John LoMonaco, MD, PA
1009 Missouri Street
Houston, Texas 77006
phone: 713.526.5550
fax: 713.526.5563
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Plastic surgery is truly experiencing a renaissance, and it couldn't come at a better time. New materials are being added every day to our armamentarium, and new techniques are being refined and developed. The need for new approaches is greatest for patients who have had bariatric surgery, or those who have lost a large amount of weight by dieting. Addressing the issues of the damaged and excess skin is challenging to say the least, but has spawned in my opinion is a new sub-specialty in plastic surgery.

The following information is designed especially to address the concerns of weight loss patients and those requiring more advanced body sculpting techniques. I have dedicated a separate section of this website, and also developed an entirely new website to accommodate what I consider to be the most challenging, rewarding, and fascinating group of patients I have worked with.

Weight loss patients have different problems, different needs before and after surgery, and different procedures needed to correct their problems. Furthermore, their tissues respond differently, and the complication profile is entirely different from "standard" plastic surgery patients.

A Special Word for Weight Loss Patients
Weight loss patients, or patients who have undergone bariatric surgery, pose special concerns for the plastic surgeon. While the information contained in this folder doesapplies to bariatric patients, this group of patients often has special needs that must be recognized by the surgeon.

Goal Weight and Timing of Surgery
Your surgeon will discuss with you the proper timing of surgery. Rather than fixate on a certain goal weight, he may decide to wait until you reach a stable weight over several months. Consultation with your bariatric surgeon may be needed, but most patents can consider plastic surgery about 1 year after their bariatric surgery The timing of surgery also depends on your original weight and BMI and the type of weight loss surgery you have had.

Fluid collections after surgery
Because a large amount of skin is often removed, space is left beneath the skin. Drains are placed to remove this fluid until your body is healed. This process can take many weeks. Drain care is simple and can be done at home, but your doctor will tell you about your chances of developing a fluid collection. The retained fluid can become infected and require aspiration or re-insertion of drains to treat. Hospitalization is rarely needed but is a possibility. Wearing your compression garment and following your doctor's directions after surgery can help minimize the chances of a fluid collection after surgery.

Nutrition
All weight loss patients have special nutritional needs. Before surgery, it is very important to be sure you are getting enough protein intake. This is essential for normal healing. Your vitamin absorption may also be limited, and proper intake of vitamins is also needed to ensure the best nutritional status before surgery. Your doctor will perform blood tests before surgery to determine any deficiency you may have. Excessive dieting before surgery should be avoided, as it can lead to poor nutrition and cause healing problems.

Some patients may develop a mild anemia after weight loss surgery, and this should also be corrected as much as possible before surgery. The anemia may make a blood transfusion more likely, and your doctor will discuss this issue carefully with you. Several options are available in case a blood transfusion is needed after surgery.

Your emotional status before and after surgery
Obesity Help Magazine 2003
"Mastopexy: An Uplifting Experience"
This is a short article about best candidates for breast lift.
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Obesity Help Magazine 2005
"Be Smart About Looking Good" This is an article about checking your surgeons credentials and the importance of board certification.
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Nuestro MundoMagazine 2005
"Ser Intelligente En Cuanto a Verse Bien" This is an article about checking your surgeons credentials and the importance of board certification.
En Espanol.
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Houston Chronicle February 2002
"Legacy of Love and Pain" An award-winning story by Daniel Vargas, featured in the Houston Chronicle about a burn patient I cared for. She survived a vicious attack, a 3-month hospitalization with 10 surgeries, and emergency evacuation when Hurricane Allison flooded the hospital.
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Tips on Getting Insurance Coverage
A document prepared with the help of my patients that gives a brief overview of what weight loss patients can do to help get insurance coverage for medically necessary surgery.
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Patient Financing. We participate with the following companies who can finance all or part of your surgery:

www.carecredit.com
www.capitalonefinance.com
www.healthready.com