title: Body contouring after biliopancreatic diversion.
abstract: BACKGROUND
  From Nov 2001 to Mar 2006, 176 patients underwent body contouring plastic surgery after prior biliopancreatic diversion (BPD). Weight loss had varied from 30-100 kg. The plastic surgery targeted the arms (24 patients), breast (58), abdomen (62) and thighs (20), plus torsoplasty (12).
  
  
  METHODS
  BPD is a "non-cosmetic" bariatric operation which results in malabsorption and subsequent major weight loss within 12 to 18 months. The typical "empty" aspect of the slimmed areas directed our surgical choices to specific techniques: brachioplasty, reduction mammaplasty and/or mastopexy (with or without prosthesis or "self-prosthesis" technique), thigh-lift, abdominoplasty and torsoplasty. We do not consider any liposuction technique suitable for this kind of patient, because of the specific histological changes caused by BPD.
  
  
  RESULTS
  The metabolic discrepancies following BPD affect postoperative management of these patients. A higher incidence of complications has been reported, of both systemic and local nature; the local ones, common in the abdominal wall, convinced us to perform an arteriographic study preoperatively, to check anatomical alterations following the BPD.
  
  
  CONCLUSIONS
  Although the characteristics of BPD patients limit the choices, we are satisfied with the results of cosmetic correction and quality of life. All the patients, without exception, noted a high rate of positive thinking and have undergone further body-contouring surgery (or plan to do so).
authors.affiliation: Plastic Surgery and Burn Unit, San Martino University Hospital, Genova, Italy. franco.migliori@hsanmartino.it
authors.forename: Franco
authors.initials: F
authors.lastname: Migliori
authors.forename: Cristina
authors.initials: C
authors.lastname: Rosati
authors.forename: Gabriele
authors.initials: G
authors.lastname: D'Alessandro
authors.forename: Gian Giacomo Serra
authors.initials: GG
authors.lastname: Cervetti
mesh_terms: D000005:Abdomen / Q000601:surgery; D015904:Biliopancreatic Diversion / Q000009:adverse effects; D001828:Body Image; D001940:Breast / Q000601:surgery; D002081:Buttocks / Q000601:surgery; D062109:Dermatologic Surgical Procedures; D005260:Female; D006801:Humans; D008297:Male; D009767:Obesity, Morbid / Q000601:surgery*; D019651:Plastic Surgery Procedures / Q000379:methods*; D013848:Thigh / Q000601:surgery; D016896:Treatment Outcome