Obesity Surgery

, Volume 17, Issue 10, pp 1319–1324 | Cite as

Abdominoplasty after Weight Loss in Morbidly Obese Patients: A 4-Year Clinical Experience

  • Marco Fraccalvieri
  • Giacomo Datta
  • Paolo Bogetti
  • Giovanni Verna
  • Roberto Pedrale
  • Maria Alessandra Bocchiotti
  • Filippo Boriani
  • Fabrizio Duca Obbialero
  • Nicola Kefalas
  • Stefano Bruschi
Article

Background

Morbid obesity is associated with various co-morbidities. With the significant weight loss, new dysfunctions arise, and prior body contour disorders start to severely affect the patient’s quality of life. The abdominal apron is generally the greater and the first disturbance faced by the post-bariatric patient.

Methods

The authors retrospectively reviewed their clinical experience in the treatment of those disorders through abdominoplasty. The benefits in terms of relief of said disorders and drawbacks in terms of surgical complications are described.

Results

117 abdominoplasties were performed from January 2002 to December 2005 on patients who had lost significant weight.The tissue removed ranged from 400 g to 10,500 g of adipose-cutaneous tissue (mean 2,276.5 g). Mean duration of the procedure was 4 hours and 25 minutes, with a maximum of 7 and a minimum of 2 and 40. Complication rate was 50.43%.

Conclusion

Abdominoplasty in the post-obese patient is an apparently simple procedure, which in fact causes a high rate of surgical complications. The complication rate is higher than that of cosmetic abdominoplasties. Nevertheless, the improvement in quality of life following such a procedure renders it a fundamental step in the rehabilitation of the formerly obese patient.

Key words

Obesity morbid obesity plastic surgery abdominoplasty lipectomy body contouring weight loss quality of life eating 

