It is well known that liposuction and other body contouring procedures aren’t the primary answer to weight loss. However when it comes to post-massive weight loss (MWL) in patients who undergo bariatric surgery, experts argue that these procedures are a necessary part of achieving the end goal shared by physicians and the healthcare system—the long-term control of health-related comorbidities. That’s according to a recent study published in the October issue of Plastic and Reconstructive Surgery, “Plastic Surgery Improves Long-Term Weight Control after Bariatric Surgery,” which demonstrates that those outcomes are best maintained by patients who have body contouring procedures post-MWL.
In their study Dr. Ali Modarressi and colleagues of University of Geneva, Switzerland, examined the long-term weight results of 200 post-bariatric patients divided into two comparative groups. In one group, 98 post-bariatric patients had body contouring procedures, which removed the excess skin and fat that remained after MWL. In the second group, 102 patients had bariatric surgery only. The authors note that body contouring included a variety of procedures, including tummy tuck, to remove any excess remaining skin, fat and tissue from the arms, breasts and thighs. While patients overall lost an average of almost 100 pounds each at the 2-year follow up, in the years following, those patients in the bariatric-only group gained back 75% more weight than their study counterparts who underwent body contouring surgery. At the 7-year follow up, patients in the body contouring group weighed an average of 176 pounds compared with 200 pounds in the bariatric-only group, and the bariatric-only group gained back approximately 11% (50 pounds) of their weight compared with only 4% (14 pounds) in the body contouring group.
“Our study confirms the important role of plastic surgery in treatment of patients after massive weight loss,” write Modarressi et al.
From the patient perspective, only 10% of patients who undergo bariatric surgery do it for medical reasons. By contrast, the majority (66%) of patients who do it to change their life experience from a social perspective. Modarressi et al. cite research that indicates that while anywhere from 74% to 85% of patients want to have body contouring procedures after MWL, less than 20% actually can afford to have it. And that’s a problem, say the study authors. “Unfortunately, because of excess skin that appears after the quick, massive surgical weight loss, patients’ health-related quality of life remains impaired after bariatric surgery.” As shown in their research, those patients who have body contouring surgery to remove the excess skin and fat are less likely to regain as much weight.
So the question is, should body contouring be considered an essential element and therefore covered by health insurance for the MWL patient? Modarressi et al. say “Yes.” "Since plastic surgery after massive weight loss is mandatory for quality of life improvement and weight loss maintenance in many patients, body contouring must be considered a reconstructive surgery for those who have achieved massive weight loss."
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