Body Contouring Surgery Improves Weight Loss after Bariatric Surgery: A Systematic Review and Meta-Analysis
Affiliations
Affiliations
- Department of Surgery, Faculty of Medicine, Kuwait University, Kuwait city, Kuwait.
- Division of Plastic Surgery, Faculty of Medicine, Dalhousie University, Room 4447, Halifax Infirmary, 4th Floor, Plastic Surgery, 1796 Summer Street, Halifax, NS, B3H 3A7, Canada. Osamargandi@dal.ca.
- Division of Plastic Surgery, Department of Surgery, King Abdulaziz University, Jeddah, Saudi Arabia. Osamargandi@dal.ca.
- Department of Surgery, Jaber Al-Ahmed Hospital, Kuwait city, Kuwait.
- Division of Plastic Surgery, Faculty of Medicine, Dalhousie University, Room 4447, Halifax Infirmary, 4th Floor, Plastic Surgery, 1796 Summer Street, Halifax, NS, B3H 3A7, Canada.
Abstract
Introduction: Our main objective is to evaluate the effect of body contouring surgery (BCS) on the magnitude and durability of weight loss after bariatric surgery.
Methods: Medline, EMBASE, Cochrane, and Scopus search were conducted from the time of their inception to June 2020. We included comparative studies that assessed weight progression, in terms of Body Mass Index change (∆BMI), Total Body Weight Loss (TBWL%), and Excess Weight Loss (%EWL) for the post-bariatric patient population and the effect of BCS on weight progression.
Results: Eleven articles were included. The pooled sample size was 2307, of which 691 were cases who underwent BCS post-bariatric surgery, and 1616 were comparative controls. The mean follow-up time for cases and controls were 61.6 ± 23.8 months and 52.2 ± 23.8 months, respectively. Nine studies reported results of BMI changes, six provided %EWL, and five used %TBWL. Significant improvement in weight loss was observed in the BCS group when measured by either ∆BMI (3 kg/m2 points decrease, p 0.023), %TBWL (6% increase, P < 0.0001), or %EWL (14% increase, P < 0.0001). Sub-group analysis showed that increased follow-up time was associated with higher TBWL% (p 0.02).
Conclusion: The evidence provided in this review strongly supports the added long-term benefits of body contouring surgery for selected patients after massive weight loss following bariatric surgery. Having a multidisciplinary team that involves a bariatric and a plastic surgeon as well as nutritionists and psychologists for the management of patients with obesity going through the bariatric pathway is recommended.
Level of evidence iii: This journal requires that authors assign a level of evidence to each article. For a full description of these evidence-based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.
Keywords: Abdominoplasty; Bariatric surgery; Body contouring surgery; Brachioplasty; Thigh lift; Weight loss.
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References
-
- Maggard MA, Shugarman LR, Suttorp M, Maglione M, Sugerman HJ, Livingston EH et al (2005) Meta-analysis: surgical treatment of obesity. Ann Intern Med. 142(7):547–559 - PubMed
-
- Hachem A, Brennan L (2016) Quality of life outcomes of bariatric surgery: a systematic review. Obes Surg. 26(2):395–409 - PubMed
-
- Raaijmakers LC, Pouwels S, Thomassen SE, Nienhuijs SW (2017) Quality of life and bariatric surgery: a systematic review of short- and long-term results and comparison with community norms. Eur J Clin Nutr. 71(4):441–449 - PubMed
-
- Altieri MS, Yang J, Park J, Novikov D, Kang L, Spaniolas K et al (2017) Utilization of body contouring procedures following weight loss surgery: a study of 37,806 patients. Obes Surg. 27(11):2981–2987 - PubMed
-
- Kinzl JF, Traweger C, Trefalt E, Biebl W (2003) Psychosocial consequences of weight loss following gastric banding for morbid obesity. Obes Surg. 13(1):105–110 - PubMed
-
- Di Gregorio JM, Palkoner R (2001) Quality of life after obesity surgery, an evidence-based medicine literature review: how to improve systematic searches for enhanced decision-making and clinical outcomes. Obes Surg. 11(3):318–326 - PubMed
-
