Weight-loss surgery is only half the story for most patients.

The surge in weight-loss procedures such as gastric banding and duodenal switches among clinically obese people who fail to lose weight by dieting is leading to a new problem.

Typically these people can lose around a third of their total body weight, eight to ten stone or more.  However this is not the end of the story as most go from being unhappy fatties to slimmer, but still unhappy, people because of the acres of loose, saggy flesh left behind! 

Typically these people can lose around a third of their total body weight, eight to ten stone or more.  However this is not the end of the story as most go from being unhappy fatties to slimmer, but still unhappy, people because of the acres of loose, saggy flesh left behind! 

Take the case of 39 year-old primary school teacher, Su Waites, from Dewsbury.  In 2005 Sue had a duodenal switch and, over the next eight months, lost eight of the 20.5 stone she was carrying.  She was left, however, with pendulous bingo wings, sagging breasts, droopy thighs and an unsightly overhang that made it impossible for her to find clothes that fit and flattered her new shape.

"I soon realised the surgery had left me with other, unforeseen, problems; not least the continuous slap, slap, slap made by my surplus flesh as I walked!  I tried to mask it - and minimise the understandable, but hurtful, classroom jokes this precipitated - by wearing sandals but, needless to say, it did not solve the problem!" Su said.

On the advice of her bariatric surgeon, Su applied to her local Primary Care Trust (PCT) for corrective surgery but her appeal was rejected because, despite losing more than a third of her body weight and dropping from a UK dress size of 30 to a size 14, she still recorded a BMI of more than 30[i]. 

"I was at the end of my tether and did not know where to turn, until I was referred to Mr Fourie, Consultant Plastic Surgeon at Spire Methley Park hospital.  He wrote another letter on my behalf and, as a result, the PCT agreed to fund my surgery on the NHS," she said.

In May of this year, Su had an abdominoplasty procedure plus liposuction on her hips and thighs, requiring her to spend three days in hospital and a further eight weeks in recovery.

"I couldn't be happier with the results.  The initial weight-loss surgery opened up new horizons but the corrective surgery has completely revolutionised my life," she said.  

"For the first time in my adult life I am able to wear tailored clothes.  It feels fantastic.  I am now power-dressing and applying for the post of Deputy Head Teacher at several schools, a move I simply would not have had the confidence to contemplate before my latest surgery."

Speaking about the methods of corrective surgery now available, Mr Fourie said the range of techniques available can have a tremendous impact on both the patient's appearance and confidence levels.

"The greatest pitfall that awaits people after any substantial weight loss - be it via a method surgical intervention or dietary means - is the inevitable surplus flesh it leaves behind.  This is not only unsightly but can cause back problems and Intertigo a condition where sweat becomes trapped in the folds of surplus skin causing rashes in the pubic area for example.

"To eliminate these problems, we operate to remove the excess skin and tighten up the affected areas.  The flesh we remove can also be recycled to enhance the appearance of other areas of the body.  For instance, the excess fat and skin can be used for breast reconstructions.  The tummy area can be treated with either a conventional tummy tuck or, if the patient's bottom is very saggy, a circumferential body lift is performed whereby the extra skin is used to give the bottom a more pert, rounded shape.

"Typically the surgery is performed in stages, as with Sue who is booked to have a mastopexy and thigh lift this December to complete her transformation.  Unfortunately, as Sue's story illustrates, funding for corrective surgery is hard to come by on the NHS and impossible for anyone who loses weight naturally rather than via surgical means. 

"Current NHS regulations stipulate that only patients' whose weight has been stable for two years or more following bariatric surgery, and with a BMI of less than 30, qualify for corrective surgery.  Even if they do meet these criteria, their corrective surgery can only be performed by the same NHS hospital which performed their initial weight-loss surgery.  This can be a problem as the skills needed for corrective surgery are not the same as bariatric surgery. Unless the hospital in question employs a suitably skilled plastic surgeon, it is may be unable to provide this service."  Mr Fourie said.

Anyone seeking more information on Mr Fourie's clinic at Spire Methley Park in Leeds should call either 01977 603175 (nurse advisors), 01977 664258 (Mr Fourie's secretary) or visit www.spirehealthcare.com.