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GJ Medical Weight Loss Tips

Weight loss surgery is now considered to the best solution for those who want to shed excess pounds. Nevertheless, the complete information about such procedures— their side effects, associated risk, complications etc.—can sometimes be difficult to find.
In line with this, we tried to look for more information about the different weight loss surgeries that are popular today, so you can learn more about them. But always remember that the facts that we will present in the next articles should not, in any way, stop you from consulting your physician, looking for a reputable surgeon to conduct the procedure properly and carefully, and using your common sense.
The information that will be stated below pertains to the weight loss procedures in general. If you want to have more specific facts on any of the procedures, just click on the links that can found at the end of this page.
The following general guidelines will help determine if your weight loss surgery will be successful or not:
  • Bleeding
  • Complications associated with the use of anesthetic drugs
  • Infections
  • Injury to the spleen (this occurs in around 0.3% of the cases; more often than not, this requires the complete removal of the spleen)
  • Leaks (this depends on the type of procedure that will be performed)
  • Lung problems
  • Marginal ulcers
  • Vein thrombosis, or the formation of blood clots in the vein
A weight loss surgery is said to be successful if the patient lose at least 50% of his or her pre-surgery weight, and also if this weight loss is maintained for 5 years or more.  
Theoutcome of a successful weight loss surgery depends on the type of procedure performed. Short-term outcomes usually include the patient quickly losing weight 1-2 years after surgery. During the first six months, there is a reported weight loss of around 30-50%, while it goes up to as much as 77% towards the end of the first 12 months.
On the other hand, the long-term outcomes include the majority of patients maintaining a 50-60% weight loss for at least 10 years following the procedure. Moreover, there are also some studies which found out that 96% of the patients experienced major improvements on the symptoms of obesity-related health problems after the weight loss surgery. Such improvements include reductions in blood pressure and blood sugar levels, depression, back pain, and sleep apnea. In fact, there are patients with type II diabetes who have gotten better, with many of them largely reducing or even completely stopping the use of their anti-diabetic medications.

Note: Although the studies above have given such results, there still are other studies which revealed that weight loss surgeries have low success rates. It is always important to realize that the complications, success rates, and long-term outcomes depend on the procedure that will be performed. Because of this, consultation to your physician is recommended, in order to discuss with him or her everything that you need to know about the procedure.

Listed below are the procedures that we will discuss in detail in the next articles:
  • Abdominoplasty(tummy tuck)
  • Banded Gastroplasty
  • Duodenal Switch
  • Gastric Band
  • Gastric Bypass
  • Liposuction

Many of us probably know someone who has undergone a procedure called abdominoplasty, which is more popularly-known as the tummy tuck procedure. Women aged 40 and above, particularly those who have children and more or less have experienced sagging of skin in the abdominal area due to pregnancy and childbirth, are those who will have a great desire to return to their pre-pregnancy shape. And this will be achieved by going through a tummy tuck procedure. Nevertheless, the complete information on tummy tucks— their side effects, associated risk, complications etc.—can sometimes be difficult to find.
In line with this, we tried to look for more information about the tummy tuck procedure, so that you will learn more about it. But always remember that the facts that will be presented in this article should not, in any way, stop you from consulting your physician, looking for a reputable surgeon to conduct the procedure properly and carefully, and using your common sense.
The general guidelines that can determine the success of a tummy tuck procedure are numerous. Anyhow, the best candidates to undergo this weight loss surgery are those who:
  • Have a good or nice body shape but also have huge fat deposits or loose skin in the abdominal area that won’t go away even with regular exercise and meticulous diet.
  • Have abdominal muscles that are overstretched due to childbirth
  • Have skin that is too stretched, and won’t return to its normal state anymore
  • Have skin that has already lost it elasticity, due primarily to weight loss or aging
When planning to undergo a tummy tuck procedure, a lot of things must be considered in order to at least minimize any risks or complications that can result from this weight loss surgery, and to determine the short- and long-term outcomes. The following are the things that you should keep in mind when planning to go through this surgery:   
  • If you are still on the process of losing weight, you will have to wait before undergoing this procedure.
  • If you are planning to get pregnant, you will have to wait before undergoing this procedure.
  • Lastly, even if this procedure results to the improvement of your appearance, which will help you feel more confident about yourself, it will not change the way people treat you. 
The risks associated with the tummy tuck surgery pretty much similar to the risks from other surgical procedures. And it is important to discuss such risks with your physician or surgeon:
  • Complications associated with the use of anesthetic drugs
  • Blood clots
  • Infections
  • Poor wound healing resulting in obvious, and sometimes unsightly scarring
The following is the step-by-step procedure in performing the tummy tuck surgery: 
  • The surgeon will administer general and local anesthetic drugs to control pain throughout the procedure.
  • Two incisions in the abdominal area will be made:
    • The first one includes anincision directly above the pubic area, which will be extended laterally to the left and right hips (the extent of this incision depends of the amount of correction to be made).
    • The second one includes an incision around the belly button area, which is done to disconnect the belly button to the surrounding tissue, while still allowing it to remain attached to the inner abdominal wall. 
  • Once the incisions are complete, the surgeon will then reflect the skin from the abdominal wall and move it up over the ribs, to expose the underlying abdominal muscles.
  • The surgeon will now tighten the abdominal muscles by withdrawing them close together. The spaces between the muscles will also be reduced, in order to bring the muscles back to their “original” position.
  • Once in their proper position, the muscles will be sutured or “stitched” back to their new position.
  • The navel will then be repositioned to a location where, upon recovery, the chest area will still be in a symmetrical position. The navel will then be sutured into place.
  • The reflected skin will be stretched down to its original position, and the extra, previously sagging skin will be removed. Any extra fat will also be removed through liposuction.
  • The incisions will be closed at all points using sutures or skin tapes, adhesives, and clips.
  • Dressings and bandages will be applied, and a small tube will be inserted in order to drain any excess fluid that might build up in the surgical site.
The recovery period will last for several days. During that period, swelling and pain of the abdominal area may be experienced, but that will be gone once internal healing occurs. A hospital stay of around 2-3 days may be required, depending on the type and extent of the tummy tuck procedure.
When you return home, be sure to follow your surgeon’s instructions, particularly those about bathing and changing the dressing or bandage. It is also advisable that you start walking as soon as possible. 
After about a week, your surgeon will remove the sutures on the surface. The sutures that will remain will be removed after 2-3 weeks. Upon removal of the internal sutures, your surgeon will advise you to use a support garment.
Although you might be able to start working again after a few weeks, for most patients, it takes 4-5 weeks recovery period before they can get back to their normal life. Exercise facilitates faster healing, and it also aids in reducing blood clots and in toning the muscles.
The scars will be more obvious and will probably get worse in the next six months. Nevertheless, this is only normal and should not be a cause of concern. After about nine months, these scars will become lighter, more flat, and less obvious. But always remember that they will remain visible.

