SURGERY FOR WEIGHT LOSS: LIPOSUCTION, JAW WIRING AND MORE
LiposuctionLiposuction involves the suction of fatty material from under the skin by way of a trochar. It usually results in the removal of approximately 3 L of fat, but can sometimes involve the loss of 10-12 L in extreme cases. Although the technique has been attempted as a treatment for the morbidly obese, its value is as a cosmetic procedure. It has no influence on visceral or abdominal adiposity and therefore has no appreciable physiological effects on insulin resistance or other comorbid disease markers.
Jaw wiringJaw-wiring procedures are no longer recommended. The weight lost was rapidly regained once the wires were removed, often despite the fitting of a cord round the waist to limit the amount of weight regained.
Apronectomy Apronectomy is not a treatment for obesity but is helpful for patients who have lost large quantities of weight and have overhanging folds of excess skin. Skin contouring operations are not restricted to the abdomen; other sites include brachioplasty, and the inner and outer aspects of the thighs. Abdominal apronectomy can be circumferential, and males can undergo gynaecomastia correction.It can be very psychologically damaging to deny patients such surgery on cost or other grounds after they have followed medical advice diligently but are left feeling uglier and with a lower self-esteem than when they started. It is a technically straightforward procedure, and its satisfying results can help maintain long-term weight loss.
Artificial bezoarAn artificial bezoar is a balloon or other object that is inserted into the stomach to lessen its capacity as a restrictive technique. It has a limited role but can be beneficial in, for instance, initiating weight loss in the short term in individuals who are not fit for more major surgical procedures.*62/312/5*
