Body contouring can be a vital component after weight loss

It is no secret that most Americans need to lose some weight. In fact, more than two-thirds of Americans over age 20, are considered overweight, and nearly 40 percent of the population now meets the definition of obese, according to the Centers for Disease Control. It is an epidemic that afflicts 93 million people in the U.S., and it is getting worse. (https://www.cdc.gov/obesity/data/adult.html)

The health risks associated with obesity are well-known, and the benefits of maintaining a healthy weight can be dramatic. For example, many people who through surgery or lifestyle changes have achieved a healthy weight are able to eliminate or avoid having to take medications for blood pressure, cholesterol and diabetes. But, as anyone who has tried to lose weight can attest, losing substantial weight and keeping it off is very difficult. In fact, scientists often consider obesity a progressive disease because a number of factors, including hormonal, metabolic and molecular changes in the body increase the risk for even greater fat accumulation. So, it is probably not a surprise that weight loss surgery has emerged as one of the most effective means of treating obesity. Since 2011, bariatric surgery of all types has grown from about 158,000 procedures annually to nearly 230,000, according to the American Society for Bariatric and Metabolic Surgery. (https://asmbs.org/resources/estimate-of-bariatric-surgery-numbers)

However, what is probably surprising to a lot of people, especially those who have taken decisive steps to get their body weight under control, is that the health benefits of losing a substantial amount of weight can be tempered by having a large amount of loose skin afterwards. Excess skin doesn't melt away like fat. In some cases, patients are left with large folds of hanging skin that can become a health challenge in their own right, or which can leave them feeling as bad about their appearance as their obese bodies made them feel.

"The psychological and social aspects of visibly sagging skin can be just as devastating as being obese," said Omar Beidas, MD. Beidas, one of the leading surgeons in the country for body contouring after weight loss, is with the Orlando Health Aesthetic and Reconstructive Surgery Institute. While he is also a reconstructive plastic surgeon, about half the patients he sees are for body contouring surgery following substantial weight loss.

According to Beidas, problems with sagging skin for the patients often arise when they lose substantial weight quickly - usually more than 50 pounds. This can happen when a very obese person has bariatric surgery. It can also happen to patients recovering from other health problems.

Although bariatric surgery is being used more frequently, Beidas said that sometimes patients either are unaware that plastic surgery is available, or they think that it won't be covered by their health insurance.

"Most people probably think of plastic surgery as being something for celebrities," he said. "Eighty to 90 percent of the surgeries I perform are (medically necessary) reconstructive surgery," he said. About 90 percent of the surgeries to remove excess abdominal skin are covered by the patient's health insurance. Other surgeries to address excess skin on the arms, thighs and chest are often considered cosmetic by insurance companies and therefore not always covered.

Becoming an expert in this field was not an obvious choice for Beidas. As the son of an engineer, he considered pursuing that field while going to Drexel University in Philadelphia. "But I didn't find it challenging enough," he said. So, after earning his Bachelor of Science degree in bioscience and biotechnology, he earned acceptance to Temple University's medical school. There, he discovered a fascination with surgery and reconstructive plastic surgery.

It was during his third year in medical school that a plastic surgeon mistook him for a resident, a new medical doctor who is in a structured training program at a hospital. "The surgeon needed some help in the operating room with a patient; he told me to scrub in and gown up, and then he said, 'Do what I am doing.'"

After the procedure, the surgeon was surprised to discover that it was a student, not a resident doctor, that had been assisting him. It was a remarkable experience for Beidas and one that solidified his interest in reconstructive surgery.

"This is when I discovered that I liked reconstructive surgery," he said.

After medical school, Beidas completed his residency in plastic and reconstructive surgery at the University of Oklahoma and then a unique fellowship in body contouring and life after weight loss at the University of Pittsburgh. While completing that fellowship, he also served as a clinical instructor in the department of plastic surgery at the university's medical center. He has since published numerous peer-reviewed articles in medical journals and textbooks on the subject.

Here in Orlando, Beidas is working to enhance Orlando Health's team approach to weight loss health and to build a program similar to what he experienced at Pitt. "We are hoping to start the same thing here. There is no other fellowship like it. It will be part of our comprehensive team approach," he said. "Everyone at Orlando Health has been very supportive and excited about this program."

"Losing substantial weight is a life-long decision," Beidas said. "And surgery is not the easy way out. I love working with these patients. They are working very hard to achieve a healthier life, and it is very rewarding to help them complete this journey."