Impact of Abdominoplasty on Quality of Life in Post-Bariatric and Non-Bariatric Patients: A Prospective Clinical Study | ||||
| The Egyptian Journal of Plastic and Reconstructive Surgery | ||||
| Article 2, Volume 49, Issue 3, July 2025, Page 177-186 PDF (538.68 K) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/ejprs.2025.444128 | ||||
 View on SCiNiTO | ||||
| Authors | ||||
| Nada Mohamed El Negery* 1; Shorouk Mohsen2; Hesham Mostafa El Gendy3; Mohamed Hassan El Fahar1; Ahmed Hassan El Sabagh1 | ||||
| 1The Department of Plastic & Reconstructive Surgery, Faculty of Medicine, Mansoura University | ||||
| 2The Department of Public Health & Community Medicine, Faculty of Medicine, Mansoura University | ||||
| 3General Surgery Department, Faculty of Medicine, Mansoura University | ||||
| Abstract | ||||
| Background: Global obesity rates have reached alarming levels. While bariatric surgery effectively helps with weight loss, it often leads to excess skin. This prompts many patients to seek body contouring procedures like abdominoplasty, which improves the quality of life (QoL) by positively impacting body image, self-esteem, and overall well-being. Objective: Evaluation of the outcomes and QoL following abdominoplasty in two groups: Those who have undergone bariatric surgery (post-bariatric patients) and those who have achieved significant weight loss without bariatric surgery (non-bariatric patients). Patients and Methods: A non-randomized prospective cohort study was conducted from February 2023 over one year, involving 30 patients at Mansoura University Hospitals. They were divided into post-bariatric and non-bariatric groups (patients lost weight without surgery only with diet). Various abdominoplasty techniques, including traditional, mini-abdominoplasty, and belt lipectomy, were utilized. Preoperative assessments included medical history, physical examination, and laboratory investigations. Post-operative assessment Health-related quality of life (HRQOL) was evaluated utilizing the validated 15D instrument. Results: The study included 30 patients, mainly females. Both groups showed significant BMI reduction post-surgery. Group I (post-bariatric) had higher incidences of excess skin and fat accumulation compared to Group II (non-bariatric). Traditional abdominoplasty was the most common technique used. Seroma was the most frequent complication. Quality of life improvements were noted particularly in the post-bariatric group. Conclusion: Abdominoplasty significantly enhances QoL in both groups, though complications like seroma remain prevalent. The study highlights the need for personalized surgical approaches to optimize outcomes. Further research is necessary to refine techniques and improve patient care in diverse populations. | ||||
| Keywords | ||||
| Post-bariatric weight loss; Body contouring- Liposuction; Traditional abdominoplasty; Quality of life | ||||
| References | ||||
|
Van Der Beek E.S., Van Der Molen A.M. and Van Ramshorst B.: Complications after body contouring surgery in post-bariatric patients: The importance of a stable weight close to normal. Obes. Facts., 4 (1): 61-6, 2011. 2- Sarma S., Sockalingam S. and Dash S.: Obesity as a multisystem disease: Trends in obesity rates and obesity-related complications. Diabetes Obes. Metab., Suppl 1: 3-16, 2021. 3- Finkelstein E.A., Khavjou O.A., Thompson H., Trogdon J.G., Pan L., Sherry B. and Dietz W.: Obesity and severe obesity forecasts through 2030. Am. J. Prev. Med., 42 (6): 563-70, 2012. 4- Sundbom M., Hedberg J., Marsk R., Boman L., Bylund A., Hedenbro J., et al.: Scandinavian Obesity Surgery Registry Study Group. Substantial Decrease in Comorbidity 5 Years After Gastric Bypass: A Population-based Study From the Scandinavian Obesity Surgery Registry. Ann. Surg., 265 (6): 1166-1171, 2017. 