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Published in: Obesity Surgery 5/2009

01-05-2009 | Research Article

Body Contouring Surgery Following Bariatric Surgery and Dietetically Induced Massive Weight Reduction: A Risk Analysis

Authors: S. de Kerviler, R. Hüsler, A. Banic, M. A. Constantinescu

Published in: Obesity Surgery | Issue 5/2009

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Abstract

Background

This study analyzed the impact of weight reduction method, preoperative, and intraoperative variables on the outcome of reconstructive body contouring surgery following massive weight reduction.

Methods

All patients presenting with a maximal BMI ≥35 kg/m2 before weight reduction who underwent body contouring surgery of the trunk following massive weight loss (excess body mass index loss (EBMIL) ≥ 30%) between January 2002 and June 2007 were retrospectively analyzed. Incomplete records or follow-up led to exclusion. Statistical analysis focused on weight reduction method and pre-, intra-, and postoperative risk factors. The outcome was compared to current literature results.

Results

A total of 104 patients were included (87 female and 17 male; mean age 47.9 years). Massive weight reduction was achieved through bariatric surgery in 62 patients (59.6%) and dietetically in 42 patients (40.4%). Dietetically achieved excess body mass index loss (EBMIL) was 94.20% and in this cohort higher than surgically induced reduction EBMIL 80.80% (p < 0.01). Bariatric surgery did not present increased risks for complications for the secondary body contouring procedures. The observed complications (26.9%) were analyzed for risk factors. Total tissue resection weight was a significant risk factor (p < 0.05). Preoperative BMI had an impact on infections (p < 0.05). No impact on the postoperative outcome was detected in EBMIL, maximal BMI, smoking, hemoglobin, blood loss, body contouring technique or operation time. Corrective procedures were performed in 11 patients (10.6%). The results were compared to recent data.