- Biörserud C, Olbers T, Fagevik OM (2011) Patients’ experience of surplus skin after laparoscopic gastric bypass. Obes Surg. 21(3):273–277 - PubMed
-
- Klassen AF, Kaur M, Breitkopf T, Thoma A, Cano S, Pusic A (2018) Using the BODY-Q to understand impact of weight loss, excess skin, and the need for body contouring following bariatric surgery. Plast Reconstr Surg. 142(1):77–86 - PubMed
-
- Kitzinger HB, Abayev S, Pittermann A, Karle B, Kubiena H, Bohdjalian A et al (2012) The prevalence of body contouring surgery after gastric bypass surgery. Obes Surg. 22(1):8–12 - PubMed
-
- Poulsen L, Klassen A, Rose M, Roessler KK, Juhl CB, Støving RK et al (2017) Patient-reported outcomes in weight loss and body contouring surgery: a cross-sectional analysis using the BODY-Q. Plast Reconstr Surg. 140(3):491–500 - PubMed
-
- Colwell AS (2010) Current concepts in post-bariatric body contouring. Obes Surg. 20(8):1178–1182 - PubMed
-
- Klassen AF, Cano SJ, Scott A, Johnson J, Pusic AL (2012) Satisfaction and quality-of-life issues in body contouring surgery patients: a qualitative study. Obes Surg. 22(10):1527–1534 - PubMed
-
- Sarwer DB, Wadden TA, Fabricatore AN (2005) Psychosocial and behavioral aspects of bariatric surgery. Obes Res. 13(4):639–648 - PubMed
-
- van der Beek ES, Te Riele W, Specken TF, Boerma D, van Ramshorst B (2010) The impact of reconstructive procedures following bariatric surgery on patient well-being and quality of life. Obes Surg. 20(1):36–41 - PubMed
-
- Modarressi A, Balagué N, Huber O, Chilcott M, Pittet-Cuénod B (2013) Plastic surgery after gastric bypass improves long-term quality of life. Obes Surg. 23(1):24–30 - PubMed
-
- Cooper TC, Simmons EB, Webb K, Burns JL, Kushner RF (2015) Trends in weight regain following roux-en-y gastric bypass (RYGB) bariatric surgery. Obes Surg. 25(8):1474–1481 - PubMed
-
- Santo MA, Riccioppo D, Pajecki D, Kawamoto F, de Cleva R, Antonangelo L et al (2016) Weight regain after gastric bypass: influence of gut hormones. Obes Surg. 26(5):919–925 - PubMed
-
- de Vries CEE, Kalff MC, van Praag EM, Florisson JMG, Ritt M, van Veen RN et al (2020) The influence of body contouring surgery on weight control and comorbidities in patients after bariatric surgery. Obes Surg. 30(3):924–930 - PubMed
-
- Agarwal S, Shenaq D, Teven CM, Prachand V, Roughton M, Zachary L (2017) Body contouring after obesity surgery is associated with a weight loss benefit among patients. J Plast Reconstr Aesthet Surg. 70(9):1186–1190 - PubMed
-
- Balagué N, Combescure C, Huber O, Pittet-Cuénod B, Modarressi A (2013) Plastic surgery improves long-term weight control after bariatric surgery. Plast Reconstr Surg. 132(4):826–833 - PubMed
-
- Froylich D, Corcelles R, Daigle CR, Aminian A, Isakov R, Schauer PR et al (2016) Weight loss is higher among patients who undergo body contouring procedures after bariatric surgery. Surg Obes Relat Dis. 12(9):1731–1736 - PubMed
-
- Wiser I, Heller L, Spector C, Fliss E, Friedman T (2017) Body contouring procedures in three or more anatomical areas are associated with long-term body mass index decrease in massive weight loss patients: a retrospective cohort study. J Plast Reconstr Aesthet Surg. 70(9):1181–1185 - PubMed
-
- McGuire C, Samargandi OA, Corkum J, Retrouvey H, Bezuhly M (2019) Meta-analyses in plastic surgery: can we trust their results? Plast Reconstr Surg. 144(2):519–530 - PubMed
-
- Samargandi OA, Hasan H, Thoma A (2016) Methodologic quality of systematic reviews published in the plastic and reconstructive surgery literature: a systematic review. Plast Reconstr Surg. 137(1):225e-e236 - PubMed
-
- Slim K, Nini E, Forestier D, Kwiatkowski F, Panis Y, Chipponi J (2003) Methodological index for non-randomized studies (minors): development and validation of a new instrument. ANZ J Surg. 73(9):712–716 - PubMed
-
- Center for Evidence Based Medicine, Oxford. Level of evidence. OCEBM Levels of Evidence Working Group*. The Oxford Levels of Evidence 2. https://www.cebm.ox.ac.uk/resources/levels-of-evidence/ocebm-levels-of-e...
