Body contouring brings lasting improvement in quality of life after weight loss surgery

Follow-up shows life is better after surgery to remove excess skin after massive weight loss, study reports

November 8, 2012
American Society of Plastic Surgeons (ASPS)

Body contouring after weight-loss (bariatric) surgery produces long-term gains in several aspects of quality of life, reports the November issue of Plastic and Reconstructive Surgery®, the official medical journal of the American Society of Plastic Surgeons (ASPS).

"The study indicates a sustained quality of life improvement in post-bariatric patients after body contouring surgery," concludes the study led by Dr. Eva S.J. van der Beek of University Medical Center Utrecht, the Netherlands. "This suggests the importance of including reconstructive surgery as a component in the multidisciplinary approach in the surgical treatment of morbid obesity," Dr. van der Beek said.

Improved quality of life after body contouring surgery

The researchers evaluated quality-of-life assessments in 33 patients who underwent body contouring after bariatric surgery. Body contouring refers to various plastic surgery procedures done to remove excess fat and skin after massive weight loss.

The most common procedures were abdominoplasty ("tummy tuck") and operations on the breasts. Through an average of seven years after body contouring, the patients repeatedly completed a standard questionnaire evaluating obesity's impact on quality of life.

The results showed "mostly moderate to large, sustained improvement" in quality of life in the years after body contouring. Scores improved in six out of seven quality-of-life domains, including physical functioning and appearance, mental well-being, social acceptance, intimacy and social network.

Some domains showed a small decrease between four and seven years' follow-up. In general, quality-of-life scores were lower for patients who regained weight after their body contouring surgery.

Overall, 55% of patients were very satisfied with their results. All but one patient said they would undergo body contouring again, and considered it "an inevitable step to improve daily quality of life." About one-fourth of patients had further body contouring surgery-another 30% said they would do so if their insurance covered it.

Bariatric surgery produces sustained weight loss in patients with severe obesity. However, more than two-thirds of patients with massive weight loss are left with loose or overhanging skin. This may lead to decreased satisfaction with the results of bariatric surgery, as well as psychological, social and physical problems.

Previous studies have shown that body contouring improves quality of life after bariatric surgery, but the long-term benefits are unclear. "There is an ongoing debate if body contouring surgery is an optional or essential step after massive weight loss in the treatment of morbid obesity," Dr. van der Beek and coauthors write.

The new study shows significant and lasting improvements in quality of life for patients who have body contouring after bariatric surgery. "This suggests the importance of including reconstructive surgery as a component in the multidisciplinary approach in the surgical treatment of morbid obesity," the researchers write. They call for further study of the long-term benefits of body contouring-including possible reasons for the decrease in quality-of-life scores a few years after surgery.