A Prospective, Matched Comparison of Health-Related Quality of Life in Bariatric Patients following Truncal Body Contouring

Abstract

Obesity is a worldwide epidemic associated with significant morbidity, early mortality, and substantial healthcare cost. [1][2][3] In the United States alone, the prevalence is more than one-third of the population. 4 Bariatric surgery is an effective treatment for obesity with overall mortality reductions cited at 30 percent. 5 Although successful bariatric surgery results in resolution or improvement in obesity-related comorbidities, this frequently comes at a patient-level cost-symptomatic excess and redundant skin. The excess skin Disclosure: Dr. Fischer was a consultant for Gore, Integra LifeSciences, Allergan, and Becton-Dickinson during the time of this study. No financial support was provided for this research. The remaining authors have no financial disclosures to report.A Video Discussion by Jeffrey A. Gusenoff, M.D., accompanies this article. Go to PRSJournal.com and click on "Video Discussions" in the "Digital Media" tab to watch.

Body Contouring Surgery after Bariatric Surgery Improves Long-term Health-related Quality of Life and Satisfaction with Appearance

“…Prior research has primarily focused on the short-term effects of BS and BCS in cross-sectional or short-term prospective studies. 14,15,35,48 Our BS findings align with Kvalem et al, 49 where over 90% of participants were satisfied with the results 1-year post surgery, while only 69% were satisfied and felt that their expectations of BS were met 5 years post surgery. Similarly, other studies using the BODY-Q showed that HRQL for patients undergoing BS improved most significantly within the first year after surgery and then gradually declined.…”

“…Prior research has primarily focused on the short-term effects of BS and BCS in cross-sectional or short-term prospective studies 14,15,35,48 . Our BS findings align with Kvalem et al, 49 where over 90% of participants were satisfied with the results 1-year post surgery, while only 69% were satisfied and felt that their expectations of BS were met 5 years post surgery.…”

“…Another barrier to BCS uptake is the ambiguous evidence regarding the complication rate post BS. While some studies attest to BCS as a safe and effective reconstruction solution to remove excess skin following MWL, 35 others have reported high complication rates 36 . In the included countries, BS and BCS are either available through public health systems within specified criteria (Denmark and Finland), 25,37 via health insurance companies (the Netherlands, Germany, and Italy), 11,38 and National Healthcare Insurer (Poland) 39 .…”

Status of Body Contouring Following Metabolic Bariatric Surgery in a Tertiary Hospital of Greece—Still a Long Way to Go

“…There is a misconception among healthcare providers and patients alike that BCS after MBS is an aesthetic intervention that suits only younger patients. On the contrary, the typical post-bariatric patient is a middle-aged female, who could potentially benefit further from BCS on the grounds of bariatric outcome, quality of life, and general well-being, as discussed in the Introduction [23]. Therefore, health-care providers, and especially bariatric surgeons, should encourage their patients to undergo BCS once their BMI has stabilized, provided they satisfy the established selection criteria.…”

“…Furthermore, plastic and reconstructive surgeons should assume a more proactive role when consulting in the context of the multi-disciplinary bariatric team. The second most common reason was inability to cover the costs or non-reimbursement by insurance companies to support this direction, which is a recognized issue worldwide [17,23]. Healthcare providers and policymakers should accumulate the evidence on the benefits of BCS for overall health, with the aim of adjusting the prevailing reimbursement policies.…”