The Safety of Abdominal Contouring and the Lap-BandŽ : A Study of Aesthetic Surgeon Experience

The Lap-Band is the most common bariatric surgical device implanted to assist with weight loss.  Many patients having undergone this procedure present to plastic surgeons for management of body contour after weight loss.   Procedures such as abdominal liposuction, abdominoplasty, and lower body lift may be offered to patients to improve body contour following treatment with the Lap-Band.   Although many plastic surgeons offer these procedures to patients with the Lap-Band, the standard of care as it relates to plastic surgery procedures in the presence of this device is unknown.   

The purpose of this study was to determine the current standard of practice for abdominal body contouring procedures in presence of the Lap-Band device and the incidence of complications related to the presence of the Lap-Band.   Three hundred members of the American Society of Aesthetic Plastic Surgery were randomly surveyed.  A one-page questionnaire was sent by FAX to each member, with up to three repeat FAX surveys sent.   A follow-up call to the office manager of each practice was also completed to maximize participation in the study.

A total of 113 questionaires were returned with a response rate of 37.6%    92.1% of surgeons indicated that they perform abdominal liposuction, while 84.7% perform abdominoplasty/lower body lift procedures for Lap-Band patients.   74.3% of surgeons offering abdominoplasty to Lap-Band patients also perform fascial plication, with the plication location and extent determined by port location.  59.3% of surgeons provide informed consent for Lap Band patients with a standard procedure consent form supplemented by a documented oral consent outlining the additional risks of the procedure as it relates to the Lap-Band device.   In the last three years,  surgeons reported treating a mean of 11.4 Lap-Band patients having undergone abdominal liposuction, abdominoplasty, or lower body lift.   The incidence of port infection, port malposition, or reported system leak following aesthetic abdominal procedures was low, with a combined rate of 1.24% (16 system complications/1288 procedures).  

The results of this study demonstrates that aesthetic abdominal procedures following Lap-Band are commonly performed by plastic surgeons, including abdominoplasty/body lift with plication and abdominal liposuction.  The majority of surgeons provide an oral supplemental consent for Lap-Band patients, documented in the patient’s medical record.  The low complication rates noted in this study suggests that abdominal contouring procedures in the presence of a Lap-Band are safe with low Lap-Band-associated complication rates.