Liposuction and Gastric Bypass

Surgical interventions before and after weight loss, such as liposuction and gastric bypass, can carry many risks.

About Gastric Bypass Surgery

Gastric bypass surgery is for people who need to lose a great deal of weight and have not been able to achieve this by other means, such as diet and exercise. The BMI (body mass index) and certain health concerns, such as high blood pressure and diabetes, may be used by doctors to determine the appropriateness of the gastric bypass procedure. The beginning part of the surgery is to make the stomach smaller by dividing it into two sections. The top section is small, and the bottom section is larger. The small “pouch” is for the new amount of food that is eaten, and it can only hold about an ounce of contents. The bypass part of the surgery is the second step. Part of the small intestine is connected to a hole in the pouch. The food goes directly from the pouch to the small intestine, leading to fewer calories being absorbed. The surgery can be performed as an open surgery, cutting open the belly, or through laparoscopy, where a camera is used to guide the surgeon through small cuts. Laparoscopic surgery leads to shorter recovery, less pain and scars, and reduces the risk of infection or hernia. After surgery, diet and exercise will still be needed, and the surgery itself carries many risks. All surgeries could lead to medication allergic reactions, blood clots that move from the legs to the lungs, breathing problems, heart attack, stroke, infection, and blood loss. Smokers have higher risks of problems. For the surgery to have a successful long-term outcome, patients will need to stick to a strict diet. More than half of the extra weight will be lost during the first couple of years. A pureed diet will lead to more rapid weight loss.¹ There is a variation on this surgery called laparoscopic gastric banding, where the surgeon bands the stomach to create the pouch. The band can be adjusted over time. The weight loss is not as significant as with gastric bypass surgery, and the weight is lost more slowly, but the recovery time is faster. The extra risks of this surgery include gastritis or ulcers, the band slipping out of place or eroding, scarring in the belly, vomiting from eating too much, and poor nutrition.²

Liposuction Uses and Risks

Liposuction and abdominoplasty (“tummy tuck”) are procedures that may be sought after gastric bypass surgery. Fatty deposits can build up in certain areas and not decrease enough during weight loss. Liposuction removes the deposits to “re-sculpt” the body. Abdominoplasty tightens the loose skin after weight loss. It will lead to scarring, and results depend on how elastic the skin is and how much skin and fat need to be taken off. “Body contouring” may be sought by some patients after gastric bypass surgery, when the large amount of weight loss will not allow the skin to shrink. Patients may have procedures to target the upper arms, stomach, buttocks, and thighs.³ Liposuction is expensive and carries risks of bleeding, infection, embolism, swelling, nerve damage, and even death.⁴ The tummy tuck can lead to many complication, including bleeding, scarring, infection, clots, skin discoloration, nerve damage, pain, and more.⁵ There are many natural and alternative options to consider in weight loss, including regular chiropractic or massage visits, acupuncture, yoga, and seeking nutritional counseling and dietary changes. Allowing the body to become aligned, reducing stress, and seeking alternatives to medications and surgery could prevent some of the problems that might lead to surgical decisions.