Body Contouring Procedures in Three or More Anatomical Areas are Associated with Long Term Body Mass Index Decrease in Massive Weight Loss Patients - a retrospective cohort study

Publication date: Available online 9 June 2017
Source:Journal of Plastic, Reconstructive & Aesthetic Surgery
Author(s): Itay Wiser, Lior Heller, Coral Spector, Ehud Fliss, Tali Friedman
Background– Massive weight loss (MWL) patients who undergo body contouring plastic surgery (BCPS) display superior long-term weight maintenance. The effect of the number of anatomical areas contoured on weight dynamics is undetermined.Objectives– To find whether body mass index (BMI) dynamics following BCPS are associated with the number of anatomical areas operated.Methods– A retrospective cohort study. Study groups were defined by the number of anatomical areas operated (1, 2 and 3+). BMI velocity was defined as a ratio between BMI change following BCPS and follow-up time. Multinominal logistic regression was performed to assess independent association to BMI velocity.Results– A total of 222 patients undergoing 513 BCPS between 2009 and 2014 were included in the study (mean age 36.8±10.9 years, 77% females). Group 3+ (N=88) had a negative mean BMI velocity compared with positive values in groups 1 and 2 (-0.11±1.0 vs. 0.44±1.4 and 0.03±1.2, respectively; p=0.03). Independent risk factors for positive BMI velocity (>0.5 kg/m²/year) included single anatomical area BCPS compared to 3 or more (OR=3.37 CI95% 1.24 – 9.14; p=0.017) and psychiatric medication use (OR=6.73 CI95% 1.15 – 39.35; p=0.034). Independent protective factors included diabetes mellitus (OR=0.094 CI95% 0.01 – 0.99; p=0.049).Conclusions– BCPS in 3 or more anatomical areas following MWL is associated with a long-term weight loss following BCPS. As part of the health strategy to maintain normal BMI values, and achieve overall quality of life improvement in MWL patients, clinicians and health policy makers should positively consider recommending BCPS in multiple anatomical areas.



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