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Owen Haskins

Body contouring significantly improves outcomes for patients

Body contouring procedures following bariatric surgery leads to significant improvements in both the psychological and social aspects of patients’ lives, according to researchers from the Division of Plastic and Reconstructive Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, and the Department of Plastic Surgery, DSS, im T Marciniaka, Wroclaw, Poland.

The paper, ‘The long-term effect of body contouring procedures on the quality of life in morbidly obese patients after bariatric surgery’, aimed to evaluate the long-term psychosocial effects of these procedures among patients who undergone weight loss surgery and maintained their body mass for a minimum of one year, using the BODY-Q questionnaire, and comparing pre- and post-body contouring results with 12 months of follow up.

In total, 30 patients met the study’s inclusion criteria and were enrolled in the study and the overall survey response rate was 86%. All male patients (n=2) refused to fill out the BODY-Q questionnaire and were excluded from the analysis, so the final study group consisted of only female patients. Patients undergoing body contouring were, on average, 38 years old (SD 5.91) with an average weight loss of 53.1 kg (SD 5.02).

The majority of participants had a laparoscopic sleeve gastrectomy (LSG, n=20), adjustable gastric banding (AGB, n=6) and Roux-en-Y gastric bypass (RYGB, n=4) with the mean period of 34 months from body contouring. A total of 41 BC procedures were performed in 30 patients and the most common body contouring procedure was abdominoplasty (n=22; 54%) followed by lower-body lift (n=7; 17%). Seventy-three percent of patients (n=22) underwent a single procedure with the remaining eight patients undergoing two to four surgeries. The mean operative time for abdominoplasty patients 133.9 minutes and 217.5 minutes for lower body lift, and length of hospital stay was 4.9 days and 5.0 days respectively. Complications occurred in five patients (16.7%), one haematoma (3.3%) and wound dehiscence in four patients (13.3%).

Acceptance and evaluation of body appearance

There were statistically significant improvements observed in the acceptance and evaluation of body appearance in the postoperative module (p<0.001) (Figure 1), the worst satisfaction at baseline was observed in the abdominal and thigh region.

In addition, health-related quality of life was significantly enhanced (≥ 20 points) with regards to psychological well-being, social functioning, sexual well-being and body image (p<0.001) (Figure 2). For half of the patients, surgery in at least one region positively affected the perception of the rest of the body, although three patients (10%), reported a decreased satisfaction with untreated body areas. There were no significant differences in the final satisfaction rate between patients who underwent only one body contour procedure and those who had multiple procedures performed (71.36±17.15 vs. 73.38±19.02; p=0.79).

Although the researchers acknowledge that more data are required on the specific characteristics of patients that profoundly change their perception of their surgical outcomes, the BODY-Q assessment tool is an easy and efficient tool that may provide greater insight for result optimisation within this patient population, they concluded.

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