Consequences of Weight Gain After Plastic SurgeryJanuary 26, 2022
With all of the excellent food choices that surround us, weight gain is a common occurrence. However, gaining weight after a plastic surgery procedure is a significant issue and has an extra set of consequences. Postoperative weight gain can occur for many reasons, including changes in hormonal levels and the stress of recovery. Let’s explore these topics further.
Causes of Weight Gain After Plastic Surgery
Right after plastic surgery or the acute postoperative phase:
Immediately after plastic surgery procedures, patients gain weight. This type of weight gain is multi-factorial.
Edema or swelling
Most weight gain in the acute postoperative healing phase is from edema, a medical word for swelling. After plastic surgery, the body stores and absorbs fluid naturally; this is called postoperative edema.
Edema is expected from almost all types of reconstructive plastic surgery after weight loss. On average, it takes 6-8 weeks for this postoperative edema to be processed by your kidneys and excreted through urine.
Lack of exercise
During the postoperative phase, most patients are not exercising. Exercising in the acute healing phase is not suggested because exercise may place undue strain on surgical incisions. Excessive tension and strain can promote wound dehiscence or incision openings.
Also, exercise can increase blood pressure, which can cause unnecessary bleeding. Resumption of exercise is patient and procedure-dependent. In general, if everything is healing well, 4 to 6 weeks after plastic surgery, light exercise is allowed. More intense exercise may be allowed 2 to 3 months after your plastic surgery procedure.
Poor food choices
Another reason for weight gain in the postoperative phase is that patients may not eat their routine diet-friendly food. Patients may be tempted to eat non-nutritious food and sometimes even junk food in the acute postoperative phase.
During the postoperative period, you need to eat optimal food. Your diet should be high in protein. Your goal should be 80 to 100 g of protein a day. Most patients can achieve this goal with protein drinks. Usually, 3-4 weeks after surgery, you can decrease your protein intake and return to your regular pre-operative diet.
Long after plastic surgery or the long-term postoperative phase:
Losing weight is certainly not easy. Neither is undergoing plastic surgery after weight loss. Let’s explore some reasons why people gain weight long after their surgery.
Leptin is a hormone made by fat cells. Leptin acts on an area of your brain called the hypothalamus. As leptin levels increase, your appetite decreases. When your body fat falls, leptin levels drop, and your appetite increases.
Ghrelin is a hormone secreted by the stomach wall. Ghrelin triggers feelings of hunger, increases appetite, and plays a role in body weight.
PYY is another hormone and is secreted by the small intestine after meals. PYY is an appetite suppressant and counters ghrelin, an appetite stimulant. Finally, insulin is secreted in part by the pancreas in response to rising blood sugars levels. One of insulin’s functions is to suppress appetite in the brain.
After plastic surgery, all these hormones are altered.
Many things can cause stress, especially plastic surgery. First, there is stress that occurs right after surgery; this is called acute stress. Second, there is stress, which is caused long after surgery; this is called chronic stress. Acute and chronic stress are very different.
Right after surgery (acute stress), your body secretes corticotropin-releasing factor or CRF from the hypothalamus. CRF directly decreases your appetite. Another critical hormone is neuropeptide Y or NPY. Naturally, NPY decreases metabolism and increases appetite.
During acute stress, your body inhibits NPY, thus reducing appetite. In comparison, during periods of long-term stress (chronic stress), recent studies show that your leptin (appetite-suppressing hormone) levels drop, making you hungrier and more likely to overeat. In addition, chronic stress has been shown to cause insulin to be less effective (insulin resistance). Insulin resistance due to chronic stress can cause weight gain.
Poor food choices
Recently, research showed that foods high in sugar, salt and fat, can stimulate the brain reward system. This may explain why some patients preferentially eat highly palatable foods in an attempt to feel better during long periods of stress.
Not enough sleep
Not getting 8 hours of sleep can impact weight gain. Studies show that patients who sleep less than 5 hours have elevated ghrelin and lower leptin levels than patients who sleep 8 hours or more.
That means if you do not get enough nighttime sleep, your appetite increases, and you are more likely to gain weight.
Uncomfortable with their “new” body
Some patients feel that they look “too good” after plastic surgery. This may have negative consequences, like attracting too much attention from others. In addition, sometimes, postoperative plastic surgery patients lose friends and family because they look so good. As a result, patients may self-sabotage their results, so they fit in better with old family and perhaps, regain lost friends.
