Abstract

IntroductionA considerable number of patients experience some long-term weight regain after bariatric surgery. Body contouring surgery (BCS) is thought to strengthen post-bariatric surgery patients in their weight control and maintenance of achieved improvements in comorbidities.ObjectivesTo examine the impact of BCS on long-term weight control and comorbidities after bariatric surgery.MethodsWe performed a retrospective study in a prospective database. All patients who underwent primary Roux-en-Y gastric bypass (RYGB) and presented for preoperative consultation of BCS in the same hospital were included in the study. Linear and logistic mixed-effect model analyses were used to evaluate the longitudinal relationships between patients who were accepted or rejected for BCS and their weight loss outcomes or changes in comorbidities.ResultsOf the 1150 patients who underwent primary RYGB between January 2010 and December 2014, 258 patients (22.4%) presented for preoperative consultation of BCS. Of these patients, 126 patients eventually underwent BCS (48.8%). Patients who were accepted for BCS demonstrated significant better ∆body mass index (BMI) on average over time (− 1.31 kg/m2/year, 95% confidence interval (CI) −2.52 − −0.10, p = 0.034) and percent total weight loss (%TWL) was significantly different at 36 months (5.79, 95%CI 1.22 – 10.37, p = 0.013) and 48 months (6.78, 95%CI 0.93 – 12.63, p = 0.023) after body contouring consultation. Patients who were accepted or rejected did not differ significantly in the maintenance of achieved improvements in comorbidities.ConclusionBCS could not be associated with the maintenance of achieved improvements in comorbidities after bariatric surgery, whereas it could be associated with improved weight loss maintenance at 36 and 48 months after body contouring consultation. This association should be further explored in a large longitudinal study.

Highlights

  • A considerable number of patients experience some long-term weight regain after bariatric surgery

  • Other surgical procedures and revisional procedures were excluded from this study to avoid bias due to different weight loss outcomes associated with the different procedures

  • Of the patients who presented for body contouring consultation, 126 patients were accepted and underwent Body contouring surgery (BCS) (48.8%)

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Summary

Introduction

A considerable number of patients experience some long-term weight regain after bariatric surgery. Body contouring surgery (BCS) is thought to strengthen post-bariatric surgery patients in their weight control and maintenance of achieved improvements in comorbidities. Bariatric surgery is considered to be the most effective treatment resulting in significant weight loss, Amsterdam, The Netherlands 3 Department of Plastic, Reconstructive and Hand Surgery, OLVG, Amsterdam, The Netherlands 4 Department of Plastic, Reconstructive and Hand Surgery, Amsterdam UMC, location VUmc, Amsterdam, The Netherlands remission of obesity-related comorbidities, and substantial improvement in health-related quality of life (HRQoL) [2,3,4,5,6,7]. Body contouring surgery (BCS) reduces excess loose skin and has been demonstrated to improve daily impairments associated with excess skin and might strengthen post-bariatric

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