Body contouring after bariatric surgery helps obese patients keep the weight off

Patients who have plastic surgery to reshape their bodies after bariatric procedures are able to maintain "significantly greater" weight loss than those who do not have surgery, according to a new study by Henry Ford Hospital researchers.

"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," says Donna Tepper, M.D., a Henry Ford plastic surgeon and senior author of the study.

Study results will be presented Oct. 11 at the annual conference of the American Society of Plastic Surgeons in Chicago.

Used to help obese patients lose weight, bariatric surgery includes several types of procedures that limit the amount of food the stomach can hold, including removal of a portion of the stomach or constricting it with a gastric band. Such weight loss can be significant, and result in a lower risk of diabetes and heart disease.

"Bariatric surgery has a measurably significant positive impact on patient illness and death," Dr. Tepper says. "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."

The new study followed 94 patients who underwent bariatric surgery at Henry Ford from 2003 through 2013.

Of those, 47 subsequently had body recontouring procedures.

Some previously obese patients opt for plastic surgery - such as face or breast lift, so-called "tummy tuck" or lifts of sagging upper arms, thighs or buttocks - to remove inelastic excess skin and tissue after substantial weight loss and to reshape or recontour their bodies.

The Henry Ford researchers recorded each patient's Body Mass Index, or BMI - a weight-to-height ratio used to determine degrees of obesity - both before their bariatric surgery and 2.5 years after the procedure.

"Of the patients who underwent contouring surgery, the average decrease in BMI was 18.24 at 2.5 years, compared to a statistically significant 12.45 at 2.5 years for those who did not have further surgery," Dr. Tepper explains.

While these findings suggest that aesthetic procedures following bariatric surgeries may contribute to improving their long-term results, Dr. Tepper says future studies will look at changes in BMI after five years, as well as how different types of contouring procedures may maintain weight loss.

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