Morbid obesity is defined as a Body Mass Index of 40 or more (about 100 pounds or more overweight). It is a state of severe obesity, which, according to The American Obesity Association, affects 9 million American adults.

The extreme weight associated with morbid obesity stresses the body, interferes with quality of life and increases the risk of several health problems. People who are seriously overweight are at higher risk of developing type 2 diabetes, high blood pressure, high cholesterol, heart disease, stroke, gallbladder disease, gastroesophageal reflux, pancreatitis, liver problems, respiratory problems, sleep apnea, arthritis, back pain, kidney disease, and certain types of cancer. Researchers estimate a 25-year-old morbidly obese person has a reduced life span by about 12 years.

Dieting and exercise are crucial to losing weight. The body must spend more calories than it takes in to start burning off excess fat. However, for the morbidly obese, traditional weight loss is extremely difficult. Many patients turn to weight loss surgery (bariatric surgery). Although there are several different surgical techniques, the goal of the surgery is to reduce the size of the stomach and the number of calories consumed/absorbed at a time. Research shows patients who lose weight after bariatric surgery decrease or eliminate their risk for many of the health complications associated with obesity.

After the Weight Loss

People who gain a lot of weight not only have excess fat, but excess skin as well. Weight loss surgery can help patients to lose the fat. But the stretched, excess skin often remains, and causes unsightly creases and flaps of hanging skin.

To restore appearance, some patients turn to cosmetic surgeons. Doctors often use one or more techniques to contour the body and smooth out the skin lines. One procedure, liposuction, is used to remove excess fat from a specific area of the body. The surgeon inserts a thin, hollow tube (cannula) though a small incision made in the skin. The tube is connected to a vacuum device. The cannula is moved back and forth across the underlying tissue to break up the fat deposits. The excess fat is then suctioned through the cannula by the vacuum.

Another common procedure is the tummy tuck (abdominoplasty). The procedure is designed to eliminate excess skin. It can also be used to tighten muscles in the abdominal wall. An incision is made in the area (or just above) the pubic area. The skin is pulled down and the excess is cut away.

Body contouring surgery is extremely popular. According to the American Society of Plastic Surgeons, more than 106,000 procedures were performed in the U.S. last year. More than half of the procedures (56,000) were for people seeking cosmetic correction after massive weight loss.

The PULL Technique

While body contouring works well to eliminate many of the unsightly sags in the abdominal area, some patients have skin sagging in the pubic area as well. The skin pouches that develop in this area aren't effectively treated with liposuction or a tummy tuck.

Plastic Surgeon, Steve Fallek, M.D., has developed a technique that specifically addresses skin sagging in the pubic area. He calls his procedure PULL (Pubic Undermining Lift and Liposuction). Two small incisions are made in the pubic area (near the bikini line). First, liposuction is done to remove excess fat in the area. Then the incision is enlarged. The skin is lifted and pulled to create a smooth appearance. The excess is cut away and the skin lines are closed.

The PULL procedure can be performed alone or in combination with a tummy tuck or other cosmetic procedure. There is very little bruising afterwards and most patients recover within a day or two. Scars are hidden in the bikini area.

Dr. Fallek says, the PULL procedure isn't jusy for weight loss patients. Many people are becoming self-conscious about sagging skin in the pubic area. With the emphasis on low-cut fashion, the PULL procedure may benefit these patients, as well.

SOURCES

American Society of Plastic Surgeons, http://www.plasticsurgery.org