Tuesday, October 28, 2003 - 3:50 PM

Body Contouring Procedures Following Gastric Bypass - A Series of 52 Consecutive Patients

Arnold S. Breitbart, MD, Dominick Gadaleta, MD, Marc Bessler, MD, Brian Parrett, BA, and Robert Grant, MD.

Body contouring is now playing a large role in the rehabilitation of the morbidly obese after bariatric surgery. After massive weight loss, there remains the presence of redundant skin, resulting in physiological and psychological difficulties for patients. Our goal is to establish the safety of subsequent contouring operations in this unique patient population. This study presents our experience with body contouring procedures over the past 4 years, including abdominoplasty, lower body lift, medial thigh lift, mastopexy, brachioplasty, excision of gynecomastia, and liposuction, in 52 consecutive patients (42 female and 10 male) who have had substantial weight loss following gastric bypass. The mean patient weight prior to gastric bypass was 343 lbs. (range 185-517 lbs.) with a mean body mass index of 55.8 kg/m2. The mean weight loss following gastric bypass was 140 lbs. (range 54-258 lbs.). The mean patient body mass index at the time of the body contouring procedure was 33 kg/m2. Patients had their body contouring procedures performed at a mean of 20 months following gastric bypass (range 9-96 months). 51 patients had abdominoplasty with 26 patients having standard abdominoplasty performed. 25 patients who had transverse skin excess in addition to their panniculus had excision of the panniculus as well as excision of transverse skin excess, with an "inverted T" closure. 2 patients had simultaneous lower body lift. 37 patients had repair of an incisional hernia at the time of abdominoplasty. 21 patients (40%) had additional procedures, including brachioplasty, mastopexy, lower body lift, medial thigh lift, gynecomastia excision, liposuction, and facelift. 18 patients had their additional body contouring procedures performed simultaneously with abdominoplasty, with the most common procedures being mastopexy and brachioplasty. The total wound complication rate was 17%. Five of the patients in this study (9.6%) had wound healing complications, all of which healed uneventfully with local wound care. Four patients (7.6%) had seroma formation treated successfully with a single aspiration. There were no deaths and only 3 minor revisions. We conclude that body contouring can be performed safely in this patient population with complication rates comparable to body contouring in the general population, and can yield dramatic improvements in body contour.

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