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References

  1. 1.
    Datta G, Cravero L, Margara A et al. The plastic surgeon in the treatment of obesity. Obes Surg 2006; 16: 5–11.CrossRefPubMedGoogle Scholar
  2. 2.
    Strauch B, Herman C, Rohde C. Mid-body contouring in the post-bariatric surgery patient. Plast Reconstr Surg 2006; 117: 2200–11.CrossRefPubMedGoogle Scholar
  3. 3.
    Da Costa LF, Landecker A, Manta M. Optimizing body contour in massive weight loss patients: the modified vertical abdominoplasty. Plast Reconstr Surg 2004; 114: 1917–23.CrossRefPubMedGoogle Scholar
  4. 4.
    Aly AS, Cram AE, Heddens C. Truncal body contouring surgery in the massive weight loss patient. Clin Plast Surg 2004; 31: 611–24.CrossRefPubMedGoogle Scholar
  5. 5.
    Rogliani M, Silvi E, Labardi L et al. Obese and nonobese patients. Complications of abdominoplasty. Ann Plast Surg 2006; 57: 336–8.CrossRefPubMedGoogle Scholar
  6. 6.
    Matarasso A, Swift RS, Rankin M. Abdominoplasty and abdominal contour surgery: a national plastic surgery survey. Plast Reconstr Surg 2006; 117: 1797–808.CrossRefPubMedGoogle Scholar
  7. 7.
    El-Khatib HA, Bener A. Abdominal dermolipectomy in an abdomen with pre-exisiting scars: a different concept. Plast Reconstr Surg 2004; 114: 992–7.CrossRefPubMedGoogle Scholar
  8. 8.
    Al-Basti HB, El-Khatib HA, Taha A et al. Intraabdominal pressure after full abdominoplasty in obese multiparous patients. Plast Reconstr Surg 2004; 113: 2145–50.PubMedGoogle Scholar
  9. 9.
    Krueger JK, Rohrich RJ. Clearing the smoke. The scientific rationale for tobacco abstention with plastic surgery. Plast Reconstr Surg 2001; 108: 1063–73.CrossRefPubMedGoogle Scholar
  10. 10.
    Manassa EH, Hertl CH, Olbrisch RR. Wound healing problems in smokers and nonsmokers after 132 abdominoplasties. Plast Reconstr Surg 2003; 111: 2082–7.CrossRefPubMedGoogle Scholar
  11. 11.
    Savage RC. Abdominoplasty following gastrointestinal bypass surgery. Plast Reconstr Surg 1983; 71: 500–9.PubMedGoogle Scholar
  12. 12.
    Matarasso A, Wallach SG, Rankin M et al. Secondary abdominal contour surgery: a review of early and late reoperative surgery. Plast Reconstr Surg 2005; 115: 627–32.CrossRefPubMedGoogle Scholar
  13. 13.
    Bragg TWH, Jose S, Srivastava S. Patient satisfaction following abdominoplasty: an NHS experience. Plast Reconstr Surg 2007; 60: 75–8.Google Scholar
  14. 14.
    Kelly HA. Excision of fat of the abdominal wall lipectomy. Surg Gynecol Obstet 1910; 10: 229.Google Scholar
  15. 15.
    Boriani F, Taveggia A, Cravero L. Obesity and body contouring: contemporary lessons from a historical example (Correspondence). Obes Surg 2005; 15: 1218.CrossRefPubMedGoogle Scholar
  16. 16.
    Thorek M. Plastic reconstruction of the female breast and abdomen. Am J Surg 1939; 43: 268.CrossRefGoogle Scholar
  17. 17.
    Pitanguy I. Abdominal lipectomy: an approach to it through an analysis of 300 consecutive cases. Plast Reconstr Surg 1967; 40: 384.CrossRefGoogle Scholar
  18. 18.
    Callia WE. Uma plastica para cirurgiao geral. Med Hosp 1967; 11: 40.Google Scholar
  19. 19.
    Yach D, Stucker D, Brownell KD. Epidemiologic and economic consequences of the global epidemics of obesity and diabetes. Nat Med 2006; 12: 62–6.CrossRefPubMedGoogle Scholar
  20. 20.
    Santry H, Gillen DL, Lauderdale DS. Trends in bariatric surgical procedures. JAMA 2005; 294: 1909–17.CrossRefPubMedGoogle Scholar
  21. 21.
    Hensel JM, Lehman JA, Tantri MP et al. An outcomes analysis and satisfaction survey of 199 consecutive abdominoplasties. Ann Plast Surg 2001; 46: 357–63.CrossRefPubMedGoogle Scholar
  22. 22.
    Sanger C, David LR. Impact of significant weight loss on outcome of body contouring surgery. Ann Plast Surg 2006; 56: 9–13.CrossRefPubMedGoogle Scholar
  23. 23.
    Gravante G, Araco A, Araco F et al. Postobese patients and inherent surgical complications. Ann Plast Surg 2006; 56: 585–6.CrossRefPubMedGoogle Scholar
  24. 24.
    Vastine VL, Morgan RF, Williams GS et al. Wound complications of abdominoplasty in obese patients. Ann Plast Surg 1999; 42: 34–9.CrossRefPubMedGoogle Scholar
  25. 25.
    Deitel M. How much weight loss is sufficient to overcome major comorbidities? (Editorial) Obes Surg 2001; 11: 659.CrossRefPubMedGoogle Scholar
  26. 26.
    Kroll SS, Netscher DT. Complications of TRAM flap breast reconstruction in obese patients. Plast Reconstr Surg 1989; 84: 886–92.PubMedCrossRefGoogle Scholar
  27. 27.
    Nemerofsky RB, Oliak DA, Capella JF. Body lift: an account of 200 consecutive cases in the massive weight loss patient. Plast Reconstr Surg 2006; 117: 414–30.CrossRefPubMedGoogle Scholar
  28. 28.
    Van Uchelen JH, Werker PM, Kon M. Complications of abdominoplasty in 86 patients. Plast Reconstr Surg 2001; 107: 1869–73.CrossRefPubMedGoogle Scholar
  29. 29.
    Grazer FM, Goldwyn RM. Abdominoplasty assessed by survey with emphasis on complications. Plast Reconstr Surg 1977; 59: 513–7.CrossRefPubMedGoogle Scholar
  30. 30.
    Kryger ZB, Fine NA, Mustoe TA. The outcome of abdominoplasty performed under conscious sedation: six-year experience in 153 consecutive cases. Plast Reconstr Surg 2004; 113; 1807–17.CrossRefPubMedGoogle Scholar
  31. 31.
    Stewart KJ, Stewart DA, Coghlan B et al. Complications of 278 consecutive abdominoplasties. J Plast Reconstr Aesthet Surg 2006; 59: 1152–5.CrossRefPubMedGoogle Scholar
  32. 32.
    Datta G, Boriani F, Obbialero FD et al. Body contouring after weight loss in morbid obesity: gain in health and leap in psychosocial functioning (Correspondence). Obes Surg 2006; 16: 673.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science + Business Media B.V. 2007

Authors and Affiliations

  • Marco Fraccalvieri
    • 1
  • Giacomo Datta
    • 1
  • Paolo Bogetti
    • 1
  • Giovanni Verna
    • 1
  • Roberto Pedrale
    • 1
  • Maria Alessandra Bocchiotti
    • 1
  • Filippo Boriani
    • 1
    • 2
  • Fabrizio Duca Obbialero
    • 1
  • Nicola Kefalas
    • 1
  • Stefano Bruschi
    • 1
  1. 1.Department of Plastic SurgeryUniversity of TurinTurinItaly
  2. 2.Istituto di Chirurgia PlasticaUniversità di TorinoTorinoItaly

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