Panniculectomy After Massive Weight Loss - Transformation Tuesday with Dr. Katzen

Speaker 1:

Both hands [inaudible]. Go ahead and drop the weight forward. [inaudible] the hip and then move yourself up. Lock those hips out with each one of those reps. From here...

Speaker 2:

Those are the pants you used to wear?

Linda:

I used to wear these. What, three years ago? Two years ago?

Speaker 2:

Two years ago.

Linda:

About two years ago. I fit in one pant leg.

Speaker 2:

She is in one pant leg. Look at that.

Linda:

One pant leg. Except for my bowling ball, but that will be gone in a week. But yeah, that's what I used to wear.

Speaker 2:

This is a very dangerous surgery are you sure you want to do this?

Linda:

And look. I even sewed it up.

Speaker 2:

Wow.

Linda:

So it was even bigger.

Speaker 2:

Oh my goodness. Bigger than that.

Linda:

I wear this around the house now. I had to sew that up. So this is what I wear around the house.

My name's Linda [de Latori]. I'm 44 years old. I I work for a worker's comp company. I had weight loss surgery four years ago. I lost... all together I've lost 177 pounds. For the weight loss surgery, they did a great job. I lost 65 pounds right away. From then, it was just... the energy you get from losing so much weight is remarkable, so then I got into working out. I was working out all the time for another year, so I lost another 50 pounds with the studio I go to. It started to get a little hard to do a lot of the different things they do at the gym, because it's classes. With the weight loss, the skin started hanging, and it was... modifications weren't working anymore.

Dr. Katzen:

What I see is everything from about maybe here, maybe a little bit higher, all that will be gone. So from here out to basically where this crease meets together there...

Linda:

Mm-hmm (affirmative).

Dr. Katzen:

All this will be gone.

Linda:

Wow.

Dr. Katzen:

So it will be much, much better.

Linda:

[inaudible]

Dr. Katzen:

So I imagine... Let's take some before pictures and... all this scar, belly button stalk will be gone. Can you lift up tummy? Is that possible?

Linda:

Yeah.

Dr. Katzen:

Great. Also the pubic region. I'm going to go low in the pubic region so it raises that.

Linda:

Okay.

Dr. Katzen:

Okay, so that will be much better for you.

This is your midline. And I'll match this up with the pubic region. [inaudible]

This bottom line to this top line.

Linda:

Oh my gosh.

Dr. Katzen:

Alright?

Linda:

I don't even know how to react to that, [crosstalk] be weird.

Dr. Katzen:

It's all going to be good. It'll be a lot easier to move around, exercise, clothing, hygiene...

Linda:

Just moving around.

Dr. Katzen:

Yeah. Life changing experience.

Linda:

Yeah.

Dr. Katzen:

So it'll be good. It'll be very good.

Linda:

Thank you for the marking.

Dr. Katzen:

Sure. My pleasure. Over the next little while, just say goodbye to this...

Linda:

Okay.

Dr. Katzen:

And we'll get rid of it for you.

Linda:

I have plenty of pictures. That's good.

Dr. Katzen:

Okay.

In Linda, she weighed 420 pounds, and when that happens... There are two chambers in the body. There is the chamber around the stomach, which develops fat, and then there is that chamber outside the stomach, outside the stomach muscles, which also can develop fat. The analogy that I use is like a glass jar. Inside your abdomen, below your rib cage, above your pelvic region, you have this chamber. It's called the peritoneal cavity. This is where the stomach is, this is where the liver is. It's all in this chamber. When you gain weight, this whole chamber expands. It gets bigger and bigger and pushes everything out. That's because, one, the chamber gets bigger, and two, there's a lot of fat that develops around the stomach and a lot of fat that develops around the small intestines. So it pushes this whole jar out.

In addition, outside this glass jar, you have your six-pack muscles, a layer of fat, and then the skin on top of that. So when you gain weight, you also gain a layer of fat just underneath the skin. So one, you got the chamber on the inside pushing it out, and two, you're gaining this layer of fat, thicker and thicker and thicker.

So in Linda, not only did that chamber get bigger, but she also developed a significant layer of fat on top of that. Then she lost about 170 plus pounds and that layer of fat just underneath the skin went down, and that chamber on the abdomen went down a little bit. Not a lot, but a little bit. So that's why, on her, that abdominal cavity still is sticking out.

So what happens with massive weight loss patients, when they lose the weight, the skin tries to recoil. But it's not perfect, it can't recoil all the way. When you're gaining weight, the weight gain goes for the spot on the skin that has the most pliability, the most stretch to it, and that's typical in the lower abdomen below the belly button. So that's why it expands in that area.

So even though Linda had lost about 170 pounds, she still has a lot of excess fat typically in that pannus. The pannus is the area that sort of hangs over the pubic region. What we're going to be doing is a panniculectomy, getting rid of that pannus, that skin and fat that hangs over the pubic region. Most of that is excess skin, okay, but primarily, 95 percent excess fat. That's on the, not inside the chamber, but on top of that chamber. That's the layer that's hanging out. So we're not doing anything to the inside of the chamber, we're just working on the outside of the chamber.

Dr. Katzen:

Okay. [crosstalk] lift up. And this is...

Linda:

Hold on. It's slipping. Okay.

Dr. Katzen:

So this is our midline. [inaudible] [crosstalk]

Dr. Katzen:

[crosstalk] Did you get any sleep last night?

Linda:

About five hours.

Dr. Katzen:

Oh, that's good.

Linda:

It was a good sleep.

Dr. Katzen:

Did you do anything fun yesterday?

Linda:

I took a hydro. I did a lot of filming yesterday.

Dr. Katzen:

Filming. Oh, so you were busy a while.

Linda:

Yeah. I went to the beach on...

Dr. Katzen:

Good.

Linda:

... Sunday.

Dr. Katzen:

Thank you.[inaudible]

Linda:

It was a difficult surgery because what I had was really big. I think it ended up being 34 pounds. So, I was a little worried that it was... going under the knife for this big thing. Then I was excited because it was going to be gone. It was going to change my life. And it has.

When I first saw my thighs, I started crying. Here I go again. I didn't feel different, but I felt emotionally... I felt amazing because I knew it was gone, and I knew that was going to change everything forward.

I look at my pictures online, or just in my thing, and I'm like, "Who is that?" That's really not me. I stand sideways, I'm like, "Look, there's not a big belly sitting there."

It's been a little rough because after that surgery, a few months later, I had another surgery, and I've got another surgery, so I haven't experienced what I'm really excited to experience. The moving around, the hiking, going to Disneyland, getting on all the rides and having fun. It's been a good experience. I'm learning a lot. I'm feeling much better. My blood pressure is great. I didn't really have any other health issues, but I still feel a lot better. More energy. I'm excited. 2018's going to be great... when I'm done recovering.