Body Contouring in Massive Weight Loss Post-Bariatric Surgery Patients

Abstract

Summary O besity is recognized by the WHO as a worldwide pandemic and the fifth leading risk factor for deaths. Obesity is a pro-inflammatory multifactorial disease which increases the risk of many comorbidities, the most prevalent of which are diabetes, hypertension, metabolic syndrome, cardiovascular disease, cerebrovascular abnormalities, respiratory problems, hepatobiliary disease, cancers, psychological abnormalities, and social malfunctioning. Failure of lifestyle modifications and pharmacological measures in achieving and maintaining long term weight loss has led to an exponential rise in the number of bariatric surgeries with a 30-fold increase in the number of procedures performed in 2010/2011 compared to those performed in 2000/2001. Bariatric Surgery is currently considered the most efficient and cost-effective treatment for obesity resulting in, not only sustained weight loss, but also the resolution of many obesity associated comorbidities, and reducing overall mortality which has led to the rise of the term “Bariatric metabolic Surgery” Bariatric procedures achieve a very high percentage of excess weight loss (EWL), ranging from 47% to 70% excess weight loss. This high percentage of EWL causes a multitude of both physiologic and anatomic changes. Although the surgery is successful in achieving weight loss and in the resolution of many comorbidities, it results in a multiplicity of both aesthetic and functional problems. Severe volume loss results in skin redundancy and sagging, which leads to issues with hygiene, infection and cosmesis, and constitutes a constant reminder and possibly a stigma of the patient’s former obese self, which leads to patient dissatisfaction and psychological problems. Therefore, it is particularly impo