Quality of Life after Postbariatric Abdominoplasty in Females: Interest of Age,
Current Weight and Weight Loss
Modolin M
*
, Cintra W Jr, Rocha RI, Faintuch J, Camargo CP and Gemperli R
Plastic Surgery Division, University of São Paulo School of Medicine, São Paulo, SP, Brazil
*
Corresponding author: Miguel Modolin, Plastic Surgeon, Rua Canada, 89, 01436-000, São Paulo, Brazil, Tel: 55-11-996565163; Fax: 55-11-30645658; E-mail:
miguelmodolin@uol.com.br
Received date: June 10, 2015; Accepted date: August 29, 2015; Published date: August 31, 2015
Copyright: © 2015 Modolin M, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted
use, distribution, and reproduction in any medium, provided the original author and source are credited.
Abstract
Background: Aiming to analyze whether abdominoplasty might benefit quality of life of postbariatric females with
redundant abdominal skin folds beyond the first year, a clinical investigation after 2-4 years was designed. Despite
being a reputed and popular procedure after massive weight loss, results are still debated. It was hypothesized that
sustained improvements in quality of life, independent of previous anti-obesity gastroplasty, would be demonstrated.
Methods: This was a prospective study in a female cohort. Patients (N=22) were submitted to abdominoplasty
with the age of 42.7 ± 9.1 years and body mass index/BMI of 27.2 ± 2.7 kg/m
2
, about five years after bariatric Roux-
en-Y gastric bypass. The interview occurred after an additional 32.0 ± 8.2 months.
Results: All post abdominoplasty indices of quality of life were benefitted, with emphasis on body contour, sexual
activity and dressing. Despite frequent surgical wound complications (40.9%), most were minor and patients had few
complaints about their scars. More than 90% would undergo the operation again, or recommend it to a friend. Major
weight loss, or low BMI at the time of abdominoplasty, signaled better sexual and dressing scores. Sexual score was
more increased in younger participants.
Conclusion: This paper suggest that abdominoplasty in ex-obese patients increased quality of life, related to the
following domains body contour, mobility, hygiene, dressing, and sexuality.
Keywords: Abdominoplasty; Roux-en-Y gastric bypass; Bariatric
surgery; Weight loss; Quality of life
Introduction
Abdominoplasty is the most performed plastic operation after
successful bariatric surgery, and improvement in quality of life has
been demonstrated [1]. Nevertheless, results are still questioned, given
the absence of prospective, randomized trials [2].
The lack of validated questionnaires targeted for this population is a
common criticism [3]. As a consequence, discrepancies between
different protocols are not infrequent, some centers reporting lack of
response in general psychosocial functioning, such as self-esteem,
satisfaction with life, and social anxiety [4]. Timing of the investigation
might also influence results. As with other aesthetic procedures [5,6],
enthusiasm in the first 6 months 5 might be sustainable or not several
years afterwards.
Massive weight loss typical of bariatric populations is a rather
unique phenomenon; therefore suitable controls are indeed a
challenge. Standardized psycho-social questionnaires are also complex
and time-consuming to develop and validate. Nevertheless, in daily
practice, most complaints are quite objective and concern body
contour, mobility, personal hygiene, sexual activity and satisfaction
with dressing (choice of clothes) [1-6].
In such circumstances, a prospective study including retrospective
information was conducted in a female cohort, aiming not only to
compare preoperative vs. postoperative findings, but also to search for
variables related to the outcome. A relatively long time lapse was
allowed (2-4 years), in order to reflect stable, mature results. The
hypothesis was that lasting aesthetic advantages of the operation
would be confirmed, reinforcing the intrinsic effects of
abdominoplasty on quality of life, independently of the previous
gastric bypass.
Methods
Study design
This was a prospective cohort clinical study. This study followed the
principles of Declaration of Helsinki. The inclusion criteria were:
female patients, age older than 18 years, 2-4 years follow-up after post-
bariatric abdominoplasty with abdominal skin excess. Exclusion
criteria were discompensated systemic disease, pregnancy, lactation or
menopause, use of corticosteroids, cancer chemotherapy or
radiotherapy, and refusal to participate in the study. Retrospective
information was included, concerning previous bariatric treatment as
well as criteria of exclusion. These were questioned during the
interview and confirmed by access to hospital files.
All patients gave written informed consent, and the protocol was
approved by the Institutional Ethical Committee.
Obesity & Weight Loss Therapy
Modolin, et al., J Obes Weight Loss Ther 2015, 5:4
http://dx.doi.org/10.4172/2165-7904.1000272
Research Article Open Access
J Obes Weight Loss Ther
ISSN:2165-7904 JOWT, an open access journal
Volume 5 • Issue 4 • 1000272