Northern Beaches Hospital’s Dr Johnny Kwei and Dr Carla Gillespie reveal how cutting-edge bariatric and body contouring techniques complete the weight loss journey.
The 2024 Australian Institute of Health and Welfare Burden of Disease Study shows 60% of Australians are obese or overweight, contributing to 8.3% of the disease burden, with a third of these diseases preventable through weight loss. Bariatric procedures such as gastric sleeve and bypasses can lower risk factors associated with heart disease such as high blood pressure, high cholesterol, and diabetes.
But for many, losing weight is just the first step, and body contouring is often used in conjunction to remove excess skin and tighten areas including the abdomen, arms, thighs, and breasts for a smoother, more sculpted appearance.
Types of Bariatric Surgery
- Gastric sleeve – removes approximately two-thirds of the stomach to reduce food intake.
- Gastric bypass – including One Anastomosis Gastric Bypass and Roux en Y Gastric Bypass- creates a smaller stomach pouch and bypasses up to 2m of small bowel to alter digestion to limit calorie absorption.
- Both procedures are efficacious not only due to effects on restriction and absorption, but also the bodies neurohormonal response to food.
Bariatric Surgery vs Medication – Which Is More Effective for Weight Loss?
While Ozempic and Mounjaro are gaining popularity in the weight loss space, bariatric surgery typically leads to significantly greater and more sustained weight loss, delivering 30% total body weight loss over four years, compared to up to 20% from medications.
Northern Bariatrics Upper Gastrointestinal and Bariatric surgeon, Dr Carla Gillespie, says, “Obesity is a chronic lifelong health condition, and any weight loss treatment must be considered as a lifelong commitment.
“As much as the new medications are excellent for some, bariatric surgery is the best long-term solution. Combined with comprehensive care and nutritional support, it permanently reduces stomach size and profoundly affects hormones that control hunger and satiety.”
Who Qualifies for Bariatric Surgery?
- People with a Body Mass Index (BMI) above 35.
- People with a BMI of 30 with medical comorbidities such as high blood pressure, high cholesterol, type II diabetes, PCOS and osteoarthritis.
Dr Gillespie adds, “In the above cases, reaching that 30% total body weight loss is crucial, especially for patients over 100 kilos who need significant weight reduction to improve their long- term health and wellbeing.”
The injectable medications require lifelong use and can be costly, and studies show that if stopped, the weight and medical conditions like diabetes and high blood pressure return.
“By the time patients come to us, they’ve already tried multiple medications,” Dr Gillespie explains. “When you consider the amount of body weight loss and the costs involved, bariatric surgery is a better long-term investment.”
Dr Gillespie and her team can be contacted at Northern Bariatrics based in Northern Beaches Hospital on 9098 6996 and northernbariatrics.com.au
Follow-Ups and Nutritional Care
Northern Bariatrics follows up patients for two years after surgery, including appointments with a dietitian and nutritional blood panel tests to ensure no nutritional deficiencies.
Funding and Access
Patients can self-refer or obtain a Medicare rebate with a GP referral. Funding options include private health insurance, self-funding or early release of superannuation.
More Than Skin Deep: The Life-Changing Benefits of Body Contouring
Losing a significant amount of weight is a major achievement, but the journey doesn’t always end there. Excess skin can be left behind, causing discomfort, rashes, mobility issues, and emotional distress.
Northern Beaches Hospital’s Head of Plastic Surgery, Dr Johnny Kwei, a Specialist Plastic and Cosmetic and Reconstructive Surgeon, says body contouring is “more than just a cosmetic procedure. It’s about restoring function, comfort, and confidence.”
Addressing Loose and Excess Skin
“With body contouring, I address both volume and excess skin, and every surgery is tailored to address the patients’ individual needs,” says Dr Kwei.
“After major weight loss, skin elasticity varies depending on age and genetics. The body produces the contractile protein, elastin, up to approximately 30 to 35 years old.
“A 19-year-old who loses 50 kilograms generally has better skin retraction than a 50-year-old losing the same amount.”
Body Contouring Myths Busted
While plastic surgery is often dismissed as purely cosmetic, Dr Kwei – who is also a Senior Medical Lecturer at Macquarie University Medical School – challenges this perception.
“It has a significant functional component,” he says. “Bariatric intervention has well-documented health benefits, and body contouring plays a complementary role by improving a person’s quality of life.
Dr Kwei’s most common procedures include:
- Tummy tuck (abdominoplasty): Removes excess skin and tightens abdominal muscles. Hernias and rectus muscle separation can be repaired at the same time.
- Breast lift/reduction: Addresses overly large breasts and ptosis (sagging) that causes discomfort.
- Arm lift (brachioplasty): Reduces excess skin on the upper arms.
- Thigh lift: Removes sagging skin on the thighs for better mobility and comfort.
- Belt lipectomy: Also known as a lower body lift, circumferential abdominoplasty, circumferential lipectomy, or 360 panniculectomy. Removes excess skin and fat from the lower body, including abdomen, hips, buttocks, and lower back.
- Face and neck lifts: Often incorporating blepharoplasty (removing excess skin on the eye lids) and adjusting (lifting) the brow position.
- 360-degree body lift: Removes excess skin around the entire torso, addressing both upper and lower abdomen, sometimes incorporating a vertical component.
Dr Kwei and his team can be contacted on 1300 375 934 and info@drjohnnykwei.com.au
“People don’t function at their optimal level when they have excess skin that prevents them from participating in healthy activities like going to the gym, I take great pride in helping my patients feel confident and positive again.
“Most tell me they wish they had done it decades ago.”
“In a body lift with multiple folds of excess skin, I perform a circumferential corset-type procedure to reshape the body,” Dr Kwei adds, stating he can tighten the waist for a more hourglass shape.
He also uses minimally invasive laser devices such as Renuvion, which uses radiofrequency energy and helium plasma to tighten skin and improve contour and can tighten skin by around 20-40% on the face and body.
Accessing Body Contouring Surgery
Not typically covered in the public system, private health insurance will contribute to procedures if they meet Medicare item number criteria, especially having had bariatric intervention. Patients can also self-fund.
Funding and Access
Patients can obtain a Medicare rebate with a GP referral. Funding options include private health insurance, superannuation withdrawal, or self-funding.
105 Frenchs Forest Road West, Frenchs Forest Ph: 9105 5000
www.northernbeacheshospital.com.au
