvements. My post-bariatric body contouring patients often drive or fly in from more than five different states to undergo a range of body-sculpting procedures designed to remove and tailor excess skin left behind after massive weight loss. They usually travel these distances because they like our before and after photos or they’ve spoken to our receptive staff. They’ve certainly done their homework, but more often than not, they are misinformed as to what to expect and how to prepare for their consultation appointment.

Most massive weight loss patients have experienced a dramatic change in their body, their psyche and their attitude for life. They frequently want to “fix everything” as fast as possible. My first piece of advice to them is to slow down and expect to undergo several post-bariatric body contouring procedures gradually. Ninety percent of my post-bariatric patients wish to address multiple aesthetic issues affecting the breasts, the abdominal area, buttocks, inner and outer thighs, arms, back and face. About 50 percent ultimately undergo all of the following five procedures: breast enhancement surgery, body lift, arm lift (brachioplasty), tummy tuck and inner thigh lift. Typically, we’ll perform a lower body lift (aka trunk lift) first, followed by breasts and arms second. These surgeries can generally be performed within a month of each other. Facial surgery and less invasive procedures are usually saved for last.

Why multiple procedures instead of one? Because these procedures take time, and the longer the surgery, the greater the risk for complications. For this reason, I try to limit surgeries to 6 hours in length. I’ll joke with patients that our first rule here at Chapin Aesthetics is that “you get to see your results.” In other words, let’s keep the surgery safe. It must be working, as I’ve never lost a patient in my 15 years of practice.

Another important factor my massive weight loss patients need to be prepared to address is insurance coverage. Here at Chapin Aesthetics we always try everything we can to submit for insurance coverage for a requested procedure. In order to obtain coverage, the insurance company needs to know what medical condition the patient has as a result of excess skin. And if you are well prepared, you win. Here’s how.

Have your doctor treat and document any rashes or back pain that may be the result of excess overhanging skin acquired through your weight loss. Once your weight loss has plateaued, you should have your doctor write a support letter explaining why you have failed medical therapy for these rashes. Our office can provide you with sample letters to give to your doctor, if necessary. Basically, the insurance companies want to know that you have exhausted all medical therapies for your rashes or back pain. It is then that they might consider covering all or a portion of your surgical procedure to remove the excess skin.

If I could offer any further advice to the massive weight loss patient, it would be this: Research your doctor. Does he or she perform this surgery often? Does the practice have photos to support their dedication to this type of surgery? In other words, do the surgeon’s results look nice? Check it out. You’ll see a wide variation in results. Then find the practice with the nicest results and the most supportive staff.

Dr. Scott Chapin

www.drchapin.com

I have been performing breast augmentation surgery for the past 15 years. All things considered, it strikes me that the decision regarding implant size seems to be the most perplexing and stressful for women considering this procedure.

Here at Chapin Aesthetics, one of our primary goals in helping you select the right breast implants size is to make you feel comfortable and at ease, so that we can openly discuss your desires and find the breast implant size that is right for you.

One of the first things my breast augmentation patients usually reveal to me is a specific bra size they would like to fit into following surgery. While this may seem like a simple, matter-of-fact statement, I always tell my patients, “If I get the bra size right and the look wrong you will be upset with your results, but if I get the bra size wrong and the look right, you will be happy.” I strongly believe in this statement and here is why:

Choosing the correct breast implant size is much more complex than just determining a specific bra size and going with it. I strongly believe that the correct breast implant size is about a specific “look” that will make your breasts appear natural, beautiful, proportionate and, most importantly, comfortable for you. That “look” requires a certain volume. So, bra size is really an inaccurate method to measure which breast implant size is right for you.

Also, consider this: bra sizes vary among manufacturers, meaning that a correct bra size in one brand may be equivalent to another size in a different brand. In fact, most of my patients admit that they fit comfortably into more than one bra size depending on the brand and design of the bra.

As you can see, there is no simple answer as to which breast implant size is right for you. Part of the answer lies in a precise evaluation of your aesthetic goals, your unique breast anatomy, your skin characteristics and the width of your chest. But the final answer is found through my custom implant fitting test. Not only do I administer the test in my practice alongside my fitting expert, but I also teach my patients how to take the test at home. I call this a custom take-home breast implant size test, during which I ask my patients to try a range of different breast sizes — wear them at home, out to dinner, at the movies and even shopping, and find out what truly feels right for you.

After taking the custom implant fitting test, I ask my patients to come back and see me. I also encourage them to bring in pictures and/or any other research materials that have been helpful in their homework. I also often ask my patients to bring in a friend, a family member or someone they trust, which allows us to form a trustworthy team comprised of individuals who have my patient’s best interest at heart, including me and my team.

Breast implants surgery is a serious surgical procedure and a big step toward accomplishing your aesthetic goals. It is essential that together we choose the correct implant size that is right for you. I truly believe in my custom implant size fitting test. It has helped us to achieve a tremendous success rate in choosing the right implant size for our patients. It’s accurate, simple and actually fun to perform. My patients love it. And they love their results!

Dr. Scott Chapin

www.drchapin.com

Chapin Aesthetics is happy to announce the debut of it’s NEW website blog. We will be providing you with updates and news relating to advancements in cosmetic surgery, skin care and hair salon treatments.  We are excited about the opportunity to share with you our latest news and we encourage your future comments.