Quality of Life Long-Term after Body Contouring Surgery following Bariatric Surgery: Sustained Improvement after 7 Years.

Utrecht and Nieuwegein, The Netherlands From the Department of Plastic and Reconstructive Surgery, University Medical Center Utrecht; the Department of Clinical and Health Psychology, Utrecht University; and the Departments of Plastic and Reconstructive Surgery and Surgery, St. Antonius Hospital.
Plastic and Reconstructive Surgery (Impact Factor: 3.33). 07/2012; 130(5):1133-9. DOI: 10.1097/PRS.0b013e318267d51d
Source: PubMed

ABSTRACT : Bariatric surgery for morbid obesity results in massive weight loss and improvement of health and quality of life. A downside of the major weight loss is the excess of overstretched skin, which may influence the patient's quality of life by causing functional and aesthetic problems. The purpose of the current study was to evaluate the patient's quality of life long-term after body contouring following bariatric surgery.
: Quality of life was measured with the Obesity Psychosocial State Questionnaire in 33 post-bariatric surgery patients 7.2 years (range, 3.2 to 13.3 years) after body contouring surgery. Data were compared with previous assessments 4.1 years (range, 0.7 to 9.2 years) after body contouring surgery of the quality of life at that time and before body contouring surgery.
: Compared with appraisals of quality of life before body contouring surgery, a significant, mostly moderate to large, sustained improvement of quality of life was observed in post-bariatric surgery patients 7.2 years after body contouring surgery in six of the seven psychosocial domains. A small deterioration occurred between 4.1- and 7.2-year follow-up on two of the seven domains except for the domain efficacy toward eating, which showed a significant improvement. At 7-year follow-up, 18 patients (55 percent) were satisfied with the result of body contouring surgery.
: This study indicates a sustained quality-of-life improvement in post-bariatric surgery patients after body contouring surgery. This suggests the importance of including reconstructive surgery as a component in the multidisciplinary approach in the surgical treatment of morbid obesity.
: Therapeutic, IV.

  • [Show abstract] [Hide abstract]
    ABSTRACT: Bariatric surgery is a way to achieve lasting weight loss in the obese. Body contouring surgery seeks to alleviate some of the discomfort caused by the excessive loose skin following massive weight loss. Higher complication rates are described in this type of surgery when done post-bariatric. The purpose of this article is to compare complication rates of body contouring surgery when performed on patients with weight loss due to bariatric surgery compared to patients who lost weight due to dietary changes and/or exercise. A total of 253 studies were identified by searches in PubMed/Medline databases as well as two hand-search strategies. Three levels of screening resulted in seven studies being considered suitable for inclusion in the meta-analysis. All statistical calculations were performed with Review Manager (RevMan) Version 5.2.3. The fixed-effects pooled risk ratio (RR) of developing complications after body contouring surgery when comparing post-bariatric and non-bariatric patients is 1.60 (95% confidence interval (CI) 1.30-1.96; P < 0.00001; I(2) = 48%) showing that there is a 60% increase in the risk of developing complications if the patient lost weight due to surgery. A subgroup analysis of studies with patients only having one body contouring procedure shows an 87% higher increase in the risk of developing a complication when being post-bariatric (RR = 1.87; 95% CI 1.46-2.40; P < 0.00001; I(2) = 0%). If we exclusively look at the studies with a less uniform patient population that included patients who had one procedure performed as well as patients who had several procedures performed, there seems to be a non-significant 4% lower risk of developing a complication in the case of post-bariatric patients compared to the non-bariatric patients (RR = 0.96; 95% CI 0.65-1.42; P = 0.84; I(2) = 0%). The analysis shows a 60-87% increased risk of complications in the post-bariatric group compared to the non-bariatric group with statistical significance.
    Journal of Plastic Reconstructive & Aesthetic Surgery 10/2013; · 1.47 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Background Massive weight loss after bariatric surgery can cause physical, functional, hygienic, and psychological problems and can also have impact on the quality of life. Reconstructive body contouring surgery can provide a solution for these problems. The number of patients seeking contouring surgery is far greater than the actual number of surgical reconstructions performed. The aim of this study was to register the demand for reconstructive surgery, take an inventory of the complaints, and index body satisfaction after massive weight loss. Methods This retrospective study is based on questionnaires filled out by 237 patients between 2007 and 2010 after undergoing a primary laparoscopic Roux-en-Y gastric bypass. Results This study showed a desire for reconstructive plastic surgery after massive weight loss in 28.3 % of the patients. These patients can in turn be divided into patients who received surgery (6.8 %), patients on the waiting list (5.5 %), and patients rejected by their insurance company (16 %). Ninety percent of these patients reported functional problems caused by excess skin, and 52 % experienced psychological distress after the massive weight loss. Patients were bothered most by their abdomen and breasts. Men were generally more satisfied than women (50 and 41 %, respectively). Conclusions Body contouring surgery reduces physical and psychological complaints after massive weight loss and positively influences quality of life. Prospective studies are needed to evaluate the approval and rejection criteria of health-care insurance companies. Level of evidence: III, risk/prognostic study
    European Journal of Plastic Surgery 02/2013;
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Quality of life of the obese patients after treatment with insertion of intragastric BIB balloon versus Atkins diet in Al Sulaimaneyah province-Iraq Hiwa O. Ahmed University of Al Sulaimaneyah .Faculty of Medicine,School of Medicine PB 13,Al Sulaimaneyah,Iraq Tel; 009647701530753 Abstract Background ; Health related quality of life (HRQOL) is studied widely, after weight loss by insertion of BioEnterics Intragastric Balloon,but quality of life (QOL) not related to the health of the patients is not studied after body weight loss by any means on wide scale. Aim: To evaluate extend of body weight loss in general and particularly after BIB insertion or Atkins diet and changes of quality of life in the obese patients after body weight loss. Patients, materials and methods: Prospective study, from a total of 180 patients, 80 of them selected over a period of 4 years, included patients divided in to two comparable groups, first treated with insertion of Bioenterics intragastric balloon and the second subjected to modified Atkins diet for 6 months. Each patient in either group followed up monthly for 18 months ,the patients were interviewed before the star and after completion of the treatments to fill the quality of life questionnaire. The collecting data were analyzed using the IBM SPSS ( statistical package for social science) statistics version 21. Results: Two comparable groups of obese patients were studied, each group consists of 40 female patients, mean age in group A was 27years (20-39 years) with mean body weight 90 kg (80-100) and mean BMI 36(31-39.9) who were treated with insertion of BIB. While mean age in group B was 29 years (20-39 years) with mean body weight 91 kg (80-102) and mean BMI 36.5 (31-39.9). Statistically important changes occurred in the quality of life of the patients after either method of treatments to different degrees (p value 0.005917) Conclusion: BioEnterics Intragastric Balloon reduces more weight and BMI in 6 months in comparison to modified Atkins diet, and results in statistically significant improvement of most aspects of quality of life. Keywords: obesity, quality of life, loss of weight, BioEnterics Intragastric Balloon, Atkins diet. BioEnterics Intragastric Balloon
    Food Science and Quality Management. 10/2013; 20:29-36.

Rinie Geenen