Body Contouring In the Post-Bariatric Patient

Goals/Purpose: The obesity epidemic has directly led to an increase in the number of bariatric procedures performed in the United States. After bariatric surgery, massive weight loss patients are often left with excess tissue and skin, which can present a psychological barrier to further weight loss maintenance and lifestyle change. We aimed to assess the effectiveness of body contouring procedures on weight loss maintenance at our institution.

Methods/Technique: A retrospective analysis of 75 adult patients (18+ yrs old) who underwent bariatric surgery and subsequent body contouring procedures between January 1, 1990 and October 1, 2009 was performed. Patients' body mass indices (BMIs) were calculated prior to bariatric and body contouring surgeries and at the time of last follow up. BMIs were corrected for the weight of tissue excised (grams) at the time of contouring surgery.

Results/Complications: Preliminary results of fifteen patients demonstrated that the average BMI immediately prior to gastric bypass and contouring procedure was 56.4 and 37.1 kg/m^2 respectively. Time to contour procedure averaged 42 months. On average patients showed a 5.0% increase in BMI following contour procedure at mean follow up of 56-months. Fourteen individuals had a BMI change of less than 10% (range -1% to +8.8%, n=14) with one patient demonstrating a +40% change.

Conclusion: The literature reports that up to 20% of bariatric surgery patients cannot sustain their weight loss after 2-3yrs. Preliminary results at our institution demonstrate that only one individual undergoing subsequent body contouring had a BMI increase of greater than 10% after an 8-year follow up. Our data suggests that post-bariatric body contouring optimizes bariatric surgery results and can aid with sustainable weight loss.