Analysis of Body Contouring on Sustained Weight Loss in Minority Patients: A Seven Year Retrospective Review
Nicolas Greige, B.S., George N. Kamel, M.D., Kayla E. Leibl, M.D., Joshua Jacobson, M.D., Evan S. Garfein, M.D., Katie E. Weichman, M.D., Teresa Benacquista, M.D..
Albert Einstein College of Medicine, Montefiore Medical Center, Division of Plastic Surgery, Bronx, NY, USA.
Background
The utility of bariatric surgery as a weight reduction modality in morbidly obese patients has been previously described. However, for bariatric surgery-related health benefits to be realized, weight reduction must be sustained long term. Previous studies have demonstrated the positive impact of body contouring procedures as adjuncts to bariatric surgery in maintaining sustained weight loss, but these studies described a narrow patient cohort. It was our objective, therefore, to evaluate the impact of post bariatric body contouring procedures on sustained weight loss in minority patients.
Methods
A retrospective review of all patients that underwent sleeve gastrectomy or gastric bypass procedures at a single institution from 2009 to 2012 was performed, and patients were included if they had 7 years of post-operative follow-up. The population was divided into three groups: those that underwent body contouring procedures (Group 1), those that had plastic surgery consultation for body contouring but did not undergo a procedure (Group 2), and those without plastic surgery consultation (Group 3). Patient demographics, surgical technique, body mass indices (BMIs), excess body weight loss (EBWL), and sustained weight loss were compared between groups. Analysis of variance and multiple regression analyses were performed.
Results
A total of 774 patients were analyzed. The average age of the study population was 41.6±10.8 years and the average pre-bariatric BMI was 47.1±7.7 kg/m2. 30% of patients identified as Black and 63% of patients identified as Hispanic or Latino. EBWL was significantly greater in Group 1 than Group 3 for post-operative years 1 through 7 with a mean difference of 16.4% (p<0.001), and significantly greater in Group 1 than Group 2 for post-operative years 2 through 5 with a mean difference of 6.9% (p<0.05). EBWL was significantly greater in Group 2 than Group 3 for post-operative years 1 through 7 with a mean difference of 10.5% (p<0.001). Multiple regression analyses were performed to ascertain the effects of body contouring on sustained weight loss. In patients that underwent sleeve gastrectomy, neither body contouring (B=2.5, p=0.242) nor plastic surgery consultation (B=-1.0, p=0.569) contributed significantly toward sustained weight loss as compared to patients without plastic surgery consultation; in the gastric bypass group, body contouring significantly contributed toward sustained weight loss (B=-3.5, p=0.010) whereas plastic surgery consultation did not (B=-2.5, p=0.054).
Conclusion
Body contouring improved sustained weight loss in minority patients that underwent bariatric surgery. This effect was significant in patients that underwent gastric bypass, but not sleeve gastrectomy.
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