Sunday, October 25, 2009 - 10:05 AM
16731

Effect of Body Contouring On Recidivism Following Bariatric Surgery: A Clinical Outcomes Study

Michael B. Wolfeld, MD, Peter Taub, MD, Justin Lipper, BS, Mark Kahn, BS, Daniel Herron, MD, Subhash Kini, MD, and Lester Silver, MD.

Purpose: A significant number of patients who undergo bariatric surgery have elected to have postoperative body contouring procedures to remove excess tissue and achieve aesthetic improvement. The rates of recidivism – or relapse of weight gain – among patients as a function of postoperative contouring, has yet to be evaluated. The goal of this study was to determine whether there was a difference in the amount of weight regain among patients who have and have not undergone body contouring. Materials & Methods: Following approval by the institutional review board at Mount Sinai Medical Center, a retrospective review of patients who underwent bariatric procedures was performed. Charts were reviewed and telephone calls were placed to determine patient weights at key time points. This was used to determine body mass index of each patient before the bariatric procedure, their lowest BMI following the procedure, and their current BMI. The percent regain of BMI, as well as the initial percent loss of BMI, for the body contouring and non-body contouring groups, as well as for various educational and socioeconomic classes, were examined. A statistical analysis was performed using independent T tests and chi-squared tests. Results: Fifty-five of the 295 bariatric patients were available for study. Of these, 16 elected to undergo a body contouring procedure (BC), while 39 patients did not (NBC). Among the 39 NBC patients, the average starting BMI was 48, the average lowest BMI achieved was 29, and the average current BMI was 32. The average percent regain of BMI from lowest achieve to current was 10%. The average percent total loss of BMI from starting to lowest achieved was 39%. Among the BC patients, the average starting BMI was 51, the average lowest BMI achieved after the bariatric procedure was 28, and the average current BMI was 31. The average percent regain of BMI from lowest achieved to current was 11%. The average percent total loss of BMI from starting to lowest achieved was 45%. The differences among these results were non-significant at a p<. 05. A statistical analysis comparing whether gender, income, education, and race had an impact on the decision to undergo a body contouring procedure did not reveal a significant difference. This analysis did reveal, however, that a higher income class among both body and non-body contouring groups was significantly associated with less regain of BMI from lowest achieved to current BMI. In regards to education, there was a positive correlation between higher education level and less percent regain of BMI, however, it was not statistically significant. Conclusion: The regain of weight among the contour group and non-contour groups was noted to be nearly identical and not significant. Additionally, when examining the total loss of weight after the bariatric procedure between the two groups, there was no significant difference. Socioeconomic class or education had no impact on the decision to undergo a contouring procedure; and income was the only variable that was significantly associated with less regain of BMI.