title: Plastic surgery after bariatric surgery.
abstract: BACKGROUND
  Massive weight loss after bariatric surgery often results in excess skin, which can lead to stigma due to appearance and pronounced physical and psychological impairments. This review considers the evidence base for post-bariatric plastic surgery and the treatment options that are available.
  
  
  METHODS
  The article is based on a literature search in PubMed with the keywords «bariatric surgery» AND «plastic surgery», in addition to the authors' experience with a large number of patients.
  
  
  RESULTS
  Body contouring surgery after massive weight loss is offered primarily for the treatment of troublesome skin conditions. The surgery can help to improve quality of life and functional status. However, there is little scientific evidence regarding indications for surgery, choice of surgical techniques and risk of complications, and the surgeon's own opinions and clinical experience often play a major role. Many plastic surgeons limit body contouring surgery to those with BMI < 28 kg/m². However, most patients who have undergone bariatric surgery have BMI ≥ 30 kg/m², and requests for body contouring surgery for these individuals are often denied, except when there are compelling medical grounds.
  
  
  CONCLUSIONS
  Plastic surgery can lead to improved functioning and increased quality of life. The evidence base with respect to indications, treatment methods and outcomes should be strengthened through well-planned prospective studies and a patient registry. There is a particular need for documentation of treatment outcomes in the large group of patients with BMI ≥ 30 kg/m².
authors.affiliation: Avdeling for plastikkirurgi Sykehuset Telemark.
authors.forename: Gudjon L
authors.initials: GL
authors.lastname: Gunnarson
authors.affiliation: Aleris Oslo.
authors.forename: Jan K
authors.initials: JK
authors.lastname: Frøyen
authors.affiliation: Senter for sykelig overvekt i Helse Sør-Øst Sykehuset i Vestfold.
authors.forename: Rune
authors.initials: R
authors.lastname: Sandbu
authors.affiliation: Avdeling for plastikkirurgi Odense Universitetshospital og Vejle Sykehus Lillebælt.
authors.forename: Jørn Bo
authors.initials: JB
authors.lastname: Thomsen
authors.affiliation: Senter for sykelig overvekt i Helse Sør-Øst Sykehuset i Vestfold og Avdeling for endokrinologi, sykelig overvekt og forebyggende medisin Medisinsk klinikk Institutt for klinisk medisin Universitetet i Oslo.
authors.forename: Jøran
authors.initials: J
authors.lastname: Hjelmesæth
mesh_terms: D050110:Bariatric Surgery / Q000009:adverse effects*; D015992:Body Mass Index; D000075202:Contraindications; D062109:Dermatologic Surgical Procedures / Q000009:adverse effects / Q000379:methods / Q000523:psychology; D006801:Humans; D009765:Obesity / Q000601:surgery; D011183:Postoperative Complications; D011788:Quality of Life; D012867:Skin / Q000473:pathology