Plastic Surgery May Keep Weight From Coming Back

Bariatric surgery patients who have body contouring may maintain a lower body mass index

(RxWiki News) For obese patients, weight loss surgery can have many benefits. The procedure, however, may cause sagging skin. But plastic surgery may tighten up the skin and keep the weight off.

Bariatric (or weight loss) surgery can improve type 2 diabetes, obstructive sleep apnea, high blood pressure and other health conditions in obese patients. Dramatic weight loss from this type of operation, however, may weaken underlying support tissue and cause drooping skin. Also, in some, the weight may come back.

A new study found that plastic surgery to remove excess skin and reshape body contours may also help bariatric surgery patients maintain weight loss.

Donna Tepper, MD, a plastic surgeon at Henry Ford Hospital in Detroit, and colleagues conducted the study.

“Bariatric surgery has a measurably significant positive impact on patient illness and death,” Dr. Tepper said in a press release. “However, even with the technical and safety advancements we’ve seen in these procedures, their long-term success may still be limited by [relapse]. There is a high incidence of patients who regain weight after the surgery.”

The study authors compared patients who had both weight loss surgery and plastic surgery to those who had only weight loss surgery.

Before surgery, the average patient body mass index was 49.

The authors found that those who had both operations had an average decrease in BMI of 18.24 points over the course of two and a half years. Those who only had bariatric surgery had a BMI drop of 12.45 points during the same time period.

BMI is a measure of body fat based on height and weight. The National Heart, Lung, and Blood Institute says a normal BMI is under 25. Overweight is between 25 and 29.9. Obese is 30 and higher.

In this research, the authors followed 94 bariatric surgery patients from 2003 to 2013. A total of 47 had body recontouring procedures after their weight loss operation.

These procedures include face-lift, breast-lift, the so-called “tummy tuck,” and lifts of sagging upper arms, thighs or buttocks. These operations get rid of excess skin and tissue after significant weight loss.

As many as 50 percent of patients may regain a small amount of their lost weight — around 5 percent — two years or more after their surgery, according to the American Society for Metabolic and Bariatric Surgery.

The following are some common weight loss surgeries:

  • Gastric bypass: This is one of the most common types of weight loss surgeries. The operation limits the amount of food a person can eat. In a typical bypass, a stomach pouch may be created out of a small portion of the stomach and attached directly to the small intestine, bypassing a large part of the stomach.
  • Gastric banding: A surgeon inserts a band around the upper part of the stomach to create a small pouch to hold food.
  • Sleeve gastrectomy: The patient has about 85 percent of the stomach surgically removed.

"People should consider bariatric surgery if they are 100 pounds over their ideal weight or if they have medical conditions that could be resolved or significantly improved with weight loss, such as type 2 diabetes, sleep apnea, high blood pressure and joint issues," Dr. Tepper told dailyRx News.

The study was presented in October at the the annual conference of the American Society of Plastic Surgeons in Chicago.

The authors disclosed no conflicts of interest.

Review Date: 
October 18, 2014