Correlating the Number of Body Contouring Procedures Following Roux-En-Y Gastric Bypass Surgery with Long-Term Weight Maintenance

Friday, April 12, 2013
Russell E. Kling, BA1, Jacob Esquenazi, BA1, Jacqueline B. Bliley, BS/MS1, Chris Chung, BA1, Ronald P. Bossert, MD2, Anita P. Courcoulas, MD, MPH3, Jeffrey A. Gusenoff, MD1 and J. Peter Rubin, MD1, (1)Department of Plastic Surgery, University of Pittsburgh, Pittsburgh, PA, (2)Department of Surgery, University of Rochester, Rochester, NY, (3)Minimally Invasive Bariatric Surgery and General Surgery, University of Pittsburgh, Pittsburgh, PA
Goals/Purpose: With the rapid increase in bariatric procedures over the past decade, there has been a concomitant rise in patients left with residual skin laxity. As a result, many patients have turned to body contouring surgery to help remedy their excess skin. Despite this, little is known about the influence of body contouring surgery on weight maintenance following massive weight loss surgery. Although many have speculated about the positive effect of body contouring surgery on weight maintenance, little objective data exists supporting or refuting this claim. The authors aimed to compare subjects who have undergone only 1 body contouring surgery following gastric bypass surgery vs. those who have undergone >1 body contouring surgery post gastric bypass surgery to provide supportive data for enhanced weight maintenance in the post body contouring surgery setting.

Methods/Technique:  A retrospective review was performed to identify massive weight loss subjects (>50 lbs. weight loss) whom underwent both body contouring surgery and gastric bypass with follow-up time of >1 year post-body contouring surgery. The senior author performed all cases. A two-tailed student’s test-test was used to determine statistical significance.

Results/Complications: Two hundred fifty-seven subjects (236 women and 22 men) were analyzed. One hundred forty-nine subjects (135 women and 14 male) underwent only 1 body contouring procedure with 99% undergoing a panniculectomy or an abdominoplasty. One hundred eight subjects (100 women and 8 men) underwent > 1 body contouring procedure with 90% undergoing at least a panniculectomy or an abdominoplasty. The average pre- gastric bypass BMI for the 1 body contouring procedure group was 49.3 (36.3-81.7, +/- 7.3) whereas the average pre- gastric bypass BMI was 48.7 (36.5-71, +/- 7.2) for the >1 body contouring procedure group. The average pre- body contouring BMI was 29.6 (21.3-60, +/- 5.8) for the 1 body contouring procedure group and the average pre- body contouring BMI was 29.2 (21.9-43.8, +/- 4.3) for the >1 body contouring procedure group. At an average long term follow-up of 3.4 years the 1 body contouring procedure group had an average BMI of 31.9 (15.9-53.9, +/- 6.6) while the >1 body contouring procedure group at an average long term follow up of 3.5 year had an average BMI of 30.4 (18.1-47.6, +/- 5.5) (p ≤ 0.05). 

Conclusion: Our results demonstrate enhanced weight maintenance post-body contouring surgery following gastric bypass surgery in the >1 body contouring procedure group at 3.5 years follow-up. Further ongoing research is investigating a definitive relationship between body contouring and weight maintenance using a control group that has not undergone body contouring surgery.

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