5- O’brien P.E., Hindle A., Brennan L., Skinner S., Burton P., Smith A., Crosthwaite G. and Brown W.: Long-Term Outcomes After Bariatric Surgery: A Systematic Review and Meta-analysis of Weight Loss at 10 or More Years for All Bariatric Procedures and a Single-Centre Review of 20- Year Outcomes After Adjustable Gastric Banding. Obes. Surg., 29 (1): 3-14, 2019. 6- Nahas F.X.: A pragmatic way to treat abdominal deformities based on skin and subcutaneous excess. Aesthetic Plast. Surg., 25 (5): 365-71, 2001. 7- Toledo L.S.: The overlap of lipoplasty and abdominoplasty: Indication, classification, and treatment. Clin. Plast. Surg., 31 (4): 539-53, 2004. 8- Lievain L., Aktouf A., Auquit-auckbur I., Coquerel-beghin D., Scotte M. and Milliez P.Y.: Complications des abdominoplasties: Particularités des patients post-bariatriques au sein d’une série de 238 patients [Abdominoplasty complications: particularities of the post-bariatric patients within a 238 patients series]. Ann. Chir. Plast. Esthet., 60 (1): 26- 34. French, 2015. 9- Staalesen T., Olsén M.F. and Elander A.: Complications of abdominoplasty after weight loss as a result of bariatric surgery or dieting/postpregnancy. J. Plast. Surg. Hand Surg., 46 (6): 416-20, 2012. 10- Papadopulos N.A., Staffler V., Mirceva V., Henrich G., Papadopoulos O.N., Kovacs L., Herschbach P., Machens H.G. and Biemer E.: Does abdominoplasty have a positive influence on quality of life, self-esteem, and emotional stability? Plast. Reconstr. Surg., Jun. 129 (6): 957e-962e, 2012. 11- Adams J.: Motivational narratives and assessments of the body after cosmetic surgery. Qual Health Res., 20 (6): 755-67, 2010. 12- The World Health Organization Quality of Life assessment (WHOQOL): Position paper from the World Health Organization. Soc. Sci. Med., 41 (10): 1403-9, 1995. 13- Matarasso A.: Abdominolipoplasty. Clin. Plast. Surg., 16 (2): 289-303, 1989. 14- Aly A.S., Cram A.E. and Heddens C.: Truncal body contouring surgery in the massive weight loss patient. Clin. Plast. Surg., 31 (4): 611-vii, 2004. doi:10.1016/j. cps.2004.04.004. 15- Sintonen H.: The 15D instrument of health-related quality of life: Properties and applications. Ann. Med., 33 (5): 328-36, 2001. 16- Shehab M.E., Isa H.M., Saleh L.M. and Alafeya Z.A.: Satisfaction and Quality of Life in Patients Who Underwent Post Massive Weight Loss Body Contouring Procedures: A Tertiary Center Experience in Bahrain. World J. Plast. Surg., 13 (1): 71-82, 2024. 17- Bischoff S.C., Boirie Y., Cederholm T., Chourdakis M., Cuerda C., Delzenne N.M., et al.: Towards a multidisciplinary approach to understand and manage obesity and related diseases. Clin. Nutr., 36 (4): 917-938. Epub, 2016. 18- GBD 2015 Obesity Collaborators; Afshin A., Forouzanfar M.H., Reitsma M.B., Sur P., Estep K., Lee A., et al. Health Effects of Overweight and Obesity in 195 Countries over 25 Years. N. Engl. J. Med., 6; 377 (1): 13-27. Epub, 2017. 19- Sutanto A., Wungu C.D.K., Susilo H. and Sutanto H.: Reduction of Major Adverse Cardiovascular Events (MACE) after Bariatric Surgery in Patients with Obesity and Cardiovascular Diseases: A Systematic Review and Meta-Analysis. Nutrients., 12; 13 (10): 3568, 2021. 20- Doumouras A.G., Wong J.A., Paterson J.M., et al.: Bariatric Surgery and Cardiovascular Outcomes in Patients With Obesity and Cardiovascular Disease: A Population-Based Retrospective Cohort Study. Circulation, 143 (15): 1468- 1480, 2021. 21- Krishnan A., Hadi Y., Alqahtani S.A., Woreta T.A., Fang W., Abunnaja S., et al.: Cardiovascular Outcomes and Mortality After Bariatric Surgery in Patients With Nonalcoholic Fatty Liver Disease and Obesity. JAMA Netw Open., 6 (4): e237188, 2023. Vol. 49, No. 3 / Impact of Abdominoplasty on QoL in Post-Bariatric & N 186 on-Bariatric Patients 22- Sadeghi P., Duarte-Bateman D., Ma W., Khalaf R., Fodor R., Pieretti G., et al.: Post-Bariatric Plastic Surgery: Abdominoplasty, the State of the Art in Body Contouring. J. Clin. Med., 11 (15): 4315, 2022. 