Banded gastroplasty,otherwise known as stomach stapling, has been a popularly-used weight loss surgery in the United States for many years already. This procedure is performed on morbidly overweight patients (or those who weigh at least 100 pounds more than their ideal weight) to help them shed excess pounds and to aid in weight control.
The procedure involves partitioning the stomach with staples in order to create a small vertical pouch on its area near the esophagus. This pouch is sealed with a band, to separate it from the remaining part of the stomach. The size of the vertical pouch significantly reduces the amount of food that can be taken into the stomach, while still allowing the patient to feel full quickly. And the slow emptying of the pouch due to the narrow opening by the band further contributes to a longer feeling of fullness, leading to less frequent eating.
However, it should also be noted that banded gastroplasty is less effective compared to the gastric bypass surgery, and much less effective than the duodenal switch procedure. According to studies, around 20% of patients who have undergone this weight loss surgery did not lose weight after surgery. Those are the same studies which found out that the average weight loss that can be achieved from weight loss surgeries is 30-50% of the person’s weight prior to the procedure.

Duodenal switch,otherwise known as gastric reduction duodenal switch (GRDS) or biliopancreatic diversion with duodenal switch, is a highly-effective yethighly-complicated weight loss surgery.  This procedure is performed on morbidly overweight patients, or those who weigh at least 100 pounds more than their ideal weight. The high success rate of this surgical procedure is due to its dual restrictive and malabsorptive effects.
The duodenal switch procedure can be performed either through a keyhole surgery (aka laparoscopic surgery) or through a standard/open surgery. The restrictive aspect of the duodenal switch involves removing a large portion of the stomach. This lessens the amount of food that can be handled by the stomach, while still retaining its normal function.
On the other hand, the malabsorptive aspect involves cutting the duodenum (or the biliopancreatic loop), and then creating two pathways (the other one being the digestive loop). The former transports bile from the liver, while the other carries food from the stomach. These pathways bring their contents in one common channel (75-100 cm portion of the small intestine), where the food and bile mix together before they empty into the large intestine. This leads to the limited absorption of nutrients and fat from food to only 20%.
The problem with duodenal switch is that, it requires the patient to take vitamin and mineral supplements, as the body can no longer absorb all the nutrients from food. However, apart from taking supplements, the patient must also undergo regular check-ups for the rest of his or her life, to ensure that the malabsorption of nutrients, particularly of proteins, will not cause serious health problems.
Editor's Note:
Most people take more time choosing a mechanic to do repairs on their cars, rather than carefully choosing and reviewing the work history of a surgeon prior to undergoing surgery.