Conclusion

Bariatric surgery does not increase risks for complications in subsequent body contouring procedures when compared to massive dietetic weight reduction.
Literature
1.
go back to reference Kuczmarski RJ, Flegal KM, Campell SM, et al. Increasing prevalence of overweight among US adults. The national health and nutrition examination surveys, 1960 to 1991. Jama. 1994;272(3):205–11.CrossRef Kuczmarski RJ, Flegal KM, Campell SM, et al. Increasing prevalence of overweight among US adults. The national health and nutrition examination surveys, 1960 to 1991. Jama. 1994;272(3):205–11.CrossRef
2.
go back to reference Eichholzer M, Luthy J, Gutzwiller F. Epidemiology of overweight in Switzerland: results of the Swiss National Health Survey 1992–93. Schweiz Med Wochenschr. 1999;129(9):353–61.PubMed Eichholzer M, Luthy J, Gutzwiller F. Epidemiology of overweight in Switzerland: results of the Swiss National Health Survey 1992–93. Schweiz Med Wochenschr. 1999;129(9):353–61.PubMed
3.
go back to reference Rickenbach M, Wietlisbach V, Beretta-Piccoli C, et al. Smoking, blood pressure and body weight in the Swiss population: MONICA study 1988–89. Schweiz Med Wochenschr Suppl. 1993;48:21–8.PubMed Rickenbach M, Wietlisbach V, Beretta-Piccoli C, et al. Smoking, blood pressure and body weight in the Swiss population: MONICA study 1988–89. Schweiz Med Wochenschr Suppl. 1993;48:21–8.PubMed
4.
go back to reference NIH conference. Gastrointestinal surgery for severe obesity. Consensus Development Conference Panel. Ann Intern Med. 1991;115(12):956–61.CrossRef NIH conference. Gastrointestinal surgery for severe obesity. Consensus Development Conference Panel. Ann Intern Med. 1991;115(12):956–61.CrossRef
5.
go back to reference Fontaine KR, Redden DT, Wang C, et al. Years of life lost due to obesity. JAMA. 2003;289(2):187–93.CrossRef Fontaine KR, Redden DT, Wang C, et al. Years of life lost due to obesity. JAMA. 2003;289(2):187–93.CrossRef
6.
go back to reference Karlsson J, Sjostrom L, Sullivan M. Swedish Obese Subjects (SOS)–an intervention study of obesity. Measuring psychosocial factors and health by means of short-form questionnaires. Results from a method study. J Clin Epidemiol. 1995;48(6):817–23.CrossRef Karlsson J, Sjostrom L, Sullivan M. Swedish Obese Subjects (SOS)–an intervention study of obesity. Measuring psychosocial factors and health by means of short-form questionnaires. Results from a method study. J Clin Epidemiol. 1995;48(6):817–23.CrossRef
7.
go back to reference Mathus-Vliegen EM, de Weerd S, de Wit LT. Health-related quality-of-life in patients with morbid obesity after gastric banding for surgically induced weight loss. Surgery. 2004;135(5):489–97.CrossRef Mathus-Vliegen EM, de Weerd S, de Wit LT. Health-related quality-of-life in patients with morbid obesity after gastric banding for surgically induced weight loss. Surgery. 2004;135(5):489–97.CrossRef
8.
go back to reference Fotopoulos L, Kehagias I, Kalfarentzos F. Dermolipectomies following weight loss after surgery for morbid obesity. Obes Surg. 2000;10(5):451–9.CrossRef Fotopoulos L, Kehagias I, Kalfarentzos F. Dermolipectomies following weight loss after surgery for morbid obesity. Obes Surg. 2000;10(5):451–9.CrossRef
9.
go back to reference Song AY, Rubin JP, Thomas V, et al. Body image and quality of life in post massive weight loss body contouring patients. Obesity (Silver Spring). 2006;14(9):1626–36.CrossRef Song AY, Rubin JP, Thomas V, et al. Body image and quality of life in post massive weight loss body contouring patients. Obesity (Silver Spring). 2006;14(9):1626–36.CrossRef
10.
go back to reference Fraccalvieri M, Datta G, Bogetti P, et al. Abdominoplasty after weight loss in morbidly obese patients: a 4-year clinical experience. Obes Surg. 2007;17(10):1319–24.CrossRef Fraccalvieri M, Datta G, Bogetti P, et al. Abdominoplasty after weight loss in morbidly obese patients: a 4-year clinical experience. Obes Surg. 2007;17(10):1319–24.CrossRef
11.
go back to reference Arthurs ZM, Cuadrado D, Sohn V, et al. Post-bariatric panniculectomy: pre-panniculectomy body mass index impacts the complication profile. Am J Surg. 2007;193(5):567–70; discussion 570.CrossRef Arthurs ZM, Cuadrado D, Sohn V, et al. Post-bariatric panniculectomy: pre-panniculectomy body mass index impacts the complication profile. Am J Surg. 2007;193(5):567–70; discussion 570.CrossRef
12.
go back to reference Chaouat M, Levan P, Lalanne B, et al. Abdominal dermolipectomies: early postoperative complications and long-term unfavorable results. Plast Reconstr Surg. 2000;106(7):1614–8; discussion 1619–23.CrossRef Chaouat M, Levan P, Lalanne B, et al. Abdominal dermolipectomies: early postoperative complications and long-term unfavorable results. Plast Reconstr Surg. 2000;106(7):1614–8; discussion 1619–23.CrossRef
13.
go back to reference Gmur RU, Banic A, Erni D. Is it safe to combine abdominoplasty with other dermolipectomy procedures to correct skin excess after weight loss? Ann Plast Surg. 2003;51(4):353–7.CrossRef Gmur RU, Banic A, Erni D. Is it safe to combine abdominoplasty with other dermolipectomy procedures to correct skin excess after weight loss? Ann Plast Surg. 2003;51(4):353–7.CrossRef