-
- Wiser I, Avinoah E, Ziv O, Parnass AJ, Averbuch Sagie R, Heller L et al (2016) Body contouring surgery decreases long-term weight regain following laparoscopic adjustable gastric banding: a matched retrospective cohort study. J Plast Reconstr Aesthet Surg. 69(11):1490–1496 - PubMed
-
- Higgins J, Green S (2011) Cochrane handbook for systematic reviews of interventions version 5.1.0. The Cochrane Collaboration. www.cochrane-handbook.org
-
- Tremp M, Delko T, Kraljević M, Zingg U, Rieger UM, Haug M et al (2015) Outcome in body-contouring surgery after massive weight loss: a prospective matched single-blind study. J Plast Reconstr Aesthet Surg. 68(10):1410–1416 - PubMed
-
- Monpellier VM, Antoniou EE, Mulkens S, Janssen IMC, van der Molen ABM, Jansen ATM (2018) Body image dissatisfaction and depression in postbariatric patients is associated with less weight loss and a desire for body contouring surgery. Surg Obes Relat Dis. 14(10):1507–1515 - PubMed
-
- Smith OJ, Hachach-Haram N, Greenfield M, Bystrzonowski N, Pucci A, Batterham RL et al (2018) Body contouring surgery and the maintenance of Weight Loss following Roux-En-Y gastric bypass: a retrospective study. Aesthet Surg J. 38(2):176–182 - PubMed
-
- Stuerz K, Piza H, Niermann K, Kinzl JF (2008) Psychosocial impact of abdominoplasty. Obes Surg. 18(1):34–38 - PubMed
-
- Pecori L, Serra Cervetti GG, Marinari GM, Migliori F, Adami GF (2007) Attitudes of morbidly obese patients to weight loss and body image following bariatric surgery and body contouring. Obes Surg. 17(1):68–73 - PubMed
-
- Gusenoff JA, Messing S, O’Malley W, Langstein HN (2008) Temporal and demographic factors influencing the desire for plastic surgery after gastric bypass surgery. Plast Reconstr Surg. 121(6):2120–2126 - PubMed
-
- Kitzinger HB, Abayev S, Pittermann A, Karle B, Bohdjalian A, Langer FB et al (2012) After massive weight loss: patients’ expectations of body contouring surgery. Obes Surg. 22(4):544–548 - PubMed
-
- Dunne JA, Wormald JC, Ghedia R, Soldin M (2017) Implementation of national body contouring surgery guidelines following massive weight loss: a national cross-sectional survey of commissioning in England. J Plast Reconstr Aesthet Surg. 70(1):54–59 - PubMed
-
- Ngaage LM, Elegbede A, Pace L, Rosen C, Tannouri S, Rada EM et al (2020) Review of insurance coverage for abdominal contouring procedures in the postbariatric population. Plast Reconstr Surg. 145(2):545–554 - PubMed
-
- Warner JP, Stacey DH, Sillah NM, Gould JC, Garren MJ, Gutowski KA (2009) National bariatric surgery and massive weight loss body contouring survey. Plast Reconstr Surg. 124(3):926–933 - PubMed
-
- Gilmartin J, Bath-Hextall F, Maclean J, Stanton W, Soldin M (2016) Quality of life among adults following bariatric and body contouring surgery: a systematic review. JBI Database Syst Rev Implement Rep. 14(11):240–270
-
- Bolton MA, Pruzinsky T, Cash TF, Persing JA (2003) Measuring outcomes in plastic surgery: body image and quality of life in abdominoplasty patients. Plast Reconstr Surg. 112(2):619–625 (discussion 26 7) - PubMed
-
- Colwell AS, Borud LJ (2008) Optimization of patient safety in postbariatric body contouring: a current review. Aesthet Surg J. 28(4):437–442 - PubMed