Frequently Asked Questions
No. You ideally want to wait until you’ve lost all your weight before proceeding with any Plastic Surgery procedures. Generally, we recommend that you wait about 1 to 2 years before deciding if you want to have any “extra” skin removed.
Hair loss can accompany the rapid and significant weight loss seen after surgery. This more commonly occurs after gastric bypass or sleeve gastrectomy surgery, as the weight loss with these procedures is faster. Some patients notice this around 4-6 months post-operatively, particularly while brushing their hair. Hair loss can occur with any significant stress to the body and is usually similar to that seen in pregnancy or trauma. The hair follicles return to normal after the weight loss subsides and virtually everyone has re-grown their hair once their weight stabilizes. Poor protein intake and some mineral deficiencies such as zinc can also contribute, so supplementation is important.
We strongly advise against becoming pregnant during the first 1-2 years following surgery. The reason is there is real potential for the fetus to suffer from the poor nutritional intake during the weight loss period. If a pregnancy was to occur during the initial weight loss period, the mother would have to take in high nutritional requirements to protect the baby. The mother will then typically not lose further weight during pregnancy and often will not lose any further weight after delivery. She will therefore miss the benefits of weight loss surgery. This is particularly important for patients undergoing a gastric bypass or sleeve gastrectomy procedure. This is why we strongly recommend waiting until after the initial weight loss period, typically the first year after surgery. Patients undergoing the LapBand procedure can usually just have fluid removed from the band when you become pregnant, thereby allowing you to eat more normally. After the pregnancy is completed, the fluid can simply be placed back into the band. It is important to note that women can actually become more fertile as they experience weight loss. Fat produces estrogen which can cause hormonal imbalances and even infertility. As you lose weight, your hormone levels can become more regular and leave you with an increased chance of becoming pregnant! Please take precautions and talk with your gynecologist about contraception techniques to avoid pregnancy. After your weight loss is over (usually 1 year after surgery), pregnancy is safe following bariatric surgery. Many of our patients have gone on to have routine pregnancies, deliveries and very healthy babies.
Non-steroidal anti-inflammatory drugs (NSAIDS) such as aspirin, ibuprofen (Advil, Motrin), Naprosyn, Aleve, Indomethacin, Celebrex or other similar medications should not be taken after surgery. It is okay to take Tylenol.
We will strongly encourage you to start walking on the day of your surgery. You will increase your activity level during your hospitalizations and should be able to walk without difficulty at your discharge. Usually by the third or fourth week after surgery, other activities are safe to resume.
-after gastric bypass:
Gastric bypass surgery alters the way your body absorbs many vitamins and nutrients. It is important to take supplements the rest of your life to avoid the deficiency problems that can develop without supplementation. Most vitamins and minerals can be replaced with a good adult multivitamin. This will have the full complement of water-soluble and fat-soluble vitamins, iron, zinc, and other minerals needed. The vitamin supplement should be chewable during the first three weeks, but afterwards can be in pill form.
The second supplement needed is calcium. Calcium is absorbed in a part of the intestine that is bypassed, so it takes additional supplementation to avoid the thinning of bones and potential fractures that can occur. The preferred calcium supplement is Calcium Citrate and the recommended intake is 1200mg daily.
The third supplement is Vitamin B-12. This vitamin is normally absorbed from the diet after it combines with a protein called intrinsic factor. This complex is then absorbed in your lower intestine. Intrinsic factor is made in the bypassed stomach and therefore Vitamin B-12 can no longer be absorbed in the diet or in pill form. Vitamin B-12 is important to help prevent anemia and also functions in spinal cord nerve function. To prevent deficiency, supplementation must occur a different way than pill form to be absorbed. Options include daily sublingual tablets (under the tongue) or monthly injections.
-after sleeve gastrectomy:
Sleeve gastrectomy is primarily a restrictive operation, so absorption of vitamins and minerals is generally unaffected. The procedure does cause you to eat less, so we do recommend an adult multivitamin. In addition, we recommend supplementing with Vitamin B-12. Vitamin B-12 requires a protein made in the stomach called intrinsic factor. This protein combines with Vitamin B-12 to be absorbed. Intrinsic factor is primarily made in the stomach that was removed, so supplementation requires sublingual tablets (under the tongue) or intermittent injections in order to be absorbed.
