Gastric banding is performed far less often than it once was, and many patients who had a band have since had it removed or converted to a sleeve or bypass. That history matters for body contouring, because it usually means weight loss happened in two phases rather than one.
Why the band group is different
- Slower, more gradual loss. Skin has longer to accommodate, so the excess is sometimes less severe than after a bypass — though after very large loss it is much the same.
- Two phases of loss. Loss with the band, often some regain, then further loss after conversion. Stability is what matters, and it is the current plateau that counts.
- Port site scars. Usually on the upper abdomen, and they can often be incorporated or improved at the time of an abdominoplasty. Raise it — it is easy to plan for and irritating to be left with.
- Reflux and oesophageal issues are common in this group and worth having managed before an anaesthetic.
If the band is still in place
Body contouring can be considered with a band in situ, provided your weight has been stable for at least six months and you are nutritionally sound. What matters is that your weight is not still moving — a band that is being adjusted is a weight that is still changing.
Discuss the timing with your bariatric team as well as with Dr Kumar.
If the band has been removed or converted
Date the six months of stability from the current plateau, not from the original band surgery. A conversion to sleeve or bypass restarts the weight loss process and, with it, the clock.
Where a conversion is planned but not yet done, body contouring waits. Operating before further weight loss produces a result that will not hold. There is background on judging stability at My Weight Loss Journey.
Nutrition
Deficiency is less common with a band alone than after a bypass, but a converted patient carries the risks of whichever operation they now have. Protein, iron, B12 and vitamin D should be checked and corrected before surgery, because wound healing depends on them. Dietitian input is available before surgery.
Medicare
The items ask about the consequences of the weight loss, not how it was achieved:
Item 30166 — weight loss equivalent to at least five BMI points, weight stable six months, functional problems.
Item 30177 — intertrigo or another skin condition failing three months of conventional treatment, interference with activities of daily living, weight stable six months.
Note that total loss across both phases is what counts, not the loss since conversion alone. The full criteria.
Recovery
The same as for any body contouring: two weeks off work, a gradual return over the following four weeks, full clearance at around twelve. Drains are used and a compression garment is worn for six weeks. Complete abstinence from all nicotine, not just smoking, for eight weeks before and after. The week-by-week timeline.
Common questions
Can the port scar be removed? Often it can be incorporated or improved during an abdominoplasty. Ask specifically.
Do I need the band out first? Not necessarily, if your weight is stable and you are nutritionally well.
My weight went up and down for years. Does that matter? What matters is the last six months.
Is a hernia likely? Less so than after open surgery, but it is assessed. Combined with hernia repair.
Next step
Bring a GP referral, recent bloods and any bariatric letters, including the band history. Dr Kumar consults at Westmead, Penrith and Orange, and you can send photos first. Call 1300 267 726. More about skin removal after bariatric surgery.
The initial consultation with Dr Kumar is $400, with a Medicare rebate of approximately $88 where you have a GP referral. Surgical fees are quoted individually after your consultation, in a written itemised quote.
All surgery carries risks, and individual results will vary. Read more about the risks of surgery here. A GP referral is required to see Dr Kumar.
Dr Rohit Kumar (MED0001630444) Registered medical practitioner, specialist plastic surgeon (specialist registration in surgery – plastic surgery).