Consequences of Weight Gain After Plastic Surgery
YOU CAN RUIN YOUR PLASTIC SURGERY RESULTS.
In general, after plastic surgery, you should try not to gain weight unless you are severely underweight. However, if you gain significant weight after plastic surgery, you can destroy your plastic surgery results.
Physical consequences of weight gain after plastic surgery:
- Fat accumulation: Weight gain after plastic surgery increases your number of fat cells. Fat cells collect in 2 places. First, fat can accumulate around the intestines. This is called visceral fat.
- Second, fat can also collect under the skin. This is called subcutaneous fat. Visceral fat accumulation can distend the abdomen and push against the abdominal muscles, ruining your tummy tuck or lower body lift results. Additionally, subcutaneous fat collection can make you appear fatter. Both visceral and subcutaneous fat can distend the skin. Thus, fat accumulation can ruin your results.
- If the weight gain is severe, you can develop diabetes or high blood pressure.
- If you stretch your skin out too much, you may need corrective plastic surgery. However, if you gain too much weight, the stretched skin may not be able to be corrected.
- If you regain weight, this adds extra pressure on joints, making it more challenging to ambulate and exercise.
Emotional consequences of weight gain after plastic surgery:
- Questioning of self-worth
- Feeling of financial loss because of loss of results
- Feeling of defeat
- Loss of self-confidence
Financial consequences of weight gain after plastic surgery:
- Plastic surgery is expensive. If you ruin your results, you will have wasted all that money spent on the procedure and the time off work. Also, all the postoperative pain will have been for nothing.
- If you ruin your results so severely that you require secondary corrective plastic surgery, you will be paying for the same procedure twice.
Ways to Avoid Weight Gain After Plastic Surgery
At 4 to 6 weeks from surgery, you will hit what I call the “critical nutrition phase.” The “critical nutrition phase” is when your body adjusts to your new weight.
Basically, with plastic surgery, fat cells are removed, and your body resets its thermostat as to what you should weigh. This is probably achieved through the hormones ghrelin, leptin, NPY, and PYY. These hormones tell your brain that fewer calories are required for normal daily function. Hormones are challenging to control, but these are some ways to manage and curb weight gain after plastic surgery.
- Focus on your short and long-term goals. Set short-term goals of what you will do today and what you are NOT going to do today. Do eat right every single meal. Do not eat junk food. Do not sit on the couch and binge-watch the latest series on Netflix. Set long-term goals of what you want to weigh in six months. Perhaps, set a goal of wearing a certain piece of clothing you want to wear, like a dress or outfit. Or perhaps, schedule a vacation to Hawaii where you want to wear a particular bathing suit.
- Eat right. If you notice yourself gaining weight after plastic surgery, you must limit your caloric intake. Count your calories. Watch your macros and micros. Get an App on your phone. Avoid all alcohol and sodas. Avoid caffeine and sugars.
- Eating is essential, but so is drinking. Plan to drink 2-3 liters of water per day.
- Exercise as much as possible every day.
- STOP smoking
- Sleep 8 hours a night
- Avoid stress and have some “me time”
If you gain some weight in the first 4-6 weeks after a plastic surgery procedure, that is OK. Everyone's weight gain is different due to anatomy, metabolism, and genetics. That may be part of your routine healing.
However, at the 6-8 week mark, you must watch what you eat. This is when your new weight baseline is being established. Bottom line: do not gain weight after plastic surgery. In general, try not to gain more than 10-15 lbs. after plastic surgery. You are undoing all the things you were striving to achieve.
If you notice yourself gaining weight after plastic surgery, you must limit your caloric intake and exercise routinely. Do not ruin all that effort and expense of undergoing plastic surgery. Make sure to research and be informed about body contouring after massive weight loss.
Plastic surgery can improve your life in many ways as long as you follow your surgeon's guidelines.
ABOUT THE AUTHORDr. J. Timothy Katzen is certified by the American Board of Plastic Surgery, and is the President of the American Society of Bariatric Plastic Surgeons. Dr. Katzen specializes in reconstructive plastic surgery after massive weight loss. He has written many articles and given lectures around the world about how to perform plastic surgery on patients who have undergone massive weight loss. Dr. Katzen has plastic surgery offices in two different states and two different countries. Specifically, he has offices in Beverly Hills (California), Las Vegas (Nevada), and Dubai (United Arab Emirates). Read more articles from Dr. Katzen!