Excess Skin Removal After Bariatric Surgery Helps Keep the Weight Off

By Megan Brooks October 15, 2014

is_141016_bariatric_surgery_obese_800x600NEW YORK (Reuters Health) – Obese patients who have plastic surgery to remove excess skin after bariatric surgery may be more apt to keep the weight off than those who don’t, a new study hints.

“As plastic and reconstructive surgeons, we are encouraged by the idea that improved body image can translate into better long-term maintenance of a healthier weight, and possibly a better quality of life for our patients,” senior author Dr. Donna Tepper, a plastic surgeon with Henry Ford Hospital in Detroit, Michigan, said in a statement.

She presented the results October 11 at the annual conference of the American Society of Plastic Surgeons in Chicago.

The researchers followed 94 patients who underwent bariatric surgery at Henry Ford from 2003 through 2013, including 47 who subsequently had body recontouring procedures.

“While both groups lost a significant amount of weight at six months, as expected, those that underwent further contouring surgery maintained their weight at two and a half years. That’s pretty remarkable,” Dr. Tepper noted in an interview with Reuters Health.

The average decrease in BMI at 2.5 years was 18.24 in patients who underwent contouring surgery, compared with 12.45 in those who did not have further surgery. This difference was statistically significant (p=0.004).

“Bariatric surgery has a measurably significant positive impact on patient illness and death,” Dr. Tepper said. “However, even with the technical and safety advancements we’ve seen in these procedures, their long-term success may still be limited by recidivism. There is a high incidence of patients who regain weight after the surgery.”

She told Reuters Health that in her experience, many patients who undergo bariatric surgery are motivated to have excess skin removed and reshape or recontour their bodies and the current study suggests it can help with weight maintenance.

Dr. Tepper noted that insurance companies will typically cover aesthetic surgery after bariatric surgery if the patient had lost at least 100 pounds excess weight and were weight-stable for six months, in addition to meeting a few other criteria, such as having chronic skin irritation or rashes, or limitations in activities of daily living because of the excess skin.

The current findings, she said, suggest that plastic surgery following bariatric surgery may contribute to better long-term results.

In an interview with Reuters Health, Dr. John Morton, from the Stanford School of Medicine in California and President-Elect of the American Society for Metabolic and Bariatric Surgeons (ASMBS), said, “Now that bariatric surgery has been shown to be very safe and very effective, the number of patients has increased and some patients are going to need some sort of reconstructive surgery. It’s been a fast-growing part of plastic surgery.”

He emphasized, “Not all patients will need reconstructive surgery after bariatric surgery, but for those that do need it, it is important that they get it and I’m glad to see this (study) helped demonstrate that.”

“I do see it as reconstructive; there is nothing aesthetic about it. It is truly for function,” Dr. Morton said. A lot of patients who lose massive amounts of weight have redundant skin that can lead to pain and repeated skin infections, he explained.

There is also an impact on body image that can keep people from exercising. In that regard, “this study is a very important one and something we’ve seen in practice, but hasn’t really been described before, which is when you remove some of those barriers to exercise, good things will happen, like seeing more weight loss,” Dr. Morton said.

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