• Is a chronic disease with impaired quality of life and high risk of morbidity and mortality that requires long-term care.
  
• Overweight & Obesity are leading to several Health risks and are the leading preventable cause of death worldwide: (https://www.cdc.gov/obesity/index.html)

Body Mass index (BMI),offers a first rough indication of body weight.

Weight loss can be achieved in 3 different ways. It is important to understand that the conservative, minimally invasive and surgical treatment options for weight loss are not competing procedures, but rather complementary forms of treatment.

Lifestyle change: A change in lifestyle, i.e. a change in eating habits and leisure activities is decisive for maintaining weight loss. Nutritional advice, advice from a physiotherapist, but also advice from a psychologist are part of the basic treatment for obesity

Weight Loss (Bariatirc) Medication: There a new medications that can lead to a significant weight loss.

Weight Loss (Bariatric) Surgery: With the development of minimal invasive surgical techniques, bariatric surgery (gastric sleeve, gastric bypass, …) became an important method of treatment.

Effective weight loss is like “being born for the second time”. However, there are some sequalae of obesity which have to be addressed, in order to improve the Quality of Life and rejoice of the new life.

• Body contour: Depending on the quality of skin, there a more or less significant deformities of the body shape, that have to be corrected
• Skin disorders
• Infertility in male
• Infertility in female patient
• Joint pain and skeletal malalignment
• Sleep disorders
• Snoring

Weight maintenance is an active lifelong process

• Keep a healthy and active lifestyle
• Regular weight check 
• •Regular check-up to control eventual necessary substitution medication (Iron, Vitamin B12)

As a result of the severe weight loss,  there are:

• significant excess of inelastic skin, with typical formation of sagging skin sacs with deep creases (with chronic skin inflammation
• more or less residual fat

The excess of inelastic skin and residual fat  lead to typical contour deformities in various body regions:

Based on many years of research and clinical experience in the field of body contouring after massive weight loss, Professor Robert Hierner has developed a holistic treatment concept, and  successfully used in his daily practice since more than 10 years. 

The goal of the treatment is to achieve a well-proportioned body shape with the highest patient satisfaction and the lowest patient risk

This concept comprises several steps:

Preoperative Care

• Improvement of the general metabolic situation: Wound healing depends on the general condition of the patient (→ Internal Medicine)
• Improvement of the skin condition before surgery: Skin conditions are important for timing of surgery and risk of surgery (→ Dermatology)

Body Contour Reconstructive Surgery

• Body contouring  operations after massive weight loss are usually major interventions, performed under general anesthesia
• To restore the total body shape, 3-4 operations are necessary with a minimum interval of 6 – 12 months
• body contouring operations have long scars, which cannot always be placed in places that are not visible.
• Minor scar revision are always necessary due to the tissue properties

Many patients tend to focus only on the initial state (before) and result of the procedure (after). But healing & rehabilitation after the procedure/surgery (in-between) is just as critical to achieving the goals you desire. 

Rehabilitation helps the natural healing process and therefore is essential to maximize your Plastic Surgery result. The  best result can be achieved by a multidisciplinary team approach

Although as a Plastic Surgeon I generally care for patients on their OUTSIDES, what I do also affects my patients on the INSIDE, too – where the results directly affect body image, self image and self-esteem. 

Topics of specific rehabilitation after Plastic Surgery are:

• Fashion
• Hair do
• Make-up