title: Thigh laxity after massive weight loss: a utilities outcomes assessment.
abstract: BACKGROUND
  The presence of excess skin after massive weight loss, particularly in the thighs, not only contributes to a negative body image but can also lead to functional deficits in mobility. In the present study, we quantified the health state utility of living with excess skin in the thighs in an attempt to objectively establish the burden on the quality of life in patients living with excess thigh skin laxity.
  
  
  METHODS
  Using visual analog scale (VAS), time trade-off (TTO), and standard gamble (SG), we compared the utility outcome scores for thigh skin excess with monocular and binocular blindness from a prospective sample of medical students and the general population. Utility scores were compared using paired t test. Linear regression was performed using age, race, and education as independent predictors of each of the utility scores.
  
  
  RESULTS
  One hundred thirty-four prospective participants were enrolled during a 6-month period, and 112 participants met our inclusion criteria. The utility outcome scores for thigh lift (VAS, TTO, and SG, 0.77 ± 0.15, 0.90 ± 0.11, and 0.89 ± 0.14, respectively) were statistically different from binocular blindness (VAS, TTO, and SG, 0.37 ± 0.18, 0.70 ± 0.23, and 0.70 ± 0.26; P < 0.001), but other than VAS (0.67 ± 0.15, P < 0.001), similar to monocular blindness (TTO and SG, 0.89 ± 0.13 and 0.81 ± 0.14, respectively; P > 0.05). SG (0.89 ± 0.14 vs 0.97 ± 0.02, P = 0.003) and TTO (0.89 ± 0.11 vs 0.95 ± 0.03, P = 0.038) were different between general population and medical students, respectively, corresponding to 3.96 versus 1.80 potential years willing to be traded (P < 0.05). Additionally, SG was higher in whites versus nonwhites who were willing to take a potential 8% chance of mortality compared to 15%, respectively (P = 0.001), to achieve "perfect" health.
  
  
  CONCLUSIONS
  We have objectified the utility of living with thigh deformity after massive weight loss. Our sample population if faced with the condition was willing to sacrifice a potential 3.6 years of life and potentially undergo a procedure with 11% chance of mortality to address excess thigh laxity.
authors.affiliation: Division of Plastic and Reconstructive Surgery, McGill University Health Center, Montreal, Quebec, Canada.
authors.forename: Ali
authors.initials: A
authors.lastname: Izadpanah
authors.forename: Hani
authors.initials: H
authors.lastname: Sinno
authors.forename: Joshua
authors.initials: J
authors.lastname: Vorstenbosch
authors.forename: Bernard T
authors.initials: BT
authors.lastname: Lee
authors.forename: Samuel J
authors.initials: SJ
authors.lastname: Lin
mesh_terms: D000328:Adult; D001294:Attitude to Health; D001766:Blindness / Q000523:psychology; D003357:Cosmetic Techniques / Q000523:psychology*; D017281:Cost of Illness; D062109:Dermatologic Surgical Procedures / Q000523:psychology*; D005260:Female; D019538:Health Care Surveys; D006301:Health Services Needs and Demand; D006801:Humans; D016014:Linear Models; D008297:Male; D011446:Prospective Studies; D011788:Quality of Life; D019057:Quality-Adjusted Life Years; D012867:Skin / Q000473:pathology; D013848:Thigh / Q000473:pathology / Q000601:surgery*; D064232:Visual Analog Scale; D015431:Weight Loss