14.
go back to reference van Uchelen JH, Werker PM, Kon M. Complications of abdominoplasty in 86 patients. Plast Reconstr Surg. 2001;107(7):1869–73.CrossRef van Uchelen JH, Werker PM, Kon M. Complications of abdominoplasty in 86 patients. Plast Reconstr Surg. 2001;107(7):1869–73.CrossRef
15.
go back to reference Deitel M, Greenstein RJ. Recommendations for reporting weight loss. Obes Surg. 2003;13(2):159–60.CrossRef Deitel M, Greenstein RJ. Recommendations for reporting weight loss. Obes Surg. 2003;13(2):159–60.CrossRef
16.
go back to reference Pitanguy I, Gontijo de Amorim NF, Radwanski HN. Contour surgery in the patient with great weight loss. Aesthetic Plast Surg. 2000;24(6):406–11.CrossRef Pitanguy I, Gontijo de Amorim NF, Radwanski HN. Contour surgery in the patient with great weight loss. Aesthetic Plast Surg. 2000;24(6):406–11.CrossRef
17.
go back to reference Shiri S, Gurevich T, Feintuch U, et al. Positive psychological impact of bariatric surgery. Obes Surg. 2007;17(5):663–8.CrossRef Shiri S, Gurevich T, Feintuch U, et al. Positive psychological impact of bariatric surgery. Obes Surg. 2007;17(5):663–8.CrossRef
18.
go back to reference Scheufler O, Erdmann D. Current concepts and trends in post-bariatric plastic surgery. Chirurg. 2007;78(4):316–25.CrossRef Scheufler O, Erdmann D. Current concepts and trends in post-bariatric plastic surgery. Chirurg. 2007;78(4):316–25.CrossRef
19.
go back to reference Faintuch J, Matsuda M, Cruz ME, et al. Severe protein-calorie malnutrition after bariatric procedures. Obes Surg. 2004;14(2):175–81.CrossRef Faintuch J, Matsuda M, Cruz ME, et al. Severe protein-calorie malnutrition after bariatric procedures. Obes Surg. 2004;14(2):175–81.CrossRef
20.
go back to reference Davies DJ, Baxter JM, Baxter JN. Nutritional deficiencies after bariatric surgery. Obes Surg. 2007;17(9):1150–8.CrossRef Davies DJ, Baxter JM, Baxter JN. Nutritional deficiencies after bariatric surgery. Obes Surg. 2007;17(9):1150–8.CrossRef
21.
go back to reference Nemerofsky RB, Oliak DA, Capella JF. Body lift: an account of 200 consecutive cases in the massive weight loss patient. Plast Reconstr Surg. 2006;117(2):414–30.CrossRef Nemerofsky RB, Oliak DA, Capella JF. Body lift: an account of 200 consecutive cases in the massive weight loss patient. Plast Reconstr Surg. 2006;117(2):414–30.CrossRef
22.
go back to reference Stewart KJ, Stewart DA, Coghlan B, et al. Complications of 278 consecutive abdominoplasties. J Plast Reconstr Aesthet Surg. 2006;59(11):1152–5.CrossRef Stewart KJ, Stewart DA, Coghlan B, et al. Complications of 278 consecutive abdominoplasties. J Plast Reconstr Aesthet Surg. 2006;59(11):1152–5.CrossRef
23.
go back to reference Shermak MA, Chang D, Magnuson TH, et al. An outcomes analysis of patients undergoing body contouring surgery after massive weight loss. Plast Reconstr Surg. 2006;118(4):1026–31.CrossRef Shermak MA, Chang D, Magnuson TH, et al. An outcomes analysis of patients undergoing body contouring surgery after massive weight loss. Plast Reconstr Surg. 2006;118(4):1026–31.CrossRef
24.
go back to reference Gravante G, Araco A, Sorge R, et al. Wound infections in post-bariatric patients undergoing body contouring abdominoplasty: the role of smoking. Obes Surg. 2007;17(10):1325–31.CrossRef Gravante G, Araco A, Sorge R, et al. Wound infections in post-bariatric patients undergoing body contouring abdominoplasty: the role of smoking. Obes Surg. 2007;17(10):1325–31.CrossRef
25.
go back to reference Deitel M, Gawdat K, Melissas J. Reporting weight loss 2007. Obes Surg. 2007;17(5):565–8.CrossRef Deitel M, Gawdat K, Melissas J. Reporting weight loss 2007. Obes Surg. 2007;17(5):565–8.CrossRef
26.
go back to reference Sugerman HJ, Kellum JM Jr, Reines HD, et al. Greater risk of incisional hernia with morbidly obese than steroid-dependent patients and low recurrence with prefascial polypropylene mesh. Am J Surg. 1996;171(1):80–4.CrossRef Sugerman HJ, Kellum JM Jr, Reines HD, et al. Greater risk of incisional hernia with morbidly obese than steroid-dependent patients and low recurrence with prefascial polypropylene mesh. Am J Surg. 1996;171(1):80–4.CrossRef
27.
go back to reference Arribas D, Elia M, Artigas C, et al. Incidence of incisional hernia following vertical banded gastroplasty. Hernia. 2004;8(2):135–7.CrossRef Arribas D, Elia M, Artigas C, et al. Incidence of incisional hernia following vertical banded gastroplasty. Hernia. 2004;8(2):135–7.CrossRef
28.
go back to reference Larsen M, Polat F, Stook FP, et al. Satisfaction and complications in post-bariatric surgery abdominoplasty patients. Acta Chir Plast. 2007;49(4):95–8.PubMed Larsen M, Polat F, Stook FP, et al. Satisfaction and complications in post-bariatric surgery abdominoplasty patients. Acta Chir Plast. 2007;49(4):95–8.PubMed
Metadata
Title
Body Contouring Surgery Following Bariatric Surgery and Dietetically Induced Massive Weight Reduction: A Risk Analysis
Authors
S. de Kerviler
R. Hüsler
A. Banic
M. A. Constantinescu
Publication date
01-05-2009
Publisher
Springer New York
Published in
Obesity Surgery / Issue 5/2009
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-008-9659-8

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