Weight Loss Surgery

Who does it?
● Plastic Surgeon
● Bariatric Surgeon

AKA Bariatric Surgery

What is it?
Weight loss surgery – which actually encompasses a number of different procedures – is continually in the news as both celebs and non-celebs alike turn to what is often a last ditch attempt to lose the extra pounds (or more likely stones) that may have plagued them for all their adult lives.

A gastric balloon is the least invasive or permanent option and its success is often dependent on the amount of aftercare you receive in the form of a carefully structured diet programme.

The gastric balloon is a soft silicone balloon that is inserted into your stomach and then filled with sterile saline. The balloon makes you feel full, meaning you feel less hungry all the time and smaller portions are all that is necessary to fill you up.

Gastric band surgery (also known as gastric banding or lap banding) is a highly effective procedure. A band is placed around the stomach, dividing it into two parts, thereby creating a small stomach pouch at the top, which dictates how much food you can eat.

The food then slowly passes into the lower stomach and then through the body as normal. The band can be inflated with saline solution to further reduce the size of the opening into the lower part of the stomach which leaves you feeling fuller for longer. This procedure can be reversed if required.

Gastric bypass surgery works by restricting the amount of food you can consume and also the amount of calories that the body can absorb.

This is a major surgical procedure that carries more risks than the other procedures and isn’t easily reversible.

Who is suitable?

A consultation with an experienced bariatric surgeon will determine which of these procedures is best for you, but generally speaking a gastric balloon is most suited to those who have less weight to lose – usually you need to have a BMI of over 30.

Patients who are eligible for both the gastric band and gastric bypass are those with a BMI of over 40 (or over 35 with associated medical conditions), however you should also be aware that you may need to lose some of the weight before it is safe to have a surgical procedure and undergo a general anaesthetic.

All surgery carries a risk, and bariatric surgery perhaps more so than most – particularly as your health is likely to be compromised already in order to render you eligible for surgery.

It is important to discuss all this in detail with your surgeon before agreeing to go ahead. S/he may also advise that you seek some psychological help to prepare you for the inevitable change in the way you approach your diet post surgery.

What’s the treatment like?
A gastric balloon procedure is usually performed under heavy sedation rather than general anaesthetic. The silicone balloon is inserted through a tube from your mouth to stomach and then once in position it is filled with the saline until it is too large to pass through your intestines.

Gastric band surgery is performed under general anaesthetic and the band is inserted into the abdomen using keyhole surgery through five or so small incisions.

The band is then adjusted by saline being injected until the right level of restriction is achieved. You should be offered follow-up appointments for the band to be checked as you may need the band inflated or deflated further.

A gastric bypass is carried out using keyhole surgery through five or six small cuts. It can also be carried out as an open operation with one vertical cut in the abdomen.

A stapler is used to divide the stomach into two parts which, like gastric band surgery, creates a much smaller stomach pouch.

Then, in a further step, the food bypasses the stomach and much of the intestine through a small intestine that has been rerouted and grafted onto the small stomach pouch – this means that the body does not absorb calories in the same way.

What happens afterwards?
Gastric balloon: you will go home on the same day and there is little downtime. However, it will take longer to adjust to the sensation of having the gastric balloon in place as it floats in your stomach.

You should be provided with strict diet guidelines and advice as it is imperative you have established a healthy diet before the balloon is removed after six months. This procedure can be repeated if necessary.

Gastric band surgery: you should be able to go home one or two days after the operation. Most patients will need approximately two weeks to recover from the procedure itself and it will take quite a bit longer to totally adjust to having the gastric band in place and what impact that has on your daily life. 

On average, most people lose around half their excess weight within two years of surgery.

Gastric bypass surgery: this is a major surgical procedure that carries more risk of complications than gastric banding.

By reducing your calorie intake, it can also cause deficiencies in certain vitamins, minerals and nutrients so you should ensure your diet is high in certain components and you may even need to take supplements as well.

One consideration to take into account before embarking on any of these procedures is that it might not be your final surgical step towards achieving a new you.

Skin that’s been stretched massively does not just ping back and you may be left with a degree of sagging skin and stretch marks that may need further procedures, such as a Body Lift, Abdominoplasty, Thigh Lift, Brachioplasty, Breast Reduction or Mastopexy to remove.

Liposuction may also be desired to remove the final stubborn pockets of fat.

Will I have a scar?
A gastric balloon procedure doesn’t leave any scarring. The other two procedures will leave you with a few small keyhole incision marks or one larger surgical scar if performed as an ‘open’ procedure.

Cost
A gastric balloon costs from £4,000 to £5,000; gastric banding costs from £5,000 to £9,500 and it can cost up to £15,000 for a gastric bypass.