title: After massive weight loss: patients' expectations of body contouring surgery.
abstract: BACKGROUND
  Massive weight loss following bariatric surgery leads to excess skin with functional and aesthetic impairments. Surplus skin can then contribute to problems with additional weight loss or gain. The aims of the current study were to evaluate the frequency of massive soft tissue development in gastric bypass patients, to determine whether males and females experience similar post-bypass body changes, and to learn about the expectations and impairments related to body contouring surgery.
  
  
  METHODS
  A questionnaire addressing information on the satisfaction of body image, quality of life, and expectation of body contouring surgery following massive weight loss was mailed to 425 patients who had undergone gastric bypass surgery between 2003 and 2009. Of these 425 individuals, 252 (59%) patients completed the survey.
  
  
  RESULTS
  Ninety percent of women and 88% of men surveyed rated their appearance following massive weight loss as satisfactory, good, or very good. However, 96% of all patients developed surplus skin, which caused intertriginous dermatitis and itching. In addition, patients reported problems with physical activity (playing sports) and finding clothing that fit appropriately. Moreover, 75% of female and 68% of male patients reported desiring body contouring surgery. The most important expectation of body contouring surgery was improved appearance, followed by improved self-confidence and quality of life.
  
  
  CONCLUSIONS
  Surplus skin resulting from gastric bypass surgery is a common issue that causes functional and aesthetic impairments in patients. Consequently, this increases the desire for body contouring surgery with high expectations for the aesthetic outcome as well as improved life satisfaction.
authors.affiliation: Divison of Plastic and Reconstructive Surgery, Department of Surgery, Medical University of Vienna, General Hospital Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria. hugo.kitzinger@meduniwien.ac.at
authors.forename: Hugo B
authors.initials: HB
authors.lastname: Kitzinger
authors.forename: Sara
authors.initials: S
authors.lastname: Abayev
authors.forename: Anna
authors.initials: A
authors.lastname: Pittermann
authors.forename: Birgit
authors.initials: B
authors.lastname: Karle
authors.forename: Arthur
authors.initials: A
authors.lastname: Bohdjalian
authors.forename: Felix B
authors.initials: FB
authors.lastname: Langer
authors.forename: Gerhard
authors.initials: G
authors.lastname: Prager
authors.forename: Manfred
authors.initials: M
authors.lastname: Frey
mesh_terms: D001317:Austria / Q000453:epidemiology; D050110:Bariatric Surgery / Q000009:adverse effects / Q000379:methods / Q000523:psychology*; D001828:Body Image; D062109:Dermatologic Surgical Procedures; D004954:Esthetics; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020380:Needs Assessment; D017063:Outcome Assessment, Health Care; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D011788:Quality of Life; D019651:Plastic Surgery Procedures / Q000379:methods / Q000523:psychology*; D012649:Self Concept; D011795:Surveys and Questionnaires; D015431:Weight Loss
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