If you are really considering going through any weight loss surgery, it is advised that you obtain as much information as you possibly can. Try to learn more the procedure-- its complications, the success rates, the risks, and the most important of all, the reputation of the surgeon who will perform the procedure.

A legitimate doctor will be not annoyed even if you ask all the questions that you have in mind before you allow them to do the surgery.

Moreover, always try to get a second opinion before you plan and schedule any surgery.

Gastric bypass surgery refers to any weight loss procedure that involves dividing the stomach into upper and lower pouches, and then repositioning and connecting the smaller intestine from the lower pouch to the upper, smaller pouch.  This procedure is a popular weight loss treatment for people who are extremely overweight, or those who weigh at least 100 pounds more than their ideal weight. Due to its excellent, permanent weight loss results, it is considered to be gold standard for weight loss surgery.
Due to the reduction of the stomach size by a whopping 90%, this weight loss surgery significantly limits the amount of food that the patient can take. And since the food goes into the pouch which does not have the ability to stretch as much as a normal stomach does, the patient can feel full much faster even with just a small amount of food consumed. This, in turn, leads to less nutrients and calories being absorbed.
Gastric bypass surgery is a long-term, if not permanent, method of weight control for obese people. Majority of patients lose at least 80%, up to as much as 100%, of their weight prior to the procedure. This amount of weight loss, nevertheless, is still dependent on the patient’s discipline and adherence to a healthy diet and exercise routine.

Considered to be the safest and least invasive, the gastric band surgery is a type of weight loss surgery that makes use of an adjustable gastric band, which is otherwise known as the lap band. This procedure, since its approval in February 2001, has been widely-used in the United States to help obese patients with BMI of 30-40 lose excess body fats. Gastric band surgery is also popular in Europe and other parts of the world due to the impressive results that it produces.
This procedure is done through keyhole surgery, wherein a laparoscope (a small, needle-like tube) is inserted through the abdominal wall to provide a view of the surgical site. With this procedure, only tiny scars are produced since only small incisions are required. Then, a small inflatable band is placed around the stomach, particularly on the part near the esophagus, to create a small pouch. The limits the amount of food that can be taken in by the patient, while at the same time increases the time taken for the food to be transferred from the stomach into the intestines. Take note that in this procedure, the absorption of nutrients is not affected. And if this gastric band surgery fails to help the patient lose weight, the surgeon can always adjust the band (in this case, another laparoscopic procedure is needed).
Majority of patients who have had gastric band surgery experienced weight loss of as much as 70% at a period of about 7 years following the procedure. But of course, this amount of weight loss is largely dependent on the long-term maintenance through healthy diet and regular exercise.

