BACKGROUND Obesity is an epidemic in the United States. Bariatric surgery and subsequent body contouring after massive weight loss are relatively novel approaches to obesity management. It is estimated by ASPS that in 2004 there were 140,000 bariatric surgeries and 56,000 subsequent body-contouring procedures. For 2005, estimates of 250,000 bariatric surgeries are reported with comparable increases in body contouring as well. The goal of our study is to prognosticate which bariatric surgery patients actually go on to body contouring procedures. To date, there are no such data reported in the obesity or plastic surgery literature.

METHODS A prospectively entered database of 381 consecutive patients who underwent laparoscopic Roux-en-Y gastric bypass surgery between August 2002 and December 2005 was retrospectively reviewed. All patients with subsequent body contouring surgery were identified. Body contouring procedures included were panniculectomy or abdominoplasty, reduction mammoplasty, brachioplasty, and/or thigh lift. This group was compared to the group of bariatric patients which did not undergo body contouring. Only patients with at least one year follow-up weight loss data were included. Variables studied were age, gender, pre-operative BMI, pre-operative excess body weight (EBW), and percent excess weight loss (%EWL) at 12 months. Statistical analysis was performed using the Student's t-Test. A result was considered statistically significant when p<0.05.

RESULTS We identified 193 bariatric patients who met inclusion criteria. Of this pool, a total of 24 underwent body-contouring surgery (group 1), whereas 169 did not (group II). Group I mean age was 36±9 years, and group II mean age was 41±10 years (p=0.023). Group I had 4 males and 20 females, and group II 29 males, and 140 females (p= 0.477). Group I mean pre-op BMI was 53±8.3, and group II mean pre-op BMI was 51.5±8.6 (p=0.204). Group I mean EBW was 191.8±59.2 lbs, and group II mean EBW was 181.5±57.31 lbs (p=0.261). Group I mean %EWL at 12 months was 70.1±13.3, and Group II mean %EWL at 12 months was 62±16.6 (p=0.0052).

CONCLUSIONS Our study is the first report to prognosticate body contouring surgery from a bariatric surgery population. The results indicate that age and %EWL at 12 month follow-up were significantly useful in predicting which bariatric patients ultimately underwent body-contouring procedures by plastic surgeons. Pre-operative BMI was not predictive. These results are significant because they allow the surgeon to enhance the quality of bariatric surgery informed consent, specifically as it relates to the potential need for future body contouring surgery.