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‘I have bat wing arms’ — dealing with massive weight loss

DR. DAVID NOWICKY
Guest Columnist

Flying squirrel deformity… Shar-Pei dog skin… is this a Discovery Channel documentary?
No, these are some of the more commonly used terms associated with massive weight loss and the resulting appearance of one’s body after losing an enormous amount of weight.
These are not my terms, and quite frankly, they may not be the most flattering but they are very descriptive.  Whether significant weight loss resulted from surgery such as a gastric bypass or a gastric sleeve operation, a Lap Band R procedure or through diet and exercise alone these images describe how many massive weight loss patients feel about themselves after shedding all of those pounds.
The epidemic of obesity in the United States is well-known and a frequent topic of sensationalized media stories and health care discussions.  The risks to one’s health and the improvements after weight loss cannot be argued.  Luckily, for those suffering from obesity and morbid obesity there are surgical options available to help them in their quest to lose weight… but these men and women embark on a transformation that is truly difficult to comprehend for those of more average weight.
What happens after somebody loses 100, 200 pounds or even more of body weight?  The new appearance of their physical body can be quite dramatic, to say the least.  Even if they are extremely lucky and have incredibly elastic and healthy skin, most likely they’ll be left with some areas of excess skin and fat that simply won’t go away and just lingers.
Sometimes, the redundant “stuff” that remains on the belly or arms is just “ugly ” or “unsightly”…but oftentimes it causes real fuctional and health related issues and problems such as chronic skin irritation and breakdown, redness, pain, tenderness, drainage and infections. It may become a constant source of irritation and aggravation. Either way, the transformation to a new body and physical appearance that is envisioned and dreamed about may only be partially fulfilled until this “stuff” is addressed.
For until the “extra arm skin that just hangs there” or the “apron that falls from my belly and gets in the way ” or those “breasts that hang to my knees”  is corrected is the full transformation complete and the goal of the journey realized. This is where plastic surgery comes to the rescue. Quite simply, all the areas of excess skin and tissue remaining after massive weight loss that doesn’t go away can be dealt with surgically and swiftly. The unsightly flapping arms skin, the left over belly rolls of fat and skin, and the shapeless and deflated breasts can all be addressed with surgical precision and reshaping.
But who should pay for all of this reshaping and re-contouring? Very good question! You may be thinking that it is the responsibility of your insurance carrier since they originally approved your surgical weight-loss procedure in the first place. You may feel that “it only makes sense that they would help with my body contouring.” Well, just because you were lucky enough to have an insurance company that saw the benefits of surgically assisted weight-loss it does NOT mean that they see the benefits of helping you reshape your new body!
But, all is not gloom and doom. One area that oftentimes can be approved by insurance and deemed “a medically necessary procedure” involves removing the extra tissue that surrounds the abdomen and belly. Oftentimes this is the most troublesome area and is the No. 1 area of concern. Surgically removing the large abdominal “pannus” or apron of skin that troubles so many weight loss patients and causes significant and real medical problems may be an insurance covered procedure. Although, all plans are different and subject to different policies, my office and I have been quite successful in getting some of these procedures covered. Other areas such as breast, arm and thigh surgeries are more difficult to get approved, however.
Many plastic surgeons, myself included, consider body contouring procedures after massive weight loss not as purely cosmetic or elective but more along the lines of necessary and functional reconstructive options. At Nowicky Plastic Surgery we are on your side and have a dedicated and passionate team who will gladly stand by you as we deal with your insurance company. Even if your initial weight-loss procedure was not covered by insurance or was strictly out of pocket we will also be able to help. We understand the economic and financial burden. With this in mind, we have set up various plans and options to assist you in your endeavors.
So, I encourage all those men and women who where courageous and brave enough to accept the challenge of massive weight loss to look into some of these plastic surgery options. Just don’t assume that you have to live with all that extra skin and tissue…just don’t believe that you will never be able to wear that short sleeve shirt, just don’t accept that you will always need to “pull up on that stuff and tuck it away under my clothing!”  No! Rise up and look into your options and complete this transformation and enjoy the vision that is so etched in your mind… you never know what it may look like over that rainbow.
Dr. David Nowicky works with Nowicky Plastic Surgery in conjunction with Carolinas Medical Center.

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