CLINICAL RESEARCH Hematological Variables and Iron Status in Abdominoplasty After Bariatric Surgery Juan Carlos Montano-Pedroso & Elvio Bueno Garcia & Ivan Rene Viana Omonte & Mario Guilherme Cesca Rocha & Lydia Masako Ferreira # Springer Science+Business Media, LLC 2012 Abstract Background Abdominoplasty, the treatment for abdominal wall deformity stemming from weight loss after bariatric surgery, can cause postoperative anemia. Moreover, bariat- ric surgery has been associated with iron deficiency, which by itself can compromise erythropoiesis. The objective of this research is to describe the development of anemia after postbariatric abdominoplasty. Methods The study group consisted of 32 adult women who had received bariatric surgery. Treatment group included 20 patients who were undergoing postbariatric abdominoplasty. Control group included 12 patients waiting for abdomino- plasty. Values of hemoglobin, reticulocytes, iron, ferritin, and the transferrin saturation were obtained on the evening before abdominoplasty and during the first, fourth, and eighth postoperative weeks. Hemoglobin was measured at 48 h. Results Mean hemoglobin levels for treatment group de- creased from 12.98 to 10.8 g/dL after 48 h, increased on day 7 to 11.53 g/dL, but did not increase further after day 7. The reticulocyte number increased in the first week. Serum iron and transferrin saturation index fell during the first week and remained low. Ferritin levels increased non- significantly from 29.77 to 37.24 ng/mL at week 1, then fell until they were decreased (16.44 ng/mL) by day 56. Conclusions As expected, hemoglobin fell after abdomino- plasty. However, after a one-third recovery of hemoglobin concentrations by week 1 postoperative, they failed to return to preoperative levels by the eighth week. Additionally, by the eighth postoperative week, 45 % of abdominoplasty patients had developed an iron deficiency and hemoglobin deficit that was higher than that of patients who maintained normal iron stocks. Keywords Anemia . Abdominal wall . Bariatric surgery . Plastic surgery . Postoperative complications . Hemoglobin . Iron . Adult . Female Introduction Bariatric surgery using various techniques is considered the most effective therapy for morbid obesity [1]. Roux- en-Y gastric bypass involves partitioning a small pouch from the proximal stomach and diverting the ingested nutrients to the jejunum with a roux-en-Y gastro- jejunostomy. This procedure is the standard technique used in the United States and many countries [2]. The effectiveness of bariatric surgery and increased levels of morbid obesity in the USA have led to a significant increase in the number of these surgeries being per- formed [3, 4]. Postbariatric patients have a different profile than those who were never obese, exhibiting serious body shape deformities and nutritional deficien- cies [5], especially iron deficiency [6] and anemia. Iron deficiency is primarily caused by reductions in iron ingestion, gastric acid secretion, and reduced contact of food with the iron-absorptive area of the diverted du- odenal and jejunal segments of the gastrointestinal tract because of deviations caused by bariatric surgery [7]. Between 20 % and 49 % of the patients have an iron deficiency at some point after bariatric surgery [8]. These rates are higher in women of reproductive age [6], who comprise the majority of patients undergoing bariatric surgery [9]. Oral iron supplements are used to prevent iron deficiency after bariatric surgery. Although J. C. Montano-Pedroso (*) : E. B. Garcia : I. R. V. Omonte : M. G. C. Rocha : L. M. Ferreira Division of Plastic Surgery, Plastic Surgery Post-Graduation Program, Federal University of São Paulo, Rua Napoleão de Barros, 715, 4th Floor, Vila Clementino, CEP: 04024-002, São Paulo, Brazil e-mail: juancmontano@gmail.com OBES SURG DOI 10.1007/s11695-012-0720-2