Gastric banding does not alter the absorption of the foods you eat. However, you will be eating less. We recommend a simple multivitamin once daily for our patients who have the Lap-Band procedure.
Most of the laparoscopic gastric bypass and sleeve gastrectomy procedures can be performed in approximately 1 hour. It may take longer if you have had previous surgery or there is anatomic difficulty accessing your stomach such as an enlarged liver. The LapBand procedure usually takes less than an hour to perform.
During the time of intense weight loss, you are at risk of developing gallstones. Gallstones can develop after any weight loss procedure, though they are more often seen after the gastric bypass or sleeve gastrectomy as the weight loss is typically so much faster with these procedures. Most people who develop gallstones do not have any symptoms from them and gallstones will actually cause problems in only 5-10% of patients. In addition, the trocar placement required for the weight loss procedures isn’t optimal for removal of the gallbladder. If the gallstones do cause problems, it is typically after you’ve lost all your weight and your gallbladder can usually be removed laparoscopically as a simple outpatient procedure. If you are having current symptoms from gallstones, we will discuss with you the risks of removal of your gallbladder and consider doing it at the time of your procedure.
There are multiple reasons to stop smoking. Patients overall will have fewer complications if they no longer smoke. Smoking damages the lungs and this can lead to higher anesthetic risks and pneumonias following surgery. It takes about a month for the lungs to recover – so stop now! In addition, weight loss surgery is about improving your health. Smoking directly contradicts this goal.
We offer several support group meeting options every month. We encourage you to attend the meetings both before and after surgery. The meetings allow the opportunity to discuss various health topics, get information from guest speakers, and talk with individuals going through the same experience.
Yes. Part of our comprehensive weight-loss program includes scheduled visits with our dietician. She will meet with you in our office and help you develop proper eating habits before and after surgery and work with you to achieve your nutritional goals.
Yes! The LAP-BAND® system has received FDA approval for use in the United States. Recent advances in surgical technique for LAP–BAND placement as well as improvements in follow up adjustment strategies have made the LAP–BAND an attractive option for surgical weight loss.
Some insurance plans now understand the medical necessity of weight-loss surgery and will give approval. However, each insurance carrier has its own idiosyncrasies. Our staff can help guide you through the insurance maze. For those patients for whom insurance does not cover obesity surgery, our office can provide you with information on other payment methods.
The typical stay in the hospital is one to two nights after the gastric bypass and one night for the sleeve gastrectomy. Most LAP–BAND procedures do not require an overnight stay and can be done on an outpatient basis. These stays may need to be extended depending on each individual’s medical situation. The bottom line is that each patient stays until the surgeon feels that it is safe for the patient to go home.
Yes. Atlanta Bariatrics offers laparoscopic Roux-en-Y gastric bypass, LAP–BAND, and laparoscopic sleeve gastrectomy procedures. Although most of our patients have the surgery in this manner, not everyone is a candidate for a laparoscopic approach. In those rare cases, the procedure can be performed through an open incision approach.
After an initial phone interview with a member of our staff, an appointment with the doctor is scheduled. The first visit is mostly informational, where we learn about you and you learn more about us. You then have a complete physical examination with us and are scheduled for appropriate pre-operative testing. As you go through this process, our office assists you in obtaining insurance approval for surgery. When this is accomplished, your final visit is made to go over all your remaining questions, review all your pre-operative test results, and again go over the goals, risks, options, and benefits of surgery in detail prior to surgery. The length of the entire process can varies somewhat depending on your insurance carrier’s requirements and speed of approval. In general it takes two to three months.
No. Although patients feel much better about their appearance after weight loss, the purpose of surgery is to become healthier. Weight loss surgery may alleviate or help the patient avoid weight related diseases. From an insurance standpoint, the surgery is definitely not cosmetic.