23- ElAbd R., Samargandi O.A., AlGhanim K., Alhamad S., Almazeedi S., Williams J., et al.: Body Contouring Surgery Improves Weight Loss after Bariatric Surgery: A Systematic Review and Meta-Analysis. Aesthetic Plast. Surg., 45 (3): 1064-1075, Epub, 2021. 24- Angrisani L., Santonicola A., Iovino P., Ramos A., Shikora S. and Kow L.: Bariatric Surgery Survey 2018: Similarities and Disparities Among the 5 IFSO Chapters. Obes. Surg., 31 (5): 1937-1948. Epub, 2021. 25- Al-Sumaih I., Donnelly M. and O’neill C.: Sociodemographic characteristics of patients and their use of post-bariatric contouring surgery in the US. BMC Health Serv. Res., 7; 22 (1): 308, 2022. 26- Manzoni A.P. and Weber M.B.: Skin changes after bariatric surgery. An Bras Dermatol., Mar-Apr. 90 (2): 157-66, 2015. 27- Cuomo R., Cuccaro C., Seth I., Rozen W.M., Vastarella M.G., Lombardo G.A.G., et al.: Experience in Post-Bariatric Abdominoplasty for Patients with Significant Weight Loss: A Prospective Study. J. Pers. Med., 25; 14 (7): 681, 2024. 28- Forester E. and Sadiq A.: Comparative analysis of the efficacy and functionality of abdominoplasty versus minimally invasive techniques in the surgical treatment of diastasis rectus abdominis in postpartum women. Surg. Endosc., 37 (12): 9052-9061, 2023. 29- Sozer S.O. and Agullo F.J.: Triple plication in miniabdominoplasty. Aesthetic Plast. Surg., 30 (3): 263-8, 2006. 30- Matarasso A.: Abdominolipoplasty: a system of classification and treatment for combined abdominoplasty and suction-assisted lipectomy. Aesthetic Plast. Surg., Spring, 15 (2): 111-21, 1991. 31- Marouf A. and Mortada H.: Complications of Body Contouring Surgery in Postbariatric Patients: A Systematic Review and Meta-Analysis. Aesth. Plast. Surg., 45: 2810– 2820, 2021. 32- Khan U.D.: Risk of seroma with simultaneous liposuction and abdominoplasty and the role of progressive tension sutures. Aesthetic Plast. Surg., Jan. 32 (1): 93-9, 2008; discussion 100, Epub 2007. 33- Gonzalez-Ulloa M.: Belt lipectomy. Br. J. Plast. Surg., 13: 179-86, 1960. 34- Greco J.A., 3rd, Castaldo E.T., Nanney L.B., Wendel J.J., Summitt J.B., Kelly K.J., et al.: The effect of weight loss surgery and body mass index on wound complications after abdominal contouring operations. Annals of plastic surgery, 61 (3): 235-42, 2008. 35- Cintra W. Jr., Modolin M.L., Gemperli R., Gobbi C.I., Faintuch J. and Ferreira M.C.: Quality of life after abdominoplasty in women after bariatric surgery. Obes. Surg., 18 (6): 728-732, 2008. 36- Lazar C.C., Clerc I., Deneuve S., Auquit-Auckbur I. and Milliez P.Y.: Abdominoplasty after major weight loss: Improvement of quality of life and psychological status. Obes. Surg., 19 (8): 1170-1175, 2009. 37- Stuerz K., Piza H., Niermann K. and Kinzl J.F.: Psychosocial impact of abdominoplasty. Obes. Surg., 18 (1): 34-38, 2008. 38- Cook S.A., Rosser R. and Salmon P.: Is cosmetic surgery an effective psychotherapeutic intervention? A systematic review of the evidence. J. Plast. Reconstr Aesthet Surg., 59 (11): 1133-51. Epub, 2006. 39- Saariniemi K.M., Salmi A.M., Peltoniemi H.H., Helle M.H., Charpentier P. and Kuokkanen H.O.: Abdominoplasty improves quality of life, psychological distress, and eating disorder symptoms: A prospective study. Plast. Surg. Int., 2014. 40- Uimonen M., Repo J.P., Homsy P., et al.: Health-related quality of life in patients having undergone abdominoplasty after massive weight loss. J Plast Reconstr Aesthet Surg., 74 (9): 2296-2302, 2021. doi:10.1016/j.bjps.2020.12.056 41- El-Gharbawi A.H., El-Sabbagh A.H., Shouman O.O., El-Hadidy M.R. and El-Fahar M.H.: Postbariatric Abdominal Contouring: Technical Approach and Quality of Life. Plast Reconstr. Surg., 150 (4): 796-806, 2022. 42- Rios-Diaz A.J., Morris M.P., Elfanagely O., et al.: Impact of Panniculectomy and/or Abdominoplasty on Quality of Life: A Retrospective Cohort Analysis of Patient-Reported Outcomes. Plast. Reconstr. Surg., 150 (4): 767e-775e, 2022. | ||||
|
Statistics Article View: 22 PDF Download: 22 |
||||
