title: Weight loss is higher among patients who undergo body contouring procedures after bariatric surgery.
abstract: BACKGROUND
  As the number of patients who have undergone bariatric surgery increases, it is expected that more patients will present for body contouring procedures after weight loss. It has been reported that abdominoplasty can improve mobility, reduce skin fold complications, and improve psychosocial functioning. No previous studies have evaluated weight loss in patients who pursue plastic surgery after bariatric surgery.
  
  
  OBJECTIVE
  The aim of this study is to evaluate weight loss outcomes in patients who choose to undergo body contouring procedures after bariatric surgery.
  
  
  METHODS
  Academic center, United States.
  
  
  METHODS
  Patients who underwent body contouring procedures after bariatric surgery between 2002 and 2014 were included. A comparison was made to a matched cohort based on age, gender, type of bariatric procedure, preoperative body mass index (BMI), and length of follow-up.
  
  
  RESULTS
  In total, 186 patients had documentation of a body contouring procedure after bariatric surgery. There were 158 (84.9%) female participants in the body countering group. Mean age was 48.5±12.7 years and mean BMI was 49.8±10.4 kg/m2. Roux-en-Y gastric bypass, sleeve gastrectomy, and adjustable gastric banding were performed in 157 (84.4%), 17 (9.1%), and 11 (5.9%) patients, respectively. After a matched follow-up period of 61 months, total weight loss was 43.0±22.6 kg in the body contouring group versus 33.5±21.7 kg in the control group (P<.001), percentage of total weight loss was 30.8±11.4% versus 24.0±13.2% (P<.001), percentage excess weight loss was 66.4±25% versus 52.5±30.5% (P<.001), and BMI dropped by 15.7±7.8 kg/m2versus 12.1±7.3 kg/m2(P<.001) in the body contouring group compared with the bariatric surgery-only group, respectively. Multivariate analysis indicated that body contouring after bariatric surgery is significantly associated with increase and durable weight loss (odds ratio 3.59, 95% confidence interval 2.04-5.14, P< .001).
  
  
  CONCLUSIONS
  Patients who underwent body contouring procedures after bariatric surgery had significantly better long-term weight loss than a matched cohort of patients. This finding likely has many contributing factors, and the association between long-term weight loss and body contouring procedures after bariatric surgery requires more detailed study.
authors.affiliation: Bariatric and Metabolic Institute, Cleveland Clinic, Cleveland, Ohio.
authors.forename: Dvir
authors.initials: D
authors.lastname: Froylich
authors.affiliation: Bariatric and Metabolic Institute, Cleveland Clinic, Cleveland, Ohio; Fundació Clínic per la Recerca Biomèdica. Hospital Clínic of Barcelona, Universitat de Barcelona, Barcelona, Spain.
authors.forename: Ricard
authors.initials: R
authors.lastname: Corcelles
authors.affiliation: Bariatric and Metabolic Institute, Cleveland Clinic, Cleveland, Ohio.
authors.forename: Christopher R
authors.initials: CR
authors.lastname: Daigle
authors.affiliation: Bariatric and Metabolic Institute, Cleveland Clinic, Cleveland, Ohio.
authors.forename: Ali
authors.initials: A
authors.lastname: Aminian
authors.affiliation: Department of Plastic Surgery, Cleveland Clinic, Cleveland, Ohio.
authors.forename: Raymond
authors.initials: R
authors.lastname: Isakov
authors.affiliation: Bariatric and Metabolic Institute, Cleveland Clinic, Cleveland, Ohio.
authors.forename: Philip R
authors.initials: PR
authors.lastname: Schauer
authors.affiliation: Bariatric and Metabolic Institute, Cleveland Clinic, Cleveland, Ohio. Electronic address: BRETHAS@ccf.org.
authors.forename: Stacy A
authors.initials: SA
authors.lastname: Brethauer
mesh_terms: D061645:Abdominoplasty / Q000706:statistics & numerical data*; D050110:Bariatric Surgery / Q000379:methods*; D015992:Body Mass Index; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000601:surgery; D011182:Postoperative Care / Q000379:methods / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D024162:Second-Look Surgery / Q000379:methods; D013997:Time Factors; D016896:Treatment Outcome; D015431:Weight Loss / Q000502:physiology*
keywords: Abdominoplasty; Bariatric surgery; Body contouring; Obesity; Weight loss