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Body Contouring OK After Big Weight Loss

Waiting a year after weight loss surgery reduces risks

By Jennifer Warner

WebMD Medical News

Reviewed By Michael Smith, MD

Oct. 28, 2003 -- A growing number of Americans are now turning to weight loss surgery to overcome their battle with obesity, but months later many are literally left with a shell of their former selves.

That excess skin and fat below the abdomen can be removed though a surgical procedure known as body contouring (or panniculectomy), but many plastic surgeons have been reluctant to perform this procedure because of a high risk of complications. But a new study shows that body contouring may be much safer than once thought, as long as patients wait nearly a year after weight loss (bariatric) surgery to allow their weight to stabilize and health to improve.

"When a patient loses large amounts of weight, the skin does not retain its shape, leaving the patient with a large hanging apron of excess skin and fat below the stomach area, otherwise known as the pannus," says researcher Ernest Manders, MD, in a news release.

"By focusing on patients who undergo a panniculectomy to remove the pannus, we found significantly fewer complications in patients who had the procedure one year after bariatric surgery rather than during the initial surgery," says Manders.

Manders presented the results of the study Wednesday at the Plastic Surgery 2003 conference in San Diego.

Waiting Reduces Risks

In the study, researchers compared the results of having body contouring performed at the same time as the weight loss surgery versus waiting in 120 men and women.

The study showed that there were significantly fewer complications reported among patients who waited nearly a year after undergoing weight loss surgery before having the body contouring procedure. Specifically, researchers found that people who waited to have the procedure had:

Fewer wound infections

Less wound reopening

Shorter hospital stays

In addition, none of the patients who waited experienced respiratory distress or died as a result of the procedure compared with 24% of the others who had breathing problems and 14% who died.

Researchers say patients who waited had lost an average of about 100 pounds and fared better because they were healthier and their bodies were in better shape than at the time they had the weight loss surgery.

Many of the patients had also gotten their diabetes under control, lowered their blood pressure, and lowered the stress on their hearts, which makes the additional surgery safer and lowers the risk of complications.

The researchers do note that the group that underwent body contouring at the same time as weight loss surgery were heavier prior to surgery. This could have interfered with the results since the heavier study participants may have been unhealthier from the start.

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