Antonia S.: There’s two sides to how I feel about my body now. One is proud that I’ve lost almost 200 pounds. That’s no simple feat. But I’m also disappointed when I see my excess skin. It makes me depressed. Even though I have this gorgeous upper body and gorgeous waist, it’s diminished by the fact that I have what feels like tumors on either side of my leg.
Speaker 2: Taking your mind off a stressful day, it’s the Night Side, hosted by Barb DiGuilio, on Newstalk 1010.
Barb DiGuilio: Welcome back to the show. We’re glad to have you along on a Thursday night. There’s a new show that airs alongside this show called “My 600 Lb Life” and this one is called “Skintight.” It deals with the situations people are in once they’ve lost a large amount of weight and are left with all this excess skin. That woman you heard is Antonia Strickland. She’s proud to have lost nearly 200 pounds, but the weight loss has left her with a lot of excess skin, especially on her lower body. Joining us to talk about what can be done in situations like this is our friend, Dr. Stephen Mulholland, founder of SpaMedica and one of the Canada’s top cosmetic surgeons. Welcome back to the show.
Stephen M.: Barb, thanks for having me.
Barb DiGuilio: Is this something that you deal with in your practice?
Stephen M.: Yeah, we have a lot of patients in Toronto because it’s a large city that have opted for the nontraditional weight loss tactics for the excessively heavy or obese patient called gastric manipulation, “gastric” meaning tummy. There can be balloons that are put in for moderate weight loss. There can be external sheaths, banding that constrict the size of gastric content, or the most commonly performed one nowadays is the bypass, gastric bypass, where a different part of the bowel is hooked up to the stomach and nutrients bypass the normal digestive process. You can lose massive amounts of weight like this. The story is phenomenal. To see people like that is to be congratulated. It’s a tremendous amount of work and commitment over a year and a half to two and a half years, but then they are betrayed by the stigma of the weight loss by this massive amounts of billows of skin that doesn’t have the contractile capability. It’s like you are permanently pregnant and then finally after 15, 20 years your baby came out but the skin just stays there.
Barb DiGuilio: Is it an amount of weight or a number of years that makes it so that the skin won’t shrink back?
Stephen M.: Well, it’s both, Barb, you’re absolutely right. But it’s truly a function of weight, distension, and time. Over time, the elastic fibers in your skin get stretched and they don’t have a recoil ability almost, like you see the white bands in an elastic band. It gets frayed. Your skin gets frayed. You don’t see them until you’ve lost the weight. Then it’s billows of loose skin and stretch marks. It’s worse than stretch marks. This will happen most commonly on the abdomen, but also on the flanks, on the arms, on the inner thighs, and the outer thighs. These are the top four areas that these poor patients who have committed to getting healthy, to losing the weight, are stigmatized by. Then they have to do the second surgery, which is often more expensive than the gastric bypass surgery.
Barb DiGuilio: Is it covered at all?
Stephen M.: No, it’s not, unfortunately. The loose skin isn’t. Sometimes in the United States where this show airs, the third party insurance will cover the weight loss surgery because it’s such a health risk, but in Canada gastric bypass surgery can be covered and it has to be approved by Ministry of Health or other provisional health programs. But they do not cover lap band or gastric ballooning, only bypass. Then you have to [inaudible 00:04:02] with a lot of health issues, and then you’re still left with this stigma of very expensive, what’s called, body lift surgery, tummy tucks, flank lifts, thigh lifts, arm lifts basically you’re taking away three times your skin surface area in a series of operations and that’s costly.
Barb DiGuilio: How series and complicated are the operations?
Stephen M.: Well, you know, in the US they’re much more apt to do what are called total body lifts. You do a circumferential lift to the tummy and the back combined with a thigh lift, a breast lift, and an arm lift. That can go on for 14, 15, 16 hours and it can have as high as 5% or 6% mortality. In Canada, like most things, we’re a little more reasonable and we tend to break the operations up into segments, like a tummy and back lift, take a break, then a thigh lift, and then maybe an arm lift and breast lift. In over two to three procedure stage, we can often get your body looking rehabilitated but then there’s going to probably be a neck lift and maybe even breast implants, oddly enough, after all the weight loss and the breast lift. Usually it’s staged, what I call aesthetic reconstruction of this loose skin, over two, three, or four years and several sessions to get the sexy feeling back that the weight loss should have brought.
Barb DiGuilio: Well, you know, it’s interesting that you mention the breast implants. I’ve seen some of these shows where the weight gain is so much that people’s breasts are under their arms.
Stephen M.: Yeah, it’s really quite sad and it’s disheartening. These poor people, they lose the weight and then they’re left with these billowing folds of skin and these [tautic 00:05:43] breasts and sometimes I tell some patients, not morbidly obese, but patients who are a little Rubenesque, full-figured, attractive-looking full-figured gals, especially when they’re young, it’s better to be smooth and full-bodied than all deflated with loose skin. That looks old and it doesn’t look attractive. Body lift surgery has been a godsend. We specialized for the last 15 years in some great results, but it’s multiple sessions. There are some risks. It is expensive. But it can be as transforming as the weight loss.
Barb DiGuilio: What are some of the costs that people would be looking at for different body parts?
Stephen M.: Yeah, you would be looking at a good- The biggest one is the front and the back lift, the tummy tuck and the back lift, and that can run between $14,000 and $20,000.
Barb DiGuilio: Wow.
Stephen M.: Then inner thigh lifts are usually $8,000 to $10,000, and a breast augment with an arm lift is again about $20,000. It can cost you, over time, $40,000 to $50,000, or an expensive Tesla, to get your body looking the way you want. Most people end up financing it over a period of 60 months or something with manageable payments.
Barb DiGuilio: No government rebate, even though it’s like a Tesla.
Stephen M.: Yeah, you think you would, especially the weight loss surgery. It’s good that that’s covered under [inaudible 00:07:01] but many provinces, it’s not. It’s a tremendous health risk. Diabetes, heart disease, stroke cause millions and millions of dollars. I see weight loss surgery, the gastric bypass, that is, as a good investment by the government and then, of course, the cosmetic consequences we wouldn’t expect the taxpayer to cover, but the patient needs to go in with their eyes wide open. They get a government-covered gastric bypass and then a very expensive luxury car to get their figure back the way they want.
Barb DiGuilio: People can find out more, I guess, on your website about this?
Stephen M.: Yes, they can, body lifting, breast lifting, thigh lifting.
Barb DiGuilio: Alright. Dr. Stephen Mulholland, thank you so much.
Stephen M.: Thanks again, Barb.
Barb DiGuilio: See you soon. Founder of SpaMedica, one of Canada’s top cosmetic surgeons.