Abstract

Enas Al-Alawi M.D

According to the statistics from the International Federation of Surgery of Obesity IFSO, the numbers of bariatric surgery performed in the Middle East and especially in the United Arab Emirates is on the rise, and the American Society of Bariatric and Metabolic Surgery reports more than 200.000 bariatric procedures in the United States in 2018. Patients undergoing weight loss surgery benefit from metabolic and psychological well-being, but the excess skin loosening throughout the body and the resulting folds can cause poor hygiene and functional impairment. Body contouring and plastic surgery in general can relieve these symptoms and such procedures improve self-esteem, body image and quality of life. However, there are no evidence based guidelines regarding indications for surgery and the choice of surgical procedures for post-bariatric patients. In this observational study, we looked at the impact of post-bariatric surgery reconstructive and aesthetic procedures on the longterm results of Bariatric surgery in terms of weight regain and patient satisfaction with body image and self-esteem. When comparing the long-term weight outcomes for two groups of patients who underwent Omega Loop Bypass surgery between 2007 and 2017, 200 patients had body contouring procedures to remove excess fat and skin and a matched group of 650 patients with similar characteristics without body contouring. Body contouring surgery included abdominoplasty, mammoplasty, brachioplasty and thigh lift. Within two years after Omega loop bypass most patients had lost an average of 80% of the initial excess weight. We found that in 3-5 years follow up, patients who underwent body contouring regained less weight: an average of 7%, compared to 29% for patients who had omega loop bypass alone. We also found that up to 60% of bariatric surgery patients suffered from some sort of psychiatric disorder during their lifetime and many had issues with body image and self-esteem. In post-bariatric surgery patients, up to 80% requested body contouring but only 20% actually had it and reported significant improvements in quality of life. In conclusion, our study showed that patients who had body contouring after bariatric surgery had less weight regain and better quality of life.