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Utilization of Body Contouring Procedures Following Weight Loss Surgery: A Study of 37,806 Patients

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Abstract

Background

Bariatric surgery has substantial health benefits; however, some patients desire body contouring (BC) procedures following rapid weight loss. There is a paucity of data regarding the true rate of BC following bariatric procedures. The purpose of our study is to examine the utilization of two common procedures, abdominoplasty, and panniculectomy, following bariatric surgery in New York State.

Methods

The SPARCS longitudinal administrative database was used to identify bariatric procedures by using ICD-9 and CPT codes between 2004 and 2010. Procedures included sleeve gastrectomy, Roux-en-Y gastric bypass, and laparoscopic adjustable gastric banding. Using a unique patient identifier, we tracked those patients who subsequently underwent either abdominoplasty or panniculectomy with at least a 4-year follow-up (until 2014). Multivariable Cox proportional hazard model was used to evaluate predictors of follow-up BC surgery.

Results

37,806 patients underwent bariatric surgery between 2004 and 2010. Only 5.58% (n = 2112) of these patients subsequently had a BC procedure, with 143 of them (6.8%) having ≥1 plastic surgery. The average time to plastic surgery after band, bypass, or sleeve was 1134.83 ± 671.09, 984.70 ± 570.53, and 903.02 ± 497.31 days, respectively (P < 0.0001). Following the multivariable Cox proportional hazard model, a female, SG patients, patients with Medicare or Medicaid, and patients in either <20 or >80%ile in yearly income were more likely to have plastic surgery after adjusting for age, race/ethnicity, comorbidities and complications (P values < 0.0001).

Conclusions

This study shows that plastic surgery is completed by only 6% of patients following bariatric procedures. As insurance and income are associated with pursuing surgery, improved access may increase the number of patients who are able to undergo these reconstructive procedures.

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Acknowledgements

We would like to thank the statistical support from the Biostatistical Consulting Core, School of Medicine, Stony Brook University.

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Authors and Affiliations

  1. Division of Bariatric, Foregut and Advanced Gastrointestinal Surgery, Department of Surgery, Stony Brook University Medical Center, 100 Nichols Road, HSC T19, Stony Brook, NY, 11794, USA

    Maria S. Altieri, David Novikov, Konstantinos Spaniolas, Andrew Bates, Mark Talamini & Aurora Pryor

  2. Department of Family, Population and Preventive Medicine, Stony Brook University Medical Center, Stony Brook, NY, USA

    Jie Yang

  3. Department of Applied Mathematics and Statistics, Stony Brook University, Stony Brook, NY, USA

    Jihye Park & Lijuan Kang

Authors
  1. Maria S. Altieri
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  2. Jie Yang
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  3. Jihye Park
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  4. David Novikov
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  5. Lijuan Kang
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  6. Konstantinos Spaniolas
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  7. Andrew Bates
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  8. Mark Talamini
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  9. Aurora Pryor
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Corresponding author

Correspondence to Maria S. Altieri.

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Conflict of Interest

Author 1, Author 2, Author 3, Author 4, Author 5, Author 6, Author 7, and Author 8 have nothing to disclose. Author 9 reports honoraria for speaking for Ethicon, Medtronic, Stryker, and Gore; and is a consultant for Medicines Company and Merck.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Does not apply to this study.

Funding

No industry or other external funding was used for this research. Dr. Pryor receives honoraria for speaking for Ethicon, Medtronic, and Gore; is a consultant for Freehold Medical and Intuitive, and has ownership interest in Transenterix.

Additional information

This work was presented at the Scientific Forum at the American College of Surgeons, Washington DC 2016.

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Altieri, M.S., Yang, J., Park, J. et al. Utilization of Body Contouring Procedures Following Weight Loss Surgery: A Study of 37,806 Patients. OBES SURG 27, 2981–2987 (2017). https://doi.org/10.1007/s11695-017-2732-4

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  • DOI: https://doi.org/10.1007/s11695-017-2732-4

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