Article

Maintenance of weight loss after body contouring surgery for massive weight loss.

Department of Surgery and Division of Plastic Surgery, The Johns Hopkins Medical Institutions, Baltimore, MD, USA.
Plastic and reconstructive surgery (impact factor: 2.74). 06/2008; 121(6):2114-9. DOI:10.1097/PRS.0b013e3181708129 pp.2114-9
Source: PubMed

ABSTRACT Weight loss can be achieved through gastric bypass surgery or diet. Surgery has been reported to be more effective in achieving long-term weight loss. The authors aimed to determine whether massive weight loss is maintained or improved after body contouring.
Seventy patients underwent body contouring surgery after massive weight loss from January of 2001 to January of 2005. Data collected included age; gender; mode of massive weight loss; body mass index before massive weight loss, at contour surgery, and at follow-up; and weight of skin excised.
Weight loss was achieved by open (n = 57) or laparoscopic gastric bypass surgery (n = 7), or by diet (n = 6). Average weight loss at contour surgery was 152 lb for open gastric bypass, 139 lb for laparoscopic gastric bypass, and 140 lb for the diet group. Mean weight of excised skin was 12.8 lb. Gastric bypass patients on average gained 2.3 lb, whereas nonsurgical patients gained 22 lb after body contouring, netting out skin excised. On multivariate analysis, weight loss did not differ between laparoscopic and open gastric bypass (p = 0.9); however, surgery led to a 27-lb greater weight loss compared with diet (p = 0.03). This effect was more remarkable with follow-up less than or equal to 18 months compared with more prolonged follow-up. Every year increase in age was associated with an 0.8-lb weight gain (p = 0.03).
Gastric bypass surgery patients maintain massive weight loss better than "diet" patients. Weight loss tapers over time for gastric bypass surgery patients, with ultimate weight gain, comparable to that seen in the general population as it ages.

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    Article: Two cases of lower body contouring with a spiral and vertical medial thigh lift.
    Sang Wha Kim, Hyun Ho Han, Je Won Seo, Jung Ho Lee, Deuk Young Oh, Sang Tae Ahn, Jong Won Rhie
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    ABSTRACT: Massive weight loss results in skin excess, leading to an unsatisfying body contour. Various thigh lift procedures can correct flabby skin in the lower leg. We present a lower body contouring technique with a report on two patients. The procedure is determined by the body contour of the patient. As the skin excess in the thigh area tended to appear mostly on the medial side, a vertical medial thigh lift was considered. Moreover, for patients with a pear/guitar-shaped body contour, we added the spiral thigh lift for skin excess in the buttocks and the lateral thigh area. The extent of tissue to excise was determined by pinching the patient in a standing position. The inferior skin flap was fixed to non-movable tissue, which was helpful for lifting the tissue and preventing the widening of the scar. After the operation, a drain was kept for 3 to 4 days. A compressive garment was used after removing the drain. There were no complications. The patients were discharged 6 to 8 days after the operation. In conclusion, skin excess, especially in the lower body, can be corrected by a thigh lift combining several procedures, varying from person to person.
    Archives of plastic surgery. 01/2012; 39(1):67-70.
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    Article: Prospective assessment of nutrition and exercise parameters before body contouring surgery: optimizing attainability in the massive weight loss population.
    Peter F Koltz, Rui Chen, Susan Messing, Jeffrey A Gusenoff
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    ABSTRACT: A lower body mass index at the time of body contouring surgery can optimize surgical options and, ultimately, aesthetic results. With increased emphasis on preoperative evaluation of the massive weight loss patient, the interrelationships between nutrition and exercise on body mass indices have not been well defined. One hundred thirty-three consecutive massive weight loss patients presented for body contouring. Two-week food logs, weekly exercise regimens, and body mass indices were measured. Outcome variables were assessed by univariate and multivariate analysis. One hundred fifteen women and 18 men presented, with a mean age of 46.5 +/- 11.0 years, a maximum body mass index of 52.8 +/- 10.6 kg/m2, current body mass index of 32.4 +/- 8.6, change in body mass index of 20.4 +/- 6.5, daily protein intake of 56.9 +/- 18.5 g, and mean exercise of 3.7 days/week. The mean change in body mass index for the bariatric surgery group was 20.9 +/- 6.4 versus 15.9 +/- 6.8 for the self-weight loss group (p = 0.01). Age correlated directly with current body mass index (p = 0.0031) and inversely with exercise (p = 0.0003). Change in body mass index was related to younger age (p = 0.0455), maximum body mass index (p < 0.0001), and bariatric surgery (p = 0.0016), but not protein intake. Exercise five or more times per week was associated with a larger change in body mass index and lower current body mass index (p < 0.0036) than exercising two or fewer times per week (p = 0.0292). Frequent exercise optimizes body mass index at the time of presentation for body contouring surgery. Further evaluation of the elements of diet will be required to determine its role. Thus, comprehensive post-bariatric surgery or lifestyle programs that promote exercise may increase surgical options and optimize results in body contouring surgery.
    Plastic and reconstructive surgery 04/2010; 125(4):1242-7. · 2.74 Impact Factor
Data provided are for informational purposes only. Although carefully collected, accuracy cannot be guaranteed. The impact factor represents a rough estimation of the journal's impact factor and does not reflect the actual current impact factor. Publisher conditions are provided by RoMEO. Differing provisions from the publisher's actual policy or licence agreement may be applicable.

Keywords

0.8-lb weight gain
 
18 months
 
body contouring surgery
 
body mass index
 
contour surgery
 
diet group
 
excised skin
 
Gastric bypass patients
 
gastric bypass surgery
 
Gastric bypass surgery patients
 
general population
 
laparoscopic gastric bypass
 
laparoscopic gastric bypass surgery
 
massive weight loss
 
Mean weight
 
multivariate analysis
 
open gastric bypass
 
skin excised
 
ultimate weight gain
 
Weight loss tapers