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This is a good question with some variables. Most plastic surgeons are more than happy to answer at anytime during your journey. Often times, I will do presentations to support groups before and after their gastric bypass surgery. This a great way to become familiar with the types of surgeries that are available and usually the group members an likewise help guide you. You should visit the plastic surgeon when you start having concerns, most generally a few months after surgery. This is a great time to see if you and the doctor and his staff “click”, usually this a relationship that will last for several months to years. Generally, most plastic surgeons like to see weight stabilazaton (+/- 10lbs) for six months before surgery. But one should try to gather information months before this so you can make all the appropriate arrangements.

Thomas B. McNemar, MD, FACS
Plastic Surgeon
Website

I am four months post-op lap RNY. I have lost 83lbs but my hair is really falling out. Also I am dumping about once a week. Is this normal still? I have been eating peanuts, is that okay? They have lots of protein.- Vickie S.

Dear Vickie,

You are doing great with your weight loss. Dumping syndrome is caused by eating the wrong foods. Be careful to avoid carbohydrates or foods with large amounts of sugar. If you avoid these foods you should not have dumping syndrome. Peanuts do contain protein but also a lot of fat so they should be eaten in moderation. As far as the hair loss there is sometimes no way to stop that. We usually recommend eating more protein as well as zinc and biotin supplements. Your body is in a catabolic state that is breaking everything down including your hair. When your weight loss slows down so will the hair loss and the hair always comes back. Most patients report noticing the hair loss in the shower but usually friends and family will not even notice it.

It makes a difference if you are using the liquid to wash food down.   If you do that you will eat more,and not feel satisfied with less. The idea is to take your time eating. Patients who drink wine with a meal lose more weight than those who do not (our own data and that of others). Wine drinkers tend not to slosh down wine with the meal - but take their time, eat slowly, and enjoy the meal. Too often people use liquid instead of their natural saliva - because they eat too fast, swallow too large a bite-- and if you have a band this can lead to band slips and band erosions. If you have a Vertical sleeve this will stretch it out, and if you have an RNY this leads to stretching the stoma. The key to weight loss after surgery is to eat slowly - enjoy the food, take your time-- be proper.

Terry Simpson, MD, FACS
Bariatric Surgeon/OH Magazine Medical Editor
Arizona Bariatric Center
Website

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