Liposuction is probably the most popular weight loss surgery today. And most of us probably know someone who has undergone such procedure. Nevertheless, the complete information on liposuction— its side effects, associated risk, complications etc.—can sometimes be difficult to find.
In line with this, we tried to look for more information about the liposuction procedure, so that you will learn more about it. But always remember that the facts that will be presented in this article should not, in any way, stop you from consulting your physician, looking for a reputable surgeon to conduct the procedure properly and carefully, and using your common sense.
Liposuction, otherwise known as lipoplasty, pertains to the removal of excess fats from the different parts of the body, particularly in the arms, abdomen, buttocks, and thighs. This is generally performed using a small tube called the cannula, which is inserted on the target area, and an aspirator, which suctions the fat on that area.  There are also specific techniques of liposuction that utilize fluid injections or ultrasound. The ideal candidates for liposuction are those who are in good general health, meaning, anyone who are at their ideal weight and does not have diseases such as diabetes, ongoing infections, and heart problems. This is to ensure that optimum results will be achieved.
Apart from the arms, abdomen, butt, and thighs, the other areas of the body where liposuction is commonly performed include the flanks (or love handles), back, hips, inner knees, chin, and neck. In men who have gynecomastia, this procedure is also performed in order to reduce the size of their breasts.
The following general guidelines will help determine if the liposuction will be successful or not:
  • It is mandatory that the patient be at least 18 years of age in order to be a good candidate for this procedure
  • Patient’s weight prior to surgery must not be 15 pounds more than his or her ideal weight
  • Patient must be in good health, and is not suffering from systemic diseases such as diabetes, infections, or any cardiovascular problems
    • Ideally, the patient should have an ongoing diet and exercise routine
  • The most appropriate liposuction technique with respect to the patient’s present condition must be chosen
  • The elasticity of the skin is important, as it determines whether or not the skin can adapt or tighten around the area that has underwent the procedure
  • The patient must have realistic expectations from the procedure
  • Lastly, liposuction must be considered only when the fats pockets were not removed by meticulous diet and exercise
Before undergoing the procedure, it is important to discuss first with your surgeon the procedure in general, along with the risks, possible complications, outcomes etc. Don’t hesitate to ask all questions that you may have regarding the procedure.
Another thing to consider when you’re planning to go through liposuction is your general health. Existing health problems may pose risks that can affect the outcome of the procedure.   Listed below are the conditions that can significantly increase the risk of complications associated with the liposuction procedures:
  • Complication/s from previous surgical procedures
  • Diabetes
  • Heart disorders
  • Hypertension
  • Pulmonary disorders
  • Seizure disorders
The risks associated with liposuctions are pretty much similar to the risks from other surgical procedures, whether it is laparoscopic surgeries or open surgeries, and is dependent on the amount of fat that needs to be removed. And it is important to discuss such risks with your physician or surgeon. Listed below are some of the most common complications from liposuction:
  • Infections
    • This complication applies to all surgical procedures. Since the body is incised and cut open, there is a high risk of bacteria getting in and causing an infection. In liposuction, puncture wounds are made when the cannula is inserted into the target area. The extent of this puncture wound depends on the liposuction technique that will be employed.
  • Fat and blood clot embolization (more commonly to the lungs)
    • Although liposuction is a relatively-safe procedure and this complication rarely happens, it still must not be ignored.
  • Hypovolemic shock
    • This refers to the shock brought about by fluid loss, particularly the loss of large amounts of blood
  • Skin damage
    • The insertion of the cannula can damage the skin and tissues underneath it. Such damage is seen as a small spot on the skin surface.
    • In rare cases, skin necrosis/death occurs. This is commonly seen as skin falling off from the affected area. The wound that results from this necrosis typically requires extreme care.
  • Nerve damage
    • Since liposuction removes fat from the deep levels of the body, there is a danger of injuring the nerves, which can lead to nerve damage.
  • Allergic reactions
    • This is usually due to the anesthetic drugs and other medications used during the procedure.
  • Scarring
    • The scars that will form after the procedure depends on the liposuction technique performed. These usually fade after a week or so. For some people, it usually takes a year for the scars to heal, and this is, more often than not, due to heredity.
  • Sagging skin
    • The only purpose of liposuction is to remove fat. It does not tighten the skin, which is why after liposuction, you will notice that your skin appears loose. This sagging skin can be removed through exercise or by other surgical procedures.
Four primary liposuction techniques exist. Your cosmetic surgeon will help you identify which among those four will be the most appropriate for your case. Usually, the selection of technique is based on the amount and location of the fat deposits that will be removed.
The suction-assisted liposuction, abbreviated as SAL, isstandard technique of liposuction. In this technique, a small incision is made into the skin.  A cannula, which is attached to a suction device, is inserted into that incision to draw the fats out from the target area. The cannula is moved in a push and pull motion, to break up the fat cells and facilitate easy suctioning of the fats. Compared to other liposuction techniques, SAL is performed the fastest. Nevertheless, it is also the one which causes the most complications, more specifically blood loss and bruising. The time it takes for the procedure to be completed is largely dependent on the amount of fat that needs to be removed and number of target areas.
Another technique of liposuction is the fluid injection technique. As the name suggests, this technique refers to theinjection of a mixture of different fluids into the deep fat layers. The mixture consists of saline solution, anesthetic drug, and epinephrine (a medication which works to constrict the blood vessels in the area, thereby reducing blood loss). This liquid mixture breaks down the fat deposits, which is then taken off from the body with the use a cannula inserted through the incision made in the skin. In the fluid injection technique, there is less bruising and blood loss. And the introduction of an anesthetic directly on the surgical site makes the patient feel less pain, facilitating faster and easier removal of the fat deposits.
The tumescent liposuction technique is pretty much similar to the fluid injection technique and the super-wet technique (will be discussed later). This technique also involves injecting a mixture of fluids (saline, anesthetics, epinephrine) into the fat deposits. The only difference is that, the amount of fluid injected is up to as much as six times the amount of fat that will be removed, causing the skin to become very firm and swollen (tumescent means “swelling”). Tumescent technique takes more time to complete compared to other liposuction techniques.
Super-wet technique is another technique wherein a mixture of fluids is injected into the fat deposits being removed. Unlike in the tumescent technique, the amount of fluid used is equal to the amount fat to be removed. Moreover, general anesthesia is also required for this technique, since the fluid mixture contains less anesthetic and epinephrine. And since the patient is under general anesthesia, here or she may choose to have other procedures done. Also, always remember to speak with your surgeon regarding the risks associated with the use of general anesthesia.
In some cases of liposuction, a technique known as UAL, or ultrasound assisted lipoplasty, is used. This technique utilizes a special type a cannula which emits ultrasonic vibrations that melts the fats, making them easier to remove using standard liposuction techniques. UAL is commonly used in fibrous area, such as on the upper back or the chest for male patients.