Richard Baker Weekly Blog

Body Contouring in the Massive Weight Loss Patient

Massive weight loss is defined as when a person loses 50% or more of their excess body weight. For example, if a person weighs 100 kg but their ideal body weight would be 60 kg on the basis of their height, then their excess body weight is 40 kg and if they lost 20 kg or more, this would be massive weight loss.

Some people achieve this through diet and exercise and others through surgery, in particular gastric bypass, which is a very effective procedure and even cures type II diabetes. Inevitably, after losing a great deal of weight, there is excess skin which does not contract back down to its original size. This is because the skin is stretched beyond its elastic capacity; for example, an elastic band that is held outstretched for a long period will eventually lose its elastic recoil.

Unfortunately, it does not matter how much time elapses since the weight loss; the skin never regains the elasticity of normal skin. The skin also becomes much thinner. The excess skin tends to hang in folds and this causes problems with clothes, taking exercise, personal hygiene and affects people’s self-esteem and relationships. Therefore, removing this excess skin, so-called ‘body contouring’, is a very worthy endeavour.

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Richard Baker Weekly Blog

What is Buried Penis Syndrome?

Obesity causes many problems including arthritis, high blood pressure, heart disease, diabetes and difficulty exercising, but in men it causes another problem that is rarely talked about – buried penis syndrome. This occurs in men who put on weight because the fat underneath the skin pushes the skin outwards to eventually bury the penis, which is attached to the underlying bone of the pelvis and therefore cannot expand outwards with the skin. The problem can reach such a point that men can no longer see their own penis. It makes passing urine difficult with dribbling and this can lead to another condition called balanitis. It is thickening and tightening of the foreskin and the end of the penis (or glans) as well as narrowing of the water pipe. It predisposes to cancer of the penis but also, because of the increased pressure required to pass water, leads to problems with